First swine flu vaccine doses expected soon

The first doses of swine flu vaccine will arrive in the Bay Area next week, but there won't be much of it and it will be in the form of a nasal spray, which isn't recommended for two of the groups most vulnerable to illness - pregnant women and people with chronic health problems.

As of late this week, the federal government was planning to send at least 600,000 doses to 21 states, plus four major cities, in its first vaccine shipment. It should arrive at public health departments and in private hospitals and doctors' offices Tuesday.

San Francisco is expecting about 7,000 of the 350,000 doses being sent to California, according to state and local public health officials.

Most communities will be offering the vaccine to school-age children first, because they are particularly vulnerable to infection and also tend to spread the virus to others. In San Francisco, the nasal spray vaccine, known as FluMist, is being delivered to about 30 pediatricians throughout the city, said Public Health Department spokeswoman Eileen Shields.

"If people are interested in getting their children vaccinated, they need to call their pediatrician," Shields said. "Find out if their practice has it, and if they ordered it, and when they can get it."

No-pain vaccine

Unlike the flu shot, the nasal spray uses a live virus to promote immunization. The virus is weakened and cannot make someone sick, but it isn't recommended for people with compromised immune systems. It may be preferable for children who aren't fond of getting shots.

Even as the first small batches of spray vaccine arrive, public health agencies are planning later this month and early next month for the largest mass-immunization effort since the polio vaccine became available in the 1950s. Swine flu, a form of influenza Type A, subtype H1N1, has infected millions of people worldwide since it was first reported in April.

The first doses of the injectable vaccine are expected to be sent out the week of Oct. 12. California health officials are expecting about 200,000 doses in the first week and ultimately may receive up to 18 million doses of both injectable and spray vaccine to cover the entire flu season. That doesn't include doses of seasonal flu vaccine.

In the Bay Area, distribution plans for the injectable and spray vaccines vary widely from one community to another, but all of them are focused on reaching high-risk groups first. Those groups include health care and emergency workers, pregnant women, caregivers of infants younger than 6 months, young people ages 6 months to 24 years, and adults younger than 65 with chronic health problems.

Some regions are planning school vaccination clinics to immunize large groups of children all at once. Other regions are relying on private doctors and businesses to provide the bulk of the vaccinations, just as they would with the seasonal flu.

Free clinics in Bay Area

Alameda County is holding a series of free clinics in early November to immunize people who don't have a regular doctor or who lack health insurance. Everyone else is being asked to get the vaccine from their primary care physician, said public health spokeswoman Vanessa Cordova.

In Contra Costa County, the vaccine will be available starting next week at a series of free clinics at 49 elementary schools, said Wendell Brunner, director of public health. "It's important that we get it into as many school children as possible right away," Brunner said.

San Francisco will be using free vaccination clinics to reach as many people in the city as possible who meet the high-risk criteria. The clinics will start Oct. 26 and move to various spots around the city, including Bill Graham Civic Auditorium.

Kaiser Permanente, the largest health care provider in the Bay Area, will be getting a small amount of spray vaccine next week, and is expecting large shipments of injectable vaccine in mid-October. Kaiser holds seasonal flu clinics every year at its hospitals and medical offices, and it will do the same for the swine flu vaccine, said Dr. Stephen Parodi, chief of infectious disease for Kaiser Permanente Northern California.

Not everyone convinced

"There's been a lot of interest, both in respect to seasonal and H1N1. That's a very good thing," Parodi said. "In the past, the general public has sometimes not had sufficient knowledge about how important it is to get vaccination from influenza."

People may be interested in the vaccine, but recent surveys suggest that many Americans aren't yet convinced that immunization is necessary.

A Consumer Reports poll released earlier this week showed that about a third of U.S. adults planned to get the swine flu vaccine - 21 percent said they would not get it, and 43 percent said it would depend on what happens this flu season. Of parents participating in the poll, 35 percent said they would vaccinate their children, 14 percent said they wouldn't, and half said they were still undecided.

What you need to know about swine flu vaccine

Q: Who can get the nasal spray?

A: Healthy children and adults under age 50. It is not recommended for pregnant women or people with chronic health problems.

Q: When it's available, who should get the injectable vaccine first?

A: Health care and emergency workers; pregnant women; caregivers of infants under 6 months; young people ages 6 months to 24 years; and adults under age 65 with chronic health problems.

Q: How many doses of the vaccine should I receive?

A: If you're 10 years old and older, you need only one dose of vaccine; children under age 10 need two.

Q: What if I've already had swine flu?

Experts say anyone who has already had a confirmed or suspected case of swine flu should get vaccinated anyway. People with confirmed cases probably are already immune, but the virus could change and leave them vulnerable once more.

Q: How do I know if I have swine flu?

A: Unless you've been tested by a doctor, you don't. Symptoms of swine flu - fever, body aches, fatigue - are the same as for seasonal influenza. But swine flu is the main strain of influenza circulating right now, so if you have the flu, chances are good it's swine flu.