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Swine flu vaccinations pose problems for NY county

By Peter Simon
The Buffalo News

BUFFALO, N.Y. — In all likelihood, Erie County faces the “monumental” task of giving the swine flu vaccination to more than 300,000 people this fall, Erie County’s health commissioner said Monday.

“If this pans out the way it’s now being viewed, this would probably be the biggest thing we’ve ever done here in public health,” said Dr. Anthony J. Billittier IV. “I’m not sure people realize the monumental proportions of this.”

Billittier stressed that the Centers for Disease Control and Prevention is still working out guidelines on the swine flu — or novel H1N1 — vaccine now being developed.

However, the CDC already has recommended that the vaccination be administered to everyone from 6 months to 24 years old, pregnant women, caregivers for children younger than 6 months old, health care and emergency medical services workers and people age 25-64 with a high risk of medical complications from influenza.

In the United States, swine flu has caused 7,511 reported hospitalizations and 477 deaths.

Billittier estimates that more than 300,000 of Erie County’s 920,000 residents would be vaccinated, requiring assistance from private physicians, hospitals, nursing homes, schools and “mass vaccinators” such as the Visiting Nursing Association of Western New York.

“There’s no way we can do this alone,” he said of the Health Department.

Other questions revolve around cost, the availability of vaccine, the level of demand from the public and finding enough health care professionals to administer the vaccinations.

To put the task in perspective, Billittier made these points:

It took five days to vaccinate 10,000 people following a hepatitis scare after a Wegmans employee was diagnosed with the disease in February. Even though the magnitude of that fell far short of the anticipated swine flu effort, “it brought us to our knees,” Billittier said.

A suburban school district, which Billittier declined to name, has estimated that each of its 15 nurses would have to give vaccinations for 33 hours in order to cover the school district’s students and faculty.

If the swine flu returns with a vengeance this fall, public demand could severely test the county’s ability.

“The question is: How much time do we have to do it?” Billittier said. “This is going to take a while. I don’t know just what that means yet, but it’s not going to take just a few days.”

The county is doing as much planning as possible, given the uncertain nature of the CDC’s final recommendations, Billittier said. The effectiveness and safety of the vaccine have yet to be determined, he added.

“The other side of the equation is that we have no idea what the demand will be,” he said. “Do people want to get vaccinated?”

An Associated Press review showed there are nearly 3 million students in school districts across the country where officials want to offer the vaccine once federal health officials begin shipping it in mid-October.

That would represent the most widespread school vaccinations since the days of polio.

Two Buffalo students died of swine flu in June, and nearly 40 other cases were reported in city schools.

Local school districts will take their cues from Billittier, said Dennis A. Kwaczala, senior health, safety and risk coordinator for the Erie 1 Board of Cooperative Education Services. “They all have the same questions,” he said. “They take their direction from him on this.”

Concerns of school administrators revolve around liability, manpower and parent consent, he added.

Billittier plans to meet with local school officials, but no date has been set.

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