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All You Wanted to Know About Swine Flu.

Summary: Experts from the Centers for Disease

Control and Aa Prevention in Aa the United Aa States answer frequently asked questions on H1N1 (swine flu swine flu
n.
A highly contagious form of human influenza caused by a filterable virus identical or related to a virus formerly isolated from infected swine.
).

Who is recommended to receive the 2009 H1N1 flu vaccine


    The flu vaccine is a vaccine to protect against the highly variable influenza virus.

    The annual flu kills an estimated 36,000 people in the United States.
    ?

    When vaccine is first available, the Centers for Disease Control and Prevention Centers for Disease Control and Prevention (CDC), agency of the U.S. Public Health Service since 1973, with headquarters in Atlanta; it was established in 1946 as the Communicable Disease Center.  (CDC See Control Data, century date change and Back Orifice.

    CDC - Control Data Corporation
    ) Advisory Committee on Immunisation Practices (ACIP ACIP Cardiology A clinical trial–Asymptomatic Cardiac Ischemia Pilot Study that evaluated 3 therapeutic strategies2 for ↓ myocardial ischemia during exercise testing. ) has recommended the 2009 H1N1 vaccine for the following five target groups (approximately 159 million persons nationally):

    1) AaAa Pregnant women

    2) AaAa Household and caregiver contacts of children younger than six months of age (e.g. parents, siblings and daycare providers)

    3) AaAa Health care and emergency medical services An Emergency medical service (abbreviated to initialism "EMS" in many countries) is a service providing out-of-hospital acute care and transport to definitive care, to patients with illnesses and injuries which the patient believes constitutes a medical emergency.  personnel

    4) AaAa Persons from six months through 24 years of age

    5) AaAa Persons aged 25 through 64 years who have medical conditions See carpal tunnel syndrome, computer vision syndrome, dry eyes and deep vein thrombosis.  associated with a higher risk of influenza complications.

    Aa

    Once providers meet the demand for vaccine among persons in these initial target groups, vaccination is recommended for all persons 25 through 64 years of age. Current studies indicate that the risk of infection among persons aged 65 or above is less than the risk for younger age groups. However, once vaccine demand among younger age groups has been met, programmes and providers should offer vaccination to people aged 65 or above.

    How should providers prioritise among the initial target groups recommended by ACIP?

    The recommendations are broad and allow for flexibility to accommodate local variability in vaccine needs and demands. Providers should be aware of and follow any additional guidance provided by their state or local health departments. If no additional guidance is provided at the state or local level, providers should vaccinate vac·ci·nate
    v.
    To inoculate with a vaccine in order to produce immunity to an infectious disease such as diphtheria or typhus.



    vac
     among the initial target group populations on a first come, first C served basis.

    How likely is it that recommendations for target groups may change during the immunisation period?

    Although it is unlikely the ACIP recommendations will change, predicting the behaviour of 2009 H1N1 influenza virus influenza virus
    n.
    Any of three viruses of the genus Influenzavirus designated type A, type B, and type C, that cause influenza and influenzalike infections.
     is difficult. CDC will continue to monitor the epidemiology of the evolving pandemic pandemic /pan·dem·ic/ (pan-dem´ik)
    1. a widespread epidemic of a disease.

    2. widely epidemic.


    pan·dem·ic
    adj.
    Epidemic over a wide geographic area.

    n.
     very closely. The ACIP will be updated frequently on the status of the pandemic, including groups at highest risk of complications, and recommendations will be modified C as necessary.

    How will the 2009 H1N1 vaccine flow from manufacturers to providers?

    The Federal Government will allocate vaccine to states based on population size. States are responsible for identifying providers who will participate in administration of 2009 H1N1 vaccine. Vaccine will be shipped to participating providers through a centralised Adj. 1. centralised - drawn toward a center or brought under the control of a central authority; "centralized control of emergency relief efforts"; "centralized government"
    centralized
     distribution process. Through this process, placing of orders is facilitated by the state/local health department, and this information is sent to the CDC to be transferred to the distributor for processing. Because of limitations related to the number of sites to which the distributor can directly ship vaccine, some project areas (including all states, territories, Chicago, DC, NYC NYC
    abbr.
    New York City


    NYC New York City
    , and LA county) may develop additional means of distributing vaccine to providers which will be communicated to providers at a C local level.

    How can providers obtain vaccine?

    State/Local public heath departments will be responsible for directing the flow of vaccine to providers within every state. They will determine which providers will receive vaccine, and will allocate vaccine among providers as it becomes available to them. Public health departments are in the process of ascertaining which providers are interested in administering vaccine. For more information, go to your stateAEs public health department website or to the CDC 2009 H1N1 website for information on how to become a 2009 H1N1 vaccine provider. Participating providers will sign a Provider Agreement assuring they intend to meet state requirements.

    Will vaccine be distributed equitably across providers?

    Public health departments will strive to ensure equitable distribution, taking into account which target groups are seen by different types of providers as well as their internal resources for possible re-distribution C of vaccine.

    What supplies will be included with the 2009 H1N1 vaccine Aa shipments?

    The Federal Government will purchase vaccine and supplies (syringes, alcohol swabs, sharps containers, and vaccine record cards) and distribute these at no cost to healthcare providers who make agreements with state and local public health authorities to provide the 2009 H1N1 vaccine. Supplies will be shipped separately from vaccine and are expected to arrive before or on the same day as vaccine.

    How can providers determine what percentage of their patients plan on getting the 2009 H1N1 vaccine in a physicianAEs office?

    It is difficult to predict where individuals will go to receive the 2009 H1N1 vaccine. However, based on unpublished data from the Adult National Immunization immunization: see immunity; vaccination.  Survey, during the 2006-2007 influenza season, among 19-49 year-olds who were vaccinated, approximately 38 per cent of persons at increased risk of complications from influenza reported receiving influenza vaccine influenza vaccine Flu vaccine A vaccine recommended for those at high risk for serious complications from influenza: > age 65; Pts with chronic diseases of heart, lung or kidneys, DM, immunosuppression, severe anemia, nursing home and other chronic-care  in a physicianAEs office. Approximately 26 per cent of persons with household contact with a high-risk person and 25 per cent of persons with no specific indications for influenza vaccine were vaccinated in a physicianAEs office.

    What are some possible approaches a practice might take to administer the 2009 H1N1 vaccine?

    Options include holding special clinics, integrating the 2009 H1N1 vaccination into usual care, providing walk-in immunisations, or coordinating with local public health clinics if unable to administer 2009 H1N1 vaccine themselves.

    In determining the best option, each practice should consider several factors, including availability of vaccine, practice resources and C patient demand.

    If my patients are vaccinated outside of my practice, how will that information be available for inclusion in the patientAEs permanent medical record?

    Recipients of the 2009 H1N1 vaccine will be provided with a hand-held card to serve as a record of vaccination and a source of information should a report to the Vaccine Adverse Event Reporting System The Vaccine Adverse Event Reporting System is a United States program for vaccine safety, co-sponsored by the Centers for Disease Control and Prevention (CDC) and the Food and Drug Administration (FDA).  (VAERS VAERS Vaccine Adverse Event Reporting System (lists hospitalizations or deaths resulting from vaccinations) ) be needed. Vaccine recipients will be encouraged to bring the hand-held card at their next visit to their primary care provider so that vaccination information can be transcribed into the patientAEs permanent medical record.

    What CDC information will be available for use in practices to help explain the need for both seasonal and 2009 H1N1 vaccine?

    A variety of materials are available on the CDC 2009 H1N1 website at http://www.cdc.gov/h1n1flu/vaccination/ . In addition, a 2009 H1N1-specific Vaccine Information Statement (VIS) will be available that will help explain the vaccine to recipients.

    Can patients who are allergic to eggs receive the 2009 H1N1 eC flu vaccine?

    Asking persons if they can eat eggs without adverse effects is a reasonable way to determine who might be at risk for allergic reactions from receiving influenza vaccines.

    Persons who have had symptoms such as hives hives (urticaria), rash consisting of blotches or localized swellings (wheals) of the skin, caused by an allergic reaction (see allergy). The swelling is caused by distention of the skin capillaries and escape of serum and white cells into the skin and tissues.  or swelling of the lips or tongue, or who have experienced acute respiratory distress Respiratory distress
    A condition in which patients with lung disease are not able to get enough oxygen.

    Mentioned in: Lung Cancer, Non-Small Cell
     after eating eggs, should consult a physician for appropriate evaluation to help determine if influenza vaccine should C be administered.

    Persons who have documented (IgE)-mediated hypersensitivity hypersensitivity, heightened response in a body tissue to an antigen or foreign substance. The body normally responds to an antigen by producing specific antibodies against it. The antibodies impart immunity for any later exposure to that antigen.  to eggs, including those who have had occupational asthma Occupational Asthma Definition

    Occupational asthma is a form of lung disease in which the breathing passages shrink, swell, or become inflamed or congested as a result of exposure to irritants in the workplace.
     related to egg exposure or other allergic responses to egg protein, also might be at increased risk for allergic reactions to influenza vaccine, and consultation with a physician before vaccination should be considered. A regimen has been developed for administering influenza vaccine to asthmatic children with severe disease and egg hypersensitivity C (J Pediatr 1985;106:931-3.).

    Will private health insurance plans reimburse private providers for administration of 2009 H1N1 vaccine?

    According to according to
    prep.
    1. As stated or indicated by; on the authority of: according to historians.

    2. In keeping with: according to instructions.

    3.
     AmericaAEs Health Insurance Plans, a national association representing nearly 1,300 companies that provide health insurance to over 200 million Americans, oEvery year health plans contribute to the seasonal flu vaccination campaign in several ways:

    a) AaAa Health plans communicate directly with plan sponsors and members on the current ACIP recommendations and encourage immunisation; they also provide information on where to get vaccinations, and who to contact with any questions.

    b) AaAa Just as health plans have provided extensive coverage for the administration of seasonal flu vaccines in the past, public health planners can make the assumption that health plans will provide reimbursement for the administration of 2009 H1N1 vaccine to their members by private sector providers in both traditional settings e.g., doctorAEs office, ambulatory clinics, health care facilities, and in non-traditional settings, where contracts with insurers have been established.o

    Aa

    Can seasonal influenza vaccine and 2009 H1N1 vaccine be given at the same visit?

    Both seasonal and 2009 H1N1 vaccines are available as inactivated inactivated

    rendered inactive; the activity is destroyed.


    inactivated viruses
    treated so that they are no longer able to produce evidence of growth or damaging effect on tissue.
     and live attenuated Attenuated
    Alive but weakened; an attenuated microorganism can no longer produce disease.

    Mentioned in: Tuberculin Skin Test


    attenuated

    having undergone a process of attenuation.
     (LAIV LAIV Live Attenuated Influenza Vaccine ) formulations. The simultaneous and sequential administration of seasonal and 2009 H1N1 inactivated vaccines is currently being studied. However, existing recommendations are that two inactivated vaccines can be administered at any time before, after, or at the same visit as each other (General Recommendations on Immunization, MMWR MMWR Morbidity & Mortality Weekly Report Epidemiology A news bulletin published by the CDC, which provides epidemiologic data–eg, statistics on the incidence of AIDS, rabies, rubella, STDs and other communicable diseases, causes of mortality–eg,  2006;55[RR-15]). Existing recommendations also state that an inactivated and live vaccine live vaccine
    n.
    A vaccine prepared from living attenuated organisms or from viruses that have been attenuated but can still replicate the cells of the host organism.
     may be administered at any time before, after or at the same visit as each other.

    Consequently, providers can administer seasonal and 2009 H1N1 inactivated vaccines, seasonal inactivated vaccine and 2009 H1N1 LAIV, or seasonal LAIV and inactivated 2009 H1N1 at the same visit, or at any time before or after each other. Live attenuated seasonal and live 2009 H1N1 vaccines should NOT be administered at the same visit until further studies are done. If a person is eligible and prefers the LAIV formulation of seasonal and 2009 H1N1 vaccine, these vaccines should be separated by a minimum of four weeks.

    Can 2009 H1N1 vaccine be administered at the same visit as eC other vaccines?

    Inactivated 2009 H1N1 vaccine can be administered at the same visit as any other vaccine, including pneumococcal polysaccharide vaccine Pneumococcal polysaccharide vaccine (PPV), also known as Pneumovax, is a vaccine used to prevent Streptococcus pneumoniae (pneumococcus) infections such as pneumonia and septicaemia. . Live H1N1 C vaccine can be administered at the same visit as any other live or inactivated vaccine EXCEPT seasonal live attenuated C influenza vaccine.

    Will the 2009 H1N1 vaccine be recommended for patients who had influenza-like illness since eC spring 2009?

    All persons in a recommended vaccination target group who did not have 2009 H1N1 virus infection confirmed by real-time reverse transcription-polymerase chain reaction (RT-PCR RT-PCR

    reverse transcriptase-polymerase chain reaction. See PCR1.
    ) should be vaccinated with the 2009 H1N1 vaccine. Aa However, most people ill with an influenza-like illness (ILI) since this spring have not had testing with the RT-PCR test, which is the only test that can confirm infection specifically with the 2009 H1N1 virus. Aa Tests such as rapid antigen detection assays, and diagnoses based on symptoms alone without RT-PCR testing, cannot specifically determine if a person has 2009 H1N1 influenza. Aa Persons who were not tested, but who became ill after being exposed to a person with lab confirmed 2009 H1N1 influenza should not assume that they also had 2009 H1N1 since many pathogens can cause an ILI, and should get the vaccine if they are in a recommended vaccination target group.

    Persons who think they had 2009 H1N1 infection diagnosed by RT-PCR should ask their doctor if they should be vaccinated. Someone who was infected with the 2009 H1N1 virus and who is not severely immune compromised will likely have some immunity to subsequent infection with 2009 H1N1 virus. Aa However, vaccination of a person with some existing immunity to the 2009 H1N1 virus will not be harmful and persons who are uncertain about how they were diagnosed should get the 2009 H1N1 vaccine. Persons recommended for seasonal vaccine should get a seasonal vaccine because infection with the 2009 H1N1 virus does not provide protection against seasonal C influenza viruses.

    Copyright 2009 Khaleej Times The Khaleej Times is a daily English language newspaper published in Dubai, United Arab Emirates. It is published by Galadari Printing and Publishing L.L.C. with the Gulf News being its main competitor. . All Rights Reserved.

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    COPYRIGHT 2009 Al Bawaba (Middle East) Ltd.
    No portion of this article can be reproduced without the express written permission from the copyright holder.
    Copyright 2009 Gale, Cengage Learning. All rights reserved.

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    Publication:Khaleej Times (Dubai, United Arab Emirates)
    Date:Sep 27, 2009
    Words:1888
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