Distribution of Swine Flu Vaccine Starts in October

By David Brown
Washington Post Staff Writer
Saturday, September 19, 2009

Vaccine for the H1N1 influenza pandemic will be distributed on a three-day turnaround time from four regional warehouses around the country next month. The vaccine deliveries, expected to equal 20 million doses a week by the end of October, will be distributed among 90,000 immunization "providers," including health departments, hospitals, clinics, doctors' offices and pharmacies.

Those were among the details unveiled Friday by the Centers for Disease Control and Prevention as part of the federal government's increasingly complex response to the pandemic of H1N1 influenza, also known as swine flu.

"This is a huge logistical process. There's not [going to be] a sudden appearance of vaccine in 90,000 refrigerators around the country," said Jay Butler, an epidemiologist who leads the CDC's task force on the vaccine.

About 3.4 million doses of nasal-spray flu vaccine -- which can be used only by people age 2 to 49 -- are expected to be available the first week of October. The form of the vaccine that can be injected, which will form the vast bulk of the 195 million doses the government has ordered, won't be available until later in October when many experts think the flu outbreak will be in full swing.

All of the H1N1 vaccine will be bought by the federal government. It will be divided among states and territories on the basis of population. Providers, including private companies such as pharmacies, will get it for free. They won't be permitted to charge people or health insurers for it, but they can charge an "administration fee" for giving the shots or sprays. In some settings, such as public health clinics, people will get the shots free.

As the vaccine arrives at the four distribution centers -- their location for the moment is secret -- the CDC will tell each state what its allocation will be. States will put in orders based on the need in their jurisdictions and the number of doses that hospitals, clinics and other providers say they can use in the immediate future.

Vaccine will then be sent directly to providers; the CDC expects to have 90,000 names and addresses on file. Orders will be filled in three business days and the vaccine shipped overnight, Butler told reporters in a teleconference Friday.

Government planners expect demand for vaccine will outstrip supply in the first weeks after it becomes available. During that time, states will have to decide which hospitals, clinics and offices are most apt to reach the priority populations and thus should get vaccine first.

The CDC won't police those decisions and expects that very quickly there will be enough vaccine to fill essentially all orders from states.

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