2009 H1N1 Influenza – General Talking Points – Rev. of Nov. 24, 2009 – p. 8
2009 H1N1 Influenza
General Talking Points
Communications Office · Minnesota Department of Health
Revision of Nov. 24, 2009
Please replace and discard any prior revisions of this document –
Including any versions posted to a Web site or otherwise archived.
These talking points will be revised in response to emerging events and new information. Please check back regularly for updates.
The Current Situation
· The second wave of illness caused by the 2009 H1N1 influenza virus appears to have peaked in Minnesota.
· The CDC classification of flu activity in Minnesota has now been downgraded from “widespread” to “regional.”
· Over the past few weeks, several indicators have suggested a general decline in influenza-like illness. These indicators include;
o schools reporting influenza-like illness (five percent or more of all students OR three or more students in the same elementary school classroom)
o hospitalizations for confirmed H1N1 illness
o patients seeking treatment for influenza-like illness at sentinel clinics around the state
· Nonetheless, the Minnesota Department of Health continues to report additional deaths from 2009 H1N1.
· The deaths being reported may have occurred up to several weeks prior to being identified as “H1N1 deaths.”
o What’s being reported is the completion of investigations into possible H1N1deaths, rather than deaths as they occur.
It’s Not Over
· Although the second wave of illness appears to have peaked, the public health threat posed by H1N1 continues.
· We may continue to see cases of H1N1 illness for sometime – just as we did during the summer, following the first wave of illness.
· Based on what we know about past flu pandemics, we may see a third wave of 2009 H1N1 illness, possibly in January or February.
· Our situation is complicated by the fact that we may also see a typical wave of regular, seasonal flu, possibly beginning as early as December.
· Because H1N1 continues to be a threat, it is still important to get vaccinated, as more vaccine for H1N1 becomes available. That’s especially true if you are in one of the high-priority groups for vaccination.
· Although the severity of the illness caused by H1N1 continues to be similar to that for seasonal flu, that doesn’t mean that it isn’t dangerous.
· Influenza is always a potentially serious, life-threatening illness – especially for people at high risk of complications. Nationwide, seasonal flu kills an estimated 36,000 people a year, making it one of our leading causes of death, year in and year out.
· H1N1 is of special concern because the groups at highest risk for serious illness are different from the high-risk groups for seasonal flu:
o Older adults appear to be at lower risk than other groups for becoming ill with 2009 H1N1 – although it can still cause severe illness in this group. They are among those at highest risk from seasonal flu.
o Pregnant women appear to be at increased risk.
§ Based on data from the first wave of H1N1 illness, pregnant women are several times as likely as the general population to be hospitalized if they develop 2009 H1N1 influenza.
§ The death rate for pregnant women with H1N1 has been described as “remarkably high.”
o Children, adolescents and young adults appear to be at increased risk.
§ The median age of patients hospitalized with 2009 H1N1 in Minnesota last spring was 12 years.
§ Younger children, in particular, seem to be at increased risk. In Minnesota, during the first wave of illness, children under five were hospitalized with 2009 H1N1 at twice the rate of children aged five to 12.
o People with underlying health conditions appear to be at increased risk of severe illness or complications from 2009 H1N1 – just as they are from seasonal flu.
Vaccination Against 2009 H1N1
Who should get it
· Although available supplies of vaccine remain limited – both in Minnesota and nationwide – MDH is now recommending that the vaccine be offered to all of the groups designated as “high priority” by CDC.
· The following have been identified as priority groups for getting the H1N1 vaccine, based on their risk of severe disease from H1N1:
o Pregnant women
o People who live with or care for children under the age of six months.
o Health care workers and emergency personnel
o All children, adolescents and young adults aged six months through 24 years
o People aged 25 to 64 who are at risk of complications because of an underlying medical or immune system condition, including:
§ some kinds of conditions that may interfere with breathing
§ chronic lung disease
§ chronic cardiovascular disease (except high blood pressure)
§ chronic kidney disease
§ chronic liver disease
§ chronic metabolic conditions or conditions involving the blood or blood-forming organs (including diabetes)
§ suppressed immune systems (due to medical treatment or infection)
· Although people age 65 and older are still a priority group for seasonal flu vaccination, they are not among the priority groups for 2009 H1N1 vaccination.
· Older people appear to be at lower risk than other groups for getting 2009 H1N1 flu – although it can still cause severe illness in this group.
· The priority groups identified by CDC for H1N1 vaccination include an estimated 159 million people in the U.S. – and 2.7 million in Minnesota.
Availability of Vaccine
· Addition H1N1 vaccine continues to be allocated for Minnesota, and ordered for Minnesota providers, on a daily basis.
· The latest information on doses allocated and ordered is available on the MDH website at www.mdhflu.com.
· As more vaccine becomes available, it is ordered for local health departments and health care providers who have registered with MDH. The vaccine is then delivered directly to local public health agencies and providers.
· MDH has attempted to order and distribute vaccine to providers as equitably as possible, emphasizing providers who serve high risk groups.
· Because available supplies of vaccine have so far been limited, some providers have inevitably gotten their vaccine before others – and some people in high risk groups may have had trouble getting vaccinated.
· People have understandably been concerned about the distribution and availability of the vaccine. We share their frustration.
· As more and more vaccine becomes available, inequalities in the distribution of the vaccine should begin to even out, and people in priority groups should be able to get vaccinated.
· People in the priority groups should be patient and persistent, and stay in contact with their health care provider or their local health department.
· Eventually, we should have enough vaccine for everyone who wants it.
· Until we reach that point, we would ask people not in a priority group to postpone getting vaccinated, and give people in priority groups a chance to go first.
· In the coming weeks, local public health agencies will be holding public vaccination clinics in schools and other locations around the state. These clinics are being organized at the local level, as vaccine becomes available.
· Watch for announcements or contact your local health department to find out about public vaccination clinics in your area.
· As more vaccine becomes available and more clinics are scheduled, MDH will be launching a “clinic finder” tool for 2009 H1N1 vaccinations at www.mdhflu.com.
· The clinic finder will help people find a time and place where they can get vaccinated.
· MDH plans to activate the clinic finder on Nov. 30.
General Information About Vaccines
· This year, you will need to get vaccinated against two kinds of flu to be fully protected – 2009 H1N1 and regular seasonal flu.
· The seasonal flu vaccine will not protect you against 2009 H1N1 flu.
o The seasonal vaccine does protect against a type of H1N1 virus, as well as two other flu virus strains.
o However, the strain in the seasonal vaccine is a different H1N1 virus – and it’s not the same strain as the 2009 H1N1 virus.
· People who’ve been ill with flu symptoms since late April should not assume they are immune to 2009 H1N1. They should still get the 2009 H1N1 vaccine.
o Most people with flu-like illness cannot assume they had 2009 H1N1 flu.
o Most have never had their illness laboratory confirmed as flu, and even fewer have had their illness confirmed as H1N1.
· Like all vaccinations, vaccination against 2009 H1N1 is completely voluntary – but it is highly recommended for people at high risk for flu complications.
· Being vaccinated against 2009 H1N1 vaccine doesn’t carry any greater risk than being vaccinated against seasonal flu.
o The two vaccines are manufactured in exactly the same way.
o They are just formulated to protect against different flu viruses.
o Otherwise, the two types of flu vaccine are identical – and the seasonal vaccine has a long history of safe use.
· There was some discussion earlier about using additives – known as adjuvants – to enhance the effectiveness of the H1N1 vaccine. However, the H1N1 vaccine does not contain any of these additives.
· Although some of the H1N1 vaccine will contain mercury-based preservatives, a preservative-free version of the vaccine is also available.
· Like the regular, seasonal flu vaccine, the H1N1 vaccine is available in two forms – either a shot or a nasal spray.
· The shot uses vaccines made with killed viruses.
· The nasal spray vaccines are made with viruses that have been weakened – but not killed.
· The nasal spray can only be given to people 2 to 49 years of age.
· Experts have concluded that most people will only need a single dose of the 2009 H1N1 vaccine to be fully immunized.
· Children under 10 (9 and under) will need two doses of the H1N1 vaccine.
· Children under 9 (8 and under) will need two doses of the seasonal vaccine if they’ve never been vaccinated before.
· You can get vaccinated for both kinds of flu at the same time if
o You get shots for both kinds of flu
o You get a shot for one kind of flu and the nasal spray vaccine for the other kind.
· You cannot be vaccinated for both kinds of flu at the same time using the nasal spray vaccine for both vaccinations.
· The two doses of nasal spray vaccine – for H1N1 and seasonal flu – would need to be given at least 4 weeks apart.
· The seasonal vaccine is especially recommended for people at high risk of serious complications from the flu. These groups include:
o Children and adolescents from six months to 18 years of age
o Adults age 50 and over
o Women who will be pregnant during flu season
o Health care workers
o People living in nursing homes or other chronic care facilities
o People who live with or care for children age five or younger (especially those under six months, who cannot be vaccinated against flu)
o Children and adolescents who regularly take aspirin as part of their medical treatment (because they may be at risk of a complication called Reye Syndrome if they get the flu)
o People who are at risk of complications because of an underlying medical condition, including:
§ some kinds of conditions that may interfere with breathing
§ chronic lung disease
§ chronic cardiovascular disease (except hypertension)
§ chronic kidney disease
§ chronic liver disease
§ chronic metabolic conditions, or conditions involving the blood or blood-forming organs (including diabetes)
§ suppressed immune systems (due to medical treatment or infection)
o People who live with or care for people with conditions that place them at high risk of flu complications.
· Because of distribution issues – and because vaccine manufacturers have switched over to making the 2009 H1N1 vaccine – some providers may not have the seasonal vaccine right now.
· As with the H1N1 vaccine, you should stay in touch with your provider about getting vaccinated against seasonal flu – if you haven’t been vaccinated already.
· Seasonal flu hasn’t made an appearance yet in Minnesota this year, and probably won’t peak until later in the winter.
Antiviral Drugs
· Antiviral drugs like Tamiflu and Relenza currently appear to be effective in treating 2009 H1N1 flu.
· To be most effective, antivirals need to be administered within 48 hours of the time that flu symptoms first appear.
· These drugs need to be individually prescribed by a physician.
· Antiviral drugs are normally made available through the private sector health care system.
· If shortages of these drugs occur in the private-sector health-care system during a pandemic, public stockpiles can be used to fill the gap.
· Enough antivirals for slightly more than one million courses of treatment from state and federal stockpiles are available for use in Minnesota.
· If the regular health-care system is overwhelmed during a severe pandemic, antivirals can be provided through specially designated regional “flu centers.”
· Although a number of flu centers were activated during the second wave of the H1N1 pandemic, they have all since closed.
· Activation of flu centers would again be an option during a possible third wave of H1N1 illness later in the winter.
· If you have possible symptoms of the flu, you can also call the Minnesota FluLine at 1-866-259-4655.
o Nurses staffing the FluLine can refer you to an appropriate source of help, based on your situation.
o If necessary, antiviral medications can be prescribed for you over the phone.
o If you lack health insurance to pay for needed anitivirals, they can be provided free of charge.
Protecting yourself against flu: a few simple steps
· Taking a few simple, common-sense precautions is still the most important thing you can do to keep from getting the flu – or spreading it to others. That applies to both seasonal flu and 2009 H1N1.