Thursday, October 29, 2009

The H1N1 Vaccine Shortage: Hate to Say I Told You So . . .

Here in Washtenaw County, Michigan, we've been told for months that there is going to be H1N1 vaccine for everyone who needs it. In my school district, three clinics were scheduled to vaccinate anyone who wanted it at the three biggest high schools in town during the first two weeks in November. Similar clinics were scheduled at a variety of school sights around the county.

Then a couple of weeks ago, the word went out that actually, not everyone was going to be able to get vaccinated. In fact, these clinics would now be limited to health care workers, pregnant women, caregivers of children under 6 months, children from 6 months through 4 years old, and children ages 5 through 18 with underlying health conditions. One of our district's three clinics was canceled.

Clinics were set to begin this past Tuesday. In the days leading up to the first clinic, the word went out that only 1,000 people would be vaccinated at the clinic on Tuesday. The idea, apparently, was to spread the vaccine around to the various locations. What was not shared was how many doses of vaccine were dedicated to all the clinics put together, just that it wasn't nearly as much as originally hoped, but more was trickling in.

Monday's clinic, at our local Intermediate School District, was slated to run from 2:30 - 9:00 PM. The first person lined up at 9:30 AM. People parked 1/4 of a mile or more away from the building to get in line. By 5:00, the clinic was closed. My son was among the many people in the designated groups who planned (or whose parents planned) to get vaccinated that day who didn't even bother to get out of their cars.

That was Monday. By this morning, all of the school-based clinics had been canceled, and the convocation center at a local university is the location for a new, "mass vaccination clinic" for the same high risk groups next week. It suddenly seemed like a better idea to try to do as many people as possible all at once rather than have people go from clinic to clinic, hoping to be in line early enough to get their shot.

While the shortage of H1N1 vaccine may not have been predictable, scenes like this one certainly were. Anyone who's ever tried to get tickets for a popular rock concert can tell you what happens when you publicize that there is only a certain amount of something that people really want and that it will become available on a certain day, at a certain time, in a certain place. Its a wonder the Health Department didn't give out wrist bands ahead of time -- they might consider that in the future.

Back in July I predicted what a shortage of vaccine, or a prioritization of who can be vaccinated, or a rationing of health care during the pandemic, might do to people psychologically and how it might cause people to act. I'm not expecting that the powers that be read this blog, but if I can figure it out, so can they. Planning clinics based on the idea that you can vaccinate a certain number of people per clinic over a certain number of clinics over a certain number of days is all well and good, but you have to take into consideration how many people will want to be vaccinated each day. Around here, the Health Department seemed genuinely shocked by the notion that significantly more than 1,000 patients showed up for a 1,000 patient clinic.

This really shouldn't be that hard. You select which groups can be vaccinated based on which groups you think you can vaccinate without turning anyone away. You set up a mass clinic with lots of parking, and you publicize that everyone in those groups who wants to will be vaccinated. You allow people to make appointments, or get wrist bands, or something to spread out the crowds. And you hold the clinic until everyone who is entitled has had their shot. When more vaccine becomes available, you do it again. And you stop being shocked that the public's priorities and ideas about how to proceed do not include the convenience of the Health Department. That ship sailed a long time ago.


Colleen said...

You could've predicted that there would be a vaccine shortage...we've never tried to vaccinate this many people in such a short period of time with such a short lead up to it before! Where were these vaccines being manufactured? I don't think that there was any reason to assume that we had the capability to get a vaccine plant grown that big, that quickly, for something temporary.

Anyway, I've been saying all along, in response to people fretting that the gov't wants to forcibly vaccinate everyone, that it doesn't matter what they want to do (even if they want to do it, which I haven't seen), they can't...there won't be enough vaccine!

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Naomi Zikmund-Fisher
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