Sebelius: Feds Knew H1N1 Vaccine Supply Was Not Enough to Cover At-Risk Americans--Still May Donate Doses to Foreign Countries

By Penny Starr | October 28, 2009 | 7:00 PM EDT

Health and Human Services Secretary Kathleen Sebelius told reporters and people watching streaming video on the Web site on Wednesday that supplies of the H1N1 vaccine are increasing but that the government knew amounts of the immunization would be limited. ( Starr)

( – Health and Human Services Secretary Kathleen Sebelius said the federal government has known all along there would not be enough H1N1 vaccine to cover all at-risk Americans and that plans to donate a percentage of the U.S. supply to foreign countries is still under consideration.

“We knew from the outset--everybody knew from the outset--we would not have enough to immunize the 150 million Americans who fit into those five priority groups,” Sebelius said during a Wednesday press conference at HHS headquarters in Washington, D.C.

Sebelius said there are now slightly more than 22 million doses of the vaccine available--just over half of the 40 million that the Centers for Disease Control (CDC) estimated would be available by the end of October and more than 125 million less than what would be needed to cover the at-risk groups of Americans identified by the CDC’s Advisory Committee on Immunization Practices for 2009. These at-risk groups include:
-- pregnant women
-- persons who live with or provide care for infants aged <6 months (e.g., parents, siblings, and daycare providers)
-- health care and emergency medical services personnel
-- persons aged 6 months - 24 years, and
-- persons aged 25 - 64 years who have medical conditions that put them at higher risk for influenza-related complications
“These five target groups comprise an estimated 159 million persons in the United States,” the advisory committee said in its recommendations for the H1N1 immunization program.
“This estimate does not accurately account for persons who might be included in more than one category (e.g., a health care worker with a high-risk condition)," said the committee. "Vaccination programs and providers should begin vaccination of persons in all these groups as soon as vaccine is available.”

Sebelius said the government is distributing the available vaccine to the states based on each state’s population, but that local and state authorities decide who gets the vaccine first.

“So from Day 1--prior to Day 1--state and local units have been prioritizing in their own states,” Sebelius said. “Some started with health care workers. Others reached out to pregnant women first.”

“Again, the orders are absolutely on a per capita basis,” Sebelius said. “We wanted to make sure that this was equitably distributed, at first and throughout, knowing that there was never going to be a sufficient supply from the beginning to vaccinate everybody.”

When asked by if, given the production delays and vaccine shortages, the Obama administration is still committed to donating 10 percent of the U.S. H1N1 vaccine supply to foreign countries, Sebelius said the plan to join 10 other donor nations will be evaluated.

“Well, there is an 11-country partnership, which has made a commitment to make vaccines available to developing nations,” Sebelius said. “It has always been the president’s intention that the safety and security of the American people be a priority in the production and distribution.

“So as vaccine becomes more available, I think evaluation will be made about when it’s appropriate for that donation to begin,” Sebelius said. “But I can tell you at this point the priority is getting the vaccines to citizens in this country, and that’s what we’re working on 24-7.”

Homeland Security Secretary Janet Napolitano said the federal government prepared for the outbreak over the summer by putting a federal response plan into place and giving guidance to schools and small businesses. ( Starr)

Homeland Security Secretary Janet Napolitano also spoke at the press conference about how the government has prepared for the H1N1 outbreak.
“Over the course of the summer, we were able to accomplish quite a bit by way of preparation in light of the fact that the flu is almost, by definition, an unpredictable disease,” Napolitano said. “Where it hits and where it hits hardest, what time specifically, those things are not precise. But they are part of the flu season, which of course we’re now in.”
Napolitano said that federal government response plans have been put in place and guidance given to “schools, small businesses and faith-based community organizations” about how to deal with the flu outbreak, including staffing recommendations if key personnel become ill.
She said she knew Americans were frustrated by the lack of vaccines, but that they could be proactive in preventing the spread of H1N1.
“We are continually reminding the American people that we are our own best protectors in a way by coughing properly, by washing your hands thoroughly, by staying home from school or work if you are exhibiting signs of the flu,” Napolitano said.
Sebelius said the vaccine supply is growing, but that it was always known that the immunization process would be gradual.
“But again, there will be a robust supply; orders placed for 250 million doses of vaccine,” Sebelius said. “We have about 100 million. To put that in perspective, there are about 100 million Americans who each and every year get a seasonal flu shot.”
“So this was always anticipated to be, you know, enough eventually to have people who want to take advantage of the vaccine to do that, but it was never going to be available all at the same time,” Sebelius said.