The US Department of Homeland Security and the Department of Health and Human Services have released the Guidance on Allocating and Targeting Pandemic Influenza Vaccine document.
"Introduction
Effective allocation of pandemic influenza vaccine will play a critical role in preventing influenza and reducing its effects on health and society when a pandemic arrives. The specific type of influenza that causes a pandemic will not be known until it occurs. Developing a new vaccine in response will take several months and pandemic vaccine may not be available when cases first occur in the United States. Moreover, once vaccine production begins, it will not be possible to make enough new vaccine to protect everyone in the early stages of a pandemic.
The U.S. Government is taking steps to minimize the need to make vaccine allocation decisions by supporting efforts to increase domestic influenza vaccine production capacity. Significant funding is being provided to develop new vaccine technologies that allow production of enough pandemic influenza vaccine for any person in the United States who wants to be vaccinated within six months of a pandemic declaration. Until this goal is met, Federal, State, local and tribal governments, communities, and the private sector will need guidance on who should be vaccinated earlier during the pandemic to best protect our people, communities, and country.
Issues to consider in drafting guidance on pandemic influenza vaccination are different and more complex than in developing recommendations for annual vaccination against seasonal influenza. In contrast with seasonal influenza, during a pandemic nobody in the population is likely to have immunity to the virus, many more people will become ill, and rates of severe illness, complications and death are likely to be much higher and more widely distributed throughout the population. The greater frequency and severity of disease will increase the burden on health care providers and institutions and may disrupt critical products and services in health care and other sectors. National and homeland security could be threatened if illness among military and other critical personnel reduces their capabilities. Because the needs that must be addressed by pandemic vaccination differ from seasonal influenza vaccination, the
guidance on vaccination differs as well.
This guidance is intended to provide strong advice to support planning an effective and consistent pandemic response by States and communities. Nevertheless, it is important that plans are flexible as the guidance may be modified based on the status of vaccine technology, the characteristics of pandemic illness, and risk groups for severe disease – factors that will remain unknown until a pandemic actually occurs.
Vaccination will be only one of several tools that can be used to fight the spread of influenza when a pandemic emerges. Additional approaches include non-pharmaceutical public health measures in communities, businesses, and households to reduce and slow the spread of infection; using antiviral medications for treatment and prevention; using facemasks and respirators in appropriate settings; and washing hands and covering coughs and sneezes. These strategies will be the initial mainstay of a pandemic response before vaccine is available and continue to have important effects throughout a pandemic. Guidance around vaccine use is meant to be applied in conjunction with and in the context of these other pandemic response efforts. More information about pandemic planning and response measures is provided at www.pandemicflu.gov...."<o:p></o:p>
Pandemic vaccine to be distributed using the following tier system:
Tier 1 includes 24 million persons:
Critical occupations
- Deployed forces
- Critical healthcare
- EMS
- Fire
- Police
High risk population
- Pregnant women
- Infants
- Toddlers
Tier 2 includes 15 million persons:
Critical occupations
- Military support
- Border protection
- National Guard
- Intelligence services
- Other natl. security
- Pharmacists
- Mortuary services
- Community services
- Utilities
- Communications
- Critical govt.
High risk population
- Infant contacts
- High risk children
Tier 3 includes 64 million persons:
Critical occupations
- Other active duty
- Other healthcare
- Other CI sectors
- Other govt.
High risk population
- Healthy children
Tier 4 includes 74 million persons:
High risk population
- High risk adults
- Elderly
Tier 5 is the rest of the population with 123 million persons.
"Introduction
Effective allocation of pandemic influenza vaccine will play a critical role in preventing influenza and reducing its effects on health and society when a pandemic arrives. The specific type of influenza that causes a pandemic will not be known until it occurs. Developing a new vaccine in response will take several months and pandemic vaccine may not be available when cases first occur in the United States. Moreover, once vaccine production begins, it will not be possible to make enough new vaccine to protect everyone in the early stages of a pandemic.
The U.S. Government is taking steps to minimize the need to make vaccine allocation decisions by supporting efforts to increase domestic influenza vaccine production capacity. Significant funding is being provided to develop new vaccine technologies that allow production of enough pandemic influenza vaccine for any person in the United States who wants to be vaccinated within six months of a pandemic declaration. Until this goal is met, Federal, State, local and tribal governments, communities, and the private sector will need guidance on who should be vaccinated earlier during the pandemic to best protect our people, communities, and country.
Issues to consider in drafting guidance on pandemic influenza vaccination are different and more complex than in developing recommendations for annual vaccination against seasonal influenza. In contrast with seasonal influenza, during a pandemic nobody in the population is likely to have immunity to the virus, many more people will become ill, and rates of severe illness, complications and death are likely to be much higher and more widely distributed throughout the population. The greater frequency and severity of disease will increase the burden on health care providers and institutions and may disrupt critical products and services in health care and other sectors. National and homeland security could be threatened if illness among military and other critical personnel reduces their capabilities. Because the needs that must be addressed by pandemic vaccination differ from seasonal influenza vaccination, the
guidance on vaccination differs as well.
This guidance is intended to provide strong advice to support planning an effective and consistent pandemic response by States and communities. Nevertheless, it is important that plans are flexible as the guidance may be modified based on the status of vaccine technology, the characteristics of pandemic illness, and risk groups for severe disease – factors that will remain unknown until a pandemic actually occurs.
Vaccination will be only one of several tools that can be used to fight the spread of influenza when a pandemic emerges. Additional approaches include non-pharmaceutical public health measures in communities, businesses, and households to reduce and slow the spread of infection; using antiviral medications for treatment and prevention; using facemasks and respirators in appropriate settings; and washing hands and covering coughs and sneezes. These strategies will be the initial mainstay of a pandemic response before vaccine is available and continue to have important effects throughout a pandemic. Guidance around vaccine use is meant to be applied in conjunction with and in the context of these other pandemic response efforts. More information about pandemic planning and response measures is provided at www.pandemicflu.gov...."<o:p></o:p>
Pandemic vaccine to be distributed using the following tier system:
Tier 1 includes 24 million persons:
Critical occupations
- Deployed forces
- Critical healthcare
- EMS
- Fire
- Police
High risk population
- Pregnant women
- Infants
- Toddlers
Tier 2 includes 15 million persons:
Critical occupations
- Military support
- Border protection
- National Guard
- Intelligence services
- Other natl. security
- Pharmacists
- Mortuary services
- Community services
- Utilities
- Communications
- Critical govt.
High risk population
- Infant contacts
- High risk children
Tier 3 includes 64 million persons:
Critical occupations
- Other active duty
- Other healthcare
- Other CI sectors
- Other govt.
High risk population
- Healthy children
Tier 4 includes 74 million persons:
High risk population
- High risk adults
- Elderly
Tier 5 is the rest of the population with 123 million persons.
Comment