Nikki Haley Supports HPV Vaccine Too! For Young Minority Girls On Medicaid!

Rising GOP star Haley has own history with HPV vaccine fallout

As the debate over Texas Gov. Rick Perry mandating the HPV vaccine continues between Republican presidential candidates, a woman whose endorsement is coveted by all them, South Carolina Gov. Nikki Haley, has her own complicated history on the issue.

In 2007, shortly before Perry issued an executive order requiring that schoolgirls be vaccinated against the sexually transmitted human papillomavirus, or HPV, that causes most cervical cancers, Haley was throwing her support behind a similar bill in South Carolina. At the time she was in her second term as a state representative.

State Rep. Joan Brady introduced the Cervical Cancer Prevention Act in South Carolina, and the Republican corralled more than 60 legislators, including Haley, to sponsor the bill. Unlike the executive order for which Perry is taking heat, this legislative mandate did not include a provision for parents to opt out of inoculating their daughters.

Within months, fierce opposition mounted, and legislative records back up accounts from sources who recall sponsors "dropping like flies" before a unanimous vote killed the bill on April 18, 2007.

More than a dozen legislators formally requested to be removed as sponsors from the bill, but the future governor of South Carolina was not one of them.

State Rep. Kris Crawford, a physician who led the debate to discredit the policy resulting in the bill's demise, said even though Haley voted against the bill like everybody else he wondered why she didn't remove herself as a bill sponsor if she opposed the mandate.

"If you're a co-sponsor of a bill and it's a bad bill, take your name off of it," Crawford said.

Haley's office declined to comment and pointed CNN to information about the vote on her campaign website.

Palmetto Family Council President Oran Smith was among the conservative activists actively lobbying legislators to oppose the bill.

"When we finally got to them and explained the full story, they were very quick to pull their names off," Smith recalls. "Sure we wish (Haley) had done that as well, but ultimately when it came up on the big board, she voted the way we wanted her to vote twice."

On her campaign website, Haley acknowledges her initial support for the bill but said in a statement, "Through the legislative process, it became clear to me that an opt-out provision was not going to be included in the bill and it sought to mandate that middle-school girls obtain a vaccine -- and strip parents of the right to make the choice for their daughter. In light of that turn of events, I voted to kill the bill."

Haley voted against the opt-out provision she says in her statement would have made the bill palatable.

Smith said that was likely part of legislative strategy by Haley and other conservative Republicans in the state House to vote against the opt-out provision so the bill with a straight mandate wouldn't have a chance of passing.

Crawford, a Republican, said he is not so sure.

"There are exactly two groups of people who can claim they were against this giant overreaching of government -- those who never sponsored the bill and those who were sponsors but subsequently removed their names from the bill when it was explained to be a boondoggle mandating vaccination of little 12-year-old girls against a sexually transmitted disease," Crawford said. "Everyone else was either for the bill or riding the fence trying to claim victory regardless of outcome."

Smith said, "In our view, the opt-out (amendment) did not remove the mandate; it just purported to remove the mandate. That was a position that then-Rep. Haley accepted, and she ultimately voted with other conservatives to not fall for that amendment."

Sheri Few, president of South Carolina Parents Involved in Education and an adviser to Haley's 2010 gubernatorial campaign, said many of the bill's co-sponsors were "misled" by those pushing it.

"Nikki was not the only one misled -- more than a third of Republicans in the House co-sponsored the bill," Few wrote in a statement on Haley's website. "When the facts came to light, even the primary sponsor moved to kill her own bill and it was defeated -- an action that included (Rep.) Haley's vote against it."

Perry's 2007 executive order was repealed two months later by the Texas Legislature, but the issue has been dogging the governor on the presidential campaign trail.

Read more about Perry's HPV executive order

Rep. Michele Bachmann of Minnesota has criticized her opponent in the GOP presidential race for being politically motivated by Merck & Co. Merck, the first company to offer a Food and Drug Administration-approved HPV vaccine, engaged in a well-documented campaign in 2007 to lobby legislators to pass laws that would add the vaccine to the list of required immunizations before attending public school.

The Texas governor denies those allegations, saying his decision to protect females against cancer-causing HPV resulted after meeting a young woman who later died from cervical cancer.

But Perry has admitted that bypassing the Texas Legislature and employing an executive order was a mistake. On Wednesday, speaking to reporters in Virginia, Perry acknowledged the order "should have had an opt-in instead of an opt-out."

The debate over Perry's executive order reminds Smith of the legislative fight in South Carolina more than four years ago. He said he empathized with Perry when the candidate was asked about his 2007 decision in recent debates.

"It was how I felt in 2007 and 2008. We didn't want cervical cancer to take the lives of women, but at the same time, we were militantly opposed to weakening parental rights," Smith said.

Smith, who advocates an "educate but not mandate" approach to the HPV vaccine, said he believes Perry will need to convince voters motivated by social issues that his HPV vaccine decision is an anomaly in his 10-year tenure as governor.

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Reports of Health Concerns Following HPV Vaccination


VAERS Limitations

VAERS data cannot be used to prove a causal association between the vaccine and the adverse event. The only association between the adverse event and vaccination is temporal, meaning that the adverse event occurred sometime after vaccination. Therefore, the adverse event may be coincidental or it may have been caused by vaccination, however we cannot make any conclusions that the events reported to VAERS were caused by the vaccine.


HPV Vaccine Safety

There are two licensed HPV vaccines, Gardasil® and Cervarix®, available to protect against the types of HPV infection that cause most cervical cancers. Gardasil® was licensed for use in females, age 9-26 years in June 2006 and for males age 9-26 years in Oct 2009. Cervarix® was licensed for use in females age 10-25 in October 2009.

The safety of HPV vaccines was studied in clinical trials worldwide before licensure. For Gardasil® , over 29,000 males and females participated in these trials. For Cervarix®, over 30,000 females participated in several clinical trials.

Since licensure, CDC and FDA have been closely monitoring the safety of HPV vaccines. There are 3 systems used to monitor the safety of vaccines after they are licensed and used in the U.S. These systems can monitor adverse events already known to be caused by vaccines, as well as detect rare adverse events that were not identified during pre-licensure clinical trials. The 3 systems are:

The Vaccine Adverse Event Reporting System (VAERS)–a useful early warning public health system that helps CDC and FDA detect possible side effects or adverse events following vaccination.

The Vaccine Safety Datalink (VSD) Project–a collaboration between CDC and 10 health care organizations which monitors and evaluates adverse events following vaccination.

The Clinical Immunization Safety Assessment (CISA) Network– a collaboration between6 academic centers in the U.S. which conduct research on adverse events that might be caused by vaccines.

Reports to VAERS Following Gardasil®

As of June 22, 2011, approximately 35 million doses of Gardasil® were distributed in the U.S. and VAERS received a total of 18,727 reports of adverse events following Gardasil® vaccination: 17,958 reports among females and 346 reports for males, of which 285 reports were received after the vaccine was licensed for males in October 2009. VAERS received 423 reports of unknown gender. Of the total number of VAERS reports following Gardasil®, 92% were considered to be non-serious, and 8% were considered serious.


Non-serious adverse event reports

VAERS defines non-serious adverse events as those other than hospitalization, death, permanent disability, or life-threatening illness.

The vast majority (92%) of the adverse events reports following Gardasil® vaccination have included fainting, pain, and swelling at the injection site (the arm), headache, nausea, and fever. Syncope (fainting) is common after injections and vaccinations, especially in adolescents. Falls after fainting may sometimes cause serious injuries, such as head injuries, which can be prevented by closely observing the person for 15 minutes after vaccination.

Serious adverse event reports

Any VAERS report that indicated hospitalization, permanent disability, life-threatening illness, congenital anomaly or death is classified as serious. As with all VAERS reports, serious events may or may not have been caused by the vaccine.


Guillain-Barré Syndrome (GBS)

Guillain-Barré syndrome (GBS) has been reported after vaccination with Gardasil® . GBS is a rare neurologic disorder that causes muscle weakness. It occurs in 1-2 out of every 100,000 people in their teens. A number of infections have been associated with GBS. There has been no indication that Gardasil® increases the rate of GBS above the rate expected in the general population, whether or not they were vaccinated.

Blood Clots

There have been some reports of blood clots in females after receiving Gardasil®. These clots have occurred in the heart, lungs, and legs. Most of these people had a risk of getting blood clots, such as taking oral contraceptives (the birth control pill), smoking, obesity, and other risk factors.


Deaths

As of June 22, 2011 there have been a total 68 VAERS reports of death among those who have received Gardasil® . There were 54 reports among females, 3 were among males, and 11 were reports of unknown gender. Thirty two of the total death reports have been confirmed and 36 remain unconfirmed due to no identifiable patient information in the report such as a name and contact information to confirm the report. A death report is confirmed (verified) after a medical doctor reviews the report and any associated records. In the 32 reports confirmed, there was no unusual pattern or clustering to the deaths that would suggest that they were caused by the vaccine and some reports indicated a cause of death unrelated to vaccination.

VAERS Reports Following Cervarix®

Since licensed in October 2009, uptake of Cervarix® vaccination in the U.S. has been low. As of June 2011, there have been 39 VAERS reports of adverse events following Cervarix® vaccination in the U.S. The majority of these reports (97%) were considered to be non-serious.

Cervarix® has also been in use in other countries such as England and Europe prior to licensing from the FDA.

Summary

Based on all of the information we have today, CDC recommends HPV vaccination for the prevention of most types of cervical cancer. As with all approved vaccines, CDC and FDA will continue to closely monitor the safety of HPV vaccines. Any problems detected with these vaccines will be reported to health officials, healthcare providers, and the public and needed action will be taken to ensure the public's health and safety.


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Sources: Center For Disease Control.gov, CNN, MSNBC, Youtube, Google Maps

Tea Party vs. GOP Establishment: Romney Vs. Perry & Bachmann (Polls)

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New CNN Poll: GOP divided over tea party movement

The Republican Party is split right down the middle between tea party movement supporters and those who do not support the two-and-a-half-year-old movement, according to a new national survey.

Full results (pdf)

And a CNN/ORC International Poll released Thursday also highlights the differences in demographics, ideology, and temperament between the two camps. According to the survey, on some issues, the two wings of the GOP are in accord, but tea party activists and supporters do not speak for the entire Republican Party on issues such as the deficit, global warming, evolution, abortion, gay marriage, the Federal Reserve, the Department of Education, or Social Security.

"Demographically, the tea party movement seems to hearken back to the 'angry white men' who were credited with the GOP's upset victory in the 1994 midterm elections," says CNN Polling Director Keating Holland. "Ideologically, it effectively boils down to the century-old contest between the conservative and moderate wings of the party."

According to the survey, roughly half (49 percent) of Republicans and independents who lean towards the GOP say they support the tea party movement or are active members, with roughly half (51 percent) saying that they have no feelings one way or another about the tea party or that they oppose the movement.

The poll indicates that demographically, tea party Republicans are more likely to be male, older, and college educated, with non-tea party Republicans more likely to be younger, less educated, female, and less likely to say they are born-again or evangelical. Both groups are predominantly white.

Nearly eight in ten tea party Republicans describe themselves as conservatives, with nearly half of non-tea party Republicans call themselves moderate, or in a few cases, liberal. But the differences are also a matter of temperament: 50 percent of tea party Republicans say they are "very angry" about the way things are going in the country today, compared to just 29 percent of their Republican counterparts.

How does all of that affect their views on the issues of the day?

"One of the biggest differences is on the relative importance of jobs versus the federal deficit. Most tea party Republicans say that Congress and President Barack Obama should pay more attention to the deficit," says Holland. "Most non-tea party Republicans say that reducing unemployment is more important than reducing the deficit."

But the "science" issue is also a strong divider. Nearly six in ten tea party Republicans say that global warming is not a proven fact. Most non-tea party Republicans disagree. Six in ten tea party Republicans say that evolution is wrong. Non-tea party Republicans are split on evolution. Six in ten tea party Republicans say the Department of Education should be abolished, but only one in five of their GOP counterparts holds that same view.

There is also disagreement on social issues: Tea party Republicans are roughly twice as likely to say that abortion should be illegal in all circumstances and roughly half as likely to support gay marriage. Tea party Republicans are also roughly twice as likely to believe that the Social Security system should be replaced, and although most Republicans on either side disagree with the assertion that Social Security is a lie and a failure, tea party GOPers are much more likely to embrace that view.

What will happen to the GOP next year if tea party Republicans don't get their way?

"Nearly half of them say that they are not very likely to support an independent presidential candidate next year - possibly because removing Obama from power is their overwhelming motivation, and they may recognize that bolting the party would ensure his re-election," says Holland.

Eight in ten tea party Republicans say that they would prefer a candidate who can beat Obama over one who agrees with them on top issues, so ideological purity may take a back seat to pragmatic politics in 2012 even if the GOP nominee is not a tea party favorite.

Non-tea party Republicans are somewhat more likely to consider voting for a third-party candidate, and place somewhat less emphasis on beating Obama.

"So it's possible that a bolt from the GOP may come from the moderates rather than the tea party activists and supporters. But there is no way to predict how people will react to inherently unpredictable events, so anything can happen," adds Holland.

The poll was conducted for CNN by ORC International September 9-11, with 446 Republicans and independents who lean towards the GOP questioned by telephone. The survey's overall sampling error is plus or minus 4.5 percentage points.


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Sources: CNN, MSNBC, Roland Martin, Youtube, Google Maps

HPV (Gardasil) Vaccine Linked To 68 Deaths (CDC)! Targeted At Black & Hispanic Girls!

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Reports of Health Concerns Following HPV Vaccination


VAERS Limitations

VAERS data cannot be used to prove a causal association between the vaccine and the adverse event. The only association between the adverse event and vaccination is temporal, meaning that the adverse event occurred sometime after vaccination. Therefore, the adverse event may be coincidental or it may have been caused by vaccination, however we cannot make any conclusions that the events reported to VAERS were caused by the vaccine.


HPV Vaccine Safety

There are two licensed HPV vaccines, Gardasil® and Cervarix®, available to protect against the types of HPV infection that cause most cervical cancers. Gardasil® was licensed for use in females, age 9-26 years in June 2006 and for males age 9-26 years in Oct 2009. Cervarix® was licensed for use in females age 10-25 in October 2009.

The safety of HPV vaccines was studied in clinical trials worldwide before licensure. For Gardasil® , over 29,000 males and females participated in these trials. For Cervarix®, over 30,000 females participated in several clinical trials.

Since licensure, CDC and FDA have been closely monitoring the safety of HPV vaccines. There are 3 systems used to monitor the safety of vaccines after they are licensed and used in the U.S. These systems can monitor adverse events already known to be caused by vaccines, as well as detect rare adverse events that were not identified during pre-licensure clinical trials. The 3 systems are:

The Vaccine Adverse Event Reporting System (VAERS)–a useful early warning public health system that helps CDC and FDA detect possible side effects or adverse events following vaccination.

The Vaccine Safety Datalink (VSD) Project–a collaboration between CDC and 10 health care organizations which monitors and evaluates adverse events following vaccination.

The Clinical Immunization Safety Assessment (CISA) Network– a collaboration between6 academic centers in the U.S. which conduct research on adverse events that might be caused by vaccines.

Reports to VAERS Following Gardasil®

As of June 22, 2011, approximately 35 million doses of Gardasil® were distributed in the U.S. and VAERS received a total of 18,727 reports of adverse events following Gardasil® vaccination: 17,958 reports among females and 346 reports for males, of which 285 reports were received after the vaccine was licensed for males in October 2009. VAERS received 423 reports of unknown gender. Of the total number of VAERS reports following Gardasil®, 92% were considered to be non-serious, and 8% were considered serious.


Non-serious adverse event reports

VAERS defines non-serious adverse events as those other than hospitalization, death, permanent disability, or life-threatening illness.

The vast majority (92%) of the adverse events reports following Gardasil® vaccination have included fainting, pain, and swelling at the injection site (the arm), headache, nausea, and fever. Syncope (fainting) is common after injections and vaccinations, especially in adolescents. Falls after fainting may sometimes cause serious injuries, such as head injuries, which can be prevented by closely observing the person for 15 minutes after vaccination.

Serious adverse event reports

Any VAERS report that indicated hospitalization, permanent disability, life-threatening illness, congenital anomaly or death is classified as serious. As with all VAERS reports, serious events may or may not have been caused by the vaccine.


Guillain-Barré Syndrome (GBS)

Guillain-Barré syndrome (GBS) has been reported after vaccination with Gardasil® . GBS is a rare neurologic disorder that causes muscle weakness. It occurs in 1-2 out of every 100,000 people in their teens. A number of infections have been associated with GBS. There has been no indication that Gardasil® increases the rate of GBS above the rate expected in the general population, whether or not they were vaccinated.

Blood Clots

There have been some reports of blood clots in females after receiving Gardasil®. These clots have occurred in the heart, lungs, and legs. Most of these people had a risk of getting blood clots, such as taking oral contraceptives (the birth control pill), smoking, obesity, and other risk factors.


Deaths

As of June 22, 2011 there have been a total 68 VAERS reports of death among those who have received Gardasil® . There were 54 reports among females, 3 were among males, and 11 were reports of unknown gender. Thirty two of the total death reports have been confirmed and 36 remain unconfirmed due to no identifiable patient information in the report such as a name and contact information to confirm the report. A death report is confirmed (verified) after a medical doctor reviews the report and any associated records. In the 32 reports confirmed, there was no unusual pattern or clustering to the deaths that would suggest that they were caused by the vaccine and some reports indicated a cause of death unrelated to vaccination.

VAERS Reports Following Cervarix®

Since licensed in October 2009, uptake of Cervarix® vaccination in the U.S. has been low. As of June 2011, there have been 39 VAERS reports of adverse events following Cervarix® vaccination in the U.S. The majority of these reports (97%) were considered to be non-serious.

Cervarix® has also been in use in other countries such as England and Europe prior to licensing from the FDA.

Summary

Based on all of the information we have today, CDC recommends HPV vaccination for the prevention of most types of cervical cancer. As with all approved vaccines, CDC and FDA will continue to closely monitor the safety of HPV vaccines. Any problems detected with these vaccines will be reported to health officials, healthcare providers, and the public and needed action will be taken to ensure the public's health and safety.


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Sources: Center For Disease Control.gov, CNN, MSNBC, Youtube, Google Maps

GOP 2012 Candidates NOT Interested In JOBS During CNN's Tea Party Debate!

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Quote of the Day: Axelrod on why GOP debate lacked real substance

David Axelrod, senior strategist for President Obama's re-election campaign:

“I think if you are an independent voter watching that debate last night, you’d kind of scratch your head and say ‘How can we spend 10 minutes talking about whether we should have created Social Security and not one minute on education?’ ‘How can we spend all this time talking about the inoculation program in Texas and not talk about how we get research development and innovation going in this country?’ There was nothing there. The only thing they seem to agree on is that we ought to roll back Wall Street reforms and give Wall Street the right to write its own rules again, and I don’t think anyone believes that’s the answer to our economic problems."


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Sources: CNN, The Guardian, MSNBC, Google Maps

H1N1 Flu Children's Vaccine Doses Recalled

Some H1N1 vaccine doses recalled. Health officials are recalling 800,000 doses of the swine flu vaccine. The doses, manufactured by Sanofi Pasteur, are pre-filled syringes intended for young children six months up to age three.

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800,000 doses of kids’ H1N1 vaccine recalled


Hundreds of thousands of swine flu shots for children have been recalled because tests indicate the vaccine doses lost some strength, government health officials said Tuesday.

The shots, made by Sanofi Pasteur, were distributed across the country last month and most have already been used, according to the Centers for Disease Control and Prevention. The 800,000 pre-filled syringes that were recalled are for young children, ages 6 months to nearly 3 years.

Dr. Anne Schuchat, a CDC flu expert, stressed that parents don't need to do anything or to worry if their child got one — or even two — of the recalled shots. The vaccine is safe and effective, she said.

The issue is the vaccine's strength. Tests done before the shots were shipped showed that the vaccines were strong enough. But tests done weeks later indicated the strength had fallen slightly below required levels.

Why the potency dropped isn't clear. "That's the $64,000 question," said Len Lavenda, a Sanofi Pasteur spokesman.

Young children are supposed to get two doses, spaced about a month apart. Health officials don't think children need to get vaccinated again, even if they got two doses from the recalled lots, said Schuchat.

Swine flu vaccine has been available since early October, and since then manufacturers have released about 95 million doses for distribution in the United States.

The recalled shots were made by Sanofi Pasteur, the vaccines division of France-based Sanofi-Aventis Group. The vaccine all tested fine when it was shipped out earlier this fall. But last week, testing of one lot showed that the potency had fallen about 12 percent below the government standard, Lavenda said.

The company found three other lots with diminished strength. It notified government health officials and did a voluntary recall, asking doctors to return any unused doses. The vaccine has been in high demand and the company doesn't expect to see much come back, Lavenda added.

Officials with the Food and Drug Administration, the CDC and the company all said they believe the strength of the recalled doses is still high enough to protect children against the virus. No potency problem has been detected in the same vaccine packaged in other types of syringes or vials, Lavenda said.

Experts have a theory that the problem is specific to the children's pre-filled syringes. For some reason, the antigen — the key vaccine ingredient — may be sticking to the walls of those syringes, said Dr. Jesse Goodman, the FDA's deputy commissioner for science and public health.

Another manufacturer, Novartis, in February recalled five lots of seasonal flu vaccine packed in pre-filled syringes under similar circumstances.

Sanofi Pasteur bills itself as the No. 1 manufacturer of flu vaccines in the world. It makes flu vaccine at sites in France and in Pennsylvania.

Swine flu was first identified in April. During the first seven months of the pandemic, it has sickened about 50 million Americans and killed about 10,000, according to CDC estimates.


Sources: MSNBC, CDC

H1N1 Flu Vaccine Went To Wall Street First...Voters Want To Know Why

Wall Street gets H1N1 Flu vaccine first before high risk citizens and children. Now Voters want to know why.

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Chris Dodd rips bankers bogarting H1N1 shots


A senior Senate Democrat is demanding answers from federal officials on why they sent swine-flu vaccines to bankers at Goldman Sachs, rather than to the schoolchildren who really need them.

“It is hard to believe that at a time when even the most vulnerable in our society are unable to obtain H1N1 vaccinations, the government is sending doses to private firms on Wall Street,” Sen. Chris Dodd (D-Conn.) said in a statement. “People are frustrated by the government’s response to this crisis, and with news like this, who can blame them? “

“Vaccines should go to people who need them most, not people who happen to work on Wall Street,” said Dodd, who’s also readying financial reform legislation that Wall Street won’t like.

Dodd sent a letter to Secretary of Health and Human Services Kathleen Sebelius, demanding she review her policies to make sure that “healthy stockbrokers” aren’t getting the H1N1 vaccine doses meant for “pregnant women and school children.” He also told Wall Street firms to immediately send back their stash.

“Schools in my state have closed; hospitals and health clinics report widespread shortages. It is shocking to think that private firms would be prioritized ahead of hospitals when the vaccine supply cannot meet the demand,” Dodd said in the letter.

News reports of that large, private employers in New York City – including Wall Street banks – and been sent of the scarce H1N1 vaccines set of a feeding frenzy Thursday. The Service Employees Union International jumped into the fray early, issuing a public call for the Wall Street fat cats to donate their doses to public hospitals.

“It’s bad enough that Wall Street crashed our economy and is back to paying out platinum bonuses after taking trillions in taxpayer-funded bailouts and backstops. But purposely endangering the health of millions of Americans during a public health crisis crosses all lines of decency,” the union’s secretary-treasurer Anna Burger said in a statement.





Flu shots for Wall Street stirs ire in New York

New York City health officials scrambled to explain themselves on Thursday in the wake of media reports about bankers who got scarce H1N1 flu vaccines through their employers.

Members of Congress fired off letters demanding immediate explanations and the U.S. Centers for Disease Control and Prevention reminded state and city health officers of the need to make sure the most vulnerable people get shots first.

"I am concerned that the distribution of the vaccine is resulting in favored treatment for the privileged," New Jersey Democratic Representative Frank Pallone said.

A shortage of H1N1 vaccines has frayed nerves, and public health departments across the country say they will not be able to meet the bulk of the demand until December or January.

The CDC estimates swine flu has infected more than five million people and it is documented as having killed 1,000.

The federal government, which is buying the vaccines and distributing them for free to 62 state and city health departments, says 35.6 million doses have been made and packaged since production began.

Connecticut Sen. Chris Dodd, a Democrat, released a letter to Health and Human Services Secretary Kathleen Sebelius saying he was "stunned" at the reports.

"I implore you to use whatever authorities you have to ensure that H1N1 vaccines already distributed but not yet used are promptly redirected to hospitals, schools, community health clinics, school-based health clinics, and pediatricians so that they can be made immediately available to at-risk members of the public as identified by the Department," Dodd wrote.

CDC Director Dr. Thomas Frieden sent out a reminder to state and city health departments that distribute vaccine.

"I ask each of you to review your plans immediately and work to ensure that the maximum number of doses is delivered to those at greatest risk as rapidly as possible," he wrote.

"I especially appreciate the many innovative ways you've found to reach them, including school-located vaccine clinics, special clinics for pregnant women, outreach to children with special needs, and making vaccine available to community- and faith-based organizations serving these high-risk populations."

Close to 160 million people are in the priority groups to get vaccine first -- healthcare workers, pregnant women, children and adults under 65 with medical conditions, caregivers for infants too young to be vaccinated and people 24 and younger.

"When H1N1 vaccine first became available in the fall, we directed all available doses to pediatricians, OB-GYNs, community health centers, public and private hospitals," New York City health department spokeswoman Jessica Scaperotti said in a telephone interview.

"As more vaccine became available we started to place small orders to providers that serve adults, including employee health centers."

She said the city had given 800,000 doses to about 1,100 providers, with Lenox Hill Hospital, for example, getting 1,200 doses and banking firm Goldman Sachs getting 200 of the 5,300 doses it asked for, Scaperotti said.

She said 16 of the city's 25 biggest employers had vaccine, including Columbia University, Citi Group and others, as well as the Federal Reserve Bank, which is not among the top 25 employers.

Morgan Stanley said it received 500 doses of the vaccine for its New York City locations and 500 doses for its Westchester location in suburban New York.

"We never thought we would receive doses ahead of area hospitals and once this was brought to our attention, we promptly donated the doses we received to a few area hospitals," including Morgan Stanley Children's Hospital in New York, a company spokeswoman said.



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Nurse Refuses To Get Swine Flu Shot...Not Very Encouraging

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Sources: MSNBC

H1N1 Flu Vaccine Shortage Frustrates Doctors...Lives Are At Stake!

(Doctors are becoming extremely frustrated with the H1N1 Flu vaccine shortages and delays. Lives are at stake!)

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(US Dept of HHS Kathleen Sebelius states that H1N1 Flu Production is picking up.)

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Sources: MSNBC

Pres. Obama Declares H1N1 Flu National Emergency!

(National Emergency: President Obama signed a proclamation that would allow medical officials to bypass certain federal requirements. MSNBC's Alex Witt reports.)

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Pres. Obama declares H1N1/ Swine Flu national emergency

President Barack Obama has signed a proclamation declaring swine flu a national emergency, the White House said Saturday.

"In keeping with the administration's proactive approach to H1N1 Flu, President Obama last night signed a proclamation declaring 2009-H1N1 Influenza a national emergency," it said in a statement. "The proclamation enhances the ability of our nation's medical treatment facilities to handle a surge in H1N1 patients by allowing, as needed, the waiver of certain standard federal requirements on a case-by-case basis."

Officials described the move as similar to a declaration ahead of a hurricane making landfall.

On Friday, federal health officials said more Americans have been vaccinated against seasonal flu this fall than ever before by this time of year.

Sixty million people have gotten the winter flu vaccine — probably because they're paying more attention to flu warnings in general, thanks to swine flu. It's an unprecedented number of seasonal flu shots for October; most usually aren't given until later in the fall.

Part of it is due to supply: There are already 85 million doses of seasonal flu vaccine available, a much larger amount than usual for this early in the fall. Most years, roughly 100 million doses are used during the season.

But a big factor probably is that swine flu is drawing attention to public health warnings that seasonal flu is also a deadly illness that can be prevented through vaccinations, said Joe Quimby, a spokesman for the U.S. Centers for Disease Control and Prevention.

"There's been a heightened awareness in the American public due to H1N1 this year," said Quimby.

More widespread than ever

Swine flu is also more widespread now than it's ever been, and has resulted in more than 1,000 U.S. deaths so far.

Flu illnesses are as widespread now as they are at the winter peak of normal flu seasons, CDC Director Dr. Thomas Frieden told reporters Friday. "To be basically in the peak of flu season in October is extremely unusual," he said.

"We expect that influenza will occur in waves and we can't predict how high, how far or how long the wave will go or when the next will come," he added.

"Many millions" of Americans have had swine flu so far, according to an estimate he gave at a Friday press conference. The government doesn't test everyone to confirm swine flu so it doesn't have an exact count.

Frieden updated some other estimates, too, saying there have been more than 20,000 hospitalizations.

Nearly 100 swine flu deaths in children have been reported, CDC officials also said.

Forty-six states now have widespread flu activity. The only states without widespread flu are Connecticut, Hawaii, New Jersey and South Carolina. There are at least two different types of flu causing illnesses; tests from about 5,000 patients suggest that nearly all the flu cases are swine flu.

Frustrating production delays

This year's seasonal flu vaccine won't protect against swine flu; a separate swine flu vaccine is needed. Vaccine production takes several months, and the work on seasonal vaccine was already well under way when swine flu was first identified in April. It was too late for the swine flu virus to be included in the seasonal doses.

Because of swine flu vaccine production delays, the government has backed off initial, optimistic estimates that as many as 120 million vaccine doses would be available by mid-October. As of Wednesday, only 11 million doses had been shipped to health departments, doctor's offices and other providers across the country, CDC officials said.

"It's frustrating to all of us. We wish there were more vaccine available," Frieden said.

The flu virus has to be grown in chicken eggs, and the yield hasn't been as high as was initially hoped, CDC officials explained. "Even if you yell at them, they don't grow faster," Frieden said.

He added that 5 million new doses became available in the past week, and vaccine should be more plentiful soon.

Much of the vaccine currently available is a nasal spray from AstraZeneca's unit MedImmune.

The Obama administration has ordered vaccine from five manufacturers: Sanofi-Aventis SA, CSL Ltd, Novartis AG, GlaxoSmithKline and AstraZeneca's MedImmune.

Global figures

Also Friday, the World Health Organization reported more than 414,000 laboratory confirmed cases of H1N1 worldwide, with nearly 5,000 deaths.

But the Geneva-based health agency noted that the figures were only the tip of the iceberg.

"As many countries have stopped counting individual cases, particularly of milder illness, the case count is significantly lower than the actual number of cases that have occurred," WHO said.

Sources: MSNBC

Florida's H1N1 Flu Death Panels...Deciding To Let Some Patients Die

(Florida Health Care Professionals are discussing that it may be wise to intentionally let some H1N1 Flu patients die if they are too sick. Isn't this a form of the "Death Panels" concept?)

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(The Center for Disease & Control warns citizens that the rapid H1N1 Flu test is not reliable.)

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Florida plan advises hospitals to bar some patients in event of severe flu pandemic

Florida health officials are drawing up guidelines that recommend barring patients with incurable cancer, end-stage multiple sclerosis and other conditions from being admitted to hospitals if the state is overwhelmed by flu cases.

The plan, which would guide Florida hospitals on how to ration scarce medical care during a severe flu outbreak, also calls for doctors to remove patients with poor prognoses from ventilators to treat those who have better chances of surviving. That decision would be made by the hospital.

The flu causes severe respiratory illnesses in a small percentage of cases, and patients who need ventilators and are deprived of them could die without the breathing assistance the machines provide.

In June, Florida Surgeon General Ana M. Viamonte Ros sent the draft guidelines — which had already undergone a series of internal revisions — to 16 state medical organizations for their feedback.

But the state has not yet publicized the guidelines or solicited input from the general public. The Florida Department of Health released a copy of the draft plan at the request of ProPublica, a nonprofit news organization, which provided it to the Sun Sentinel.

The document addresses one of the most heart-rending issues in medicine: What to do if the number of people in need of ventilators and other treatment dramatically exceeds what is available.

The goal, the plan says, is to focus care on patients whose lives could be saved and who would be most likely to improve. While it says those decisions are not to be made based on patients' perceived social worth or role, the plan calls for different rules for some populations.

The list of conditions that disqualify hospital admission would be applied to most people only in the two most severe levels of a pandemic. However, they would also be applied in the first level ofa pandemic for patients transferred to hospitals from "other institutional facilities," such as nursing homes and mental health facilities.

Florida's planning effort reflects a growing acknowledgment that hospitals across the nation would be unable to cope with the flood of patients that a severe influenza pandemic, like the one that gripped the nation in 1918, would unleash. That resource gap is in the spotlight now, as the country is battered by a second wave of pandemic swine flu, also known as the H1N1 virus.

"What we have seen are real stresses, particularly on the emergency departments," Thomas Frieden, commissioner of the Centers for Disease Control and Prevention, said at a press conference last week.

The H1NI virus is much milder than the 1918 flu, but a small proportion of H1N1 patients, including some who have no risk factors and are young and healthy, develop severe breathing problems requiring mechanical ventilation and life support.

So far, intensive care units in the U.S. haven't been overwhelmed with people needing ventilators.

"That's something that we're tracking closely," Frieden said.

In Winnipeg, Canada, all regional critical care beds were full at the peak of the outbreak last spring, and in Mexico, patients experienced long delays before being admitted to ICUs. Four died before being transferred from the emergency room.

Florida health officials believe that the number of severely ill flu patients will likely remain at a manageable level, provided residents get vaccinated, that they know when to stay home and when to seek medical care (visit myflusafety.com or call 877-352-3581 for information), and that the existing flu strain does not mutate into a more virulent form.

In the case of a much severer scenario, Florida's draft guidelines call for hospitals to turn away anyone whose doctor has signed a "Do Not Resuscitate" order, which instructs rescuers not to revive a patient whose heartbeat or breathing stops.

A recent report from a panel of national experts convened by the Institute of Medicine urged states not to use DNR orders for this purpose, because they reflect preferences about end-of-life planning "more than an accurate estimate of survival."

The Florida plan also calls for intensive care unit patients and those using ventilators to be reassessed after 48 to 72 hours.

Those whose chances of survival have significantly worsened would be taken off the machines or discharged from critical care to make way for others who may have a better chance of survival. If needed, they would be given palliative care to keep them comfortable.

One goal of Florida's plan is to "reduce or eliminate" the legal liability of health care workers who, in good faith, deny or withdraw treatment from some patients in an emergency. The plan includes sample executive orders that the governor could issue to shield workers and authorize hospitals to implement the guidelines.

The draft document also outlines how the health care system should stretch critical resources before moving to ration care.

The guidelines suggest reusing supplies, canceling surgeries that are not absolutely necessary, training staff to perform additional tasks and drawing on stockpiles. The general public's responsibilities include treating certain sick family members at home and monitoring public health messages.

Florida's draft guidelines aim to provide the "greatest good for the greatest number" when doing the best for all patients is no longer possible.

That goal needs to be balanced with an effort to distribute scarce resources in the least discriminatory way, said professor Ken Goodman, who directs the University of Miami bioethics program and the Florida Bioethics Network.

"Among the ways we can do that is to somehow take the evidence about what we think works and bolt it to the values that I think are uncontroversially shared: Namely, life is good, suffering is bad."

He said that methods included in the draft are still imperfect: "It's a very difficult problem to figure out how the world of science can help ensure that our strategies for allocating resources are fair and effective."

Viamonte Ros will have final approval authority and the plan will remain voluntary and subject to review, according to Doc Kokol, the health department's information officer.

The Florida health department's original goal was to have a final draft of the plan ready by December.

But with public health workers scrambling to cope with other aspects of the H1N1 pandemic, that is now unlikely, state officials said.

"People would like to have that policy," said Goodman, who chaired an ethics meeting on these issues at Jackson Memorial Hospital in Miami last week. He said that staff at the hospital have drawn up their own draft plan to cope with a potential surge of patients needing care. Florida plans to accept public input after the guidelines are revised by health officials. Kokol wrote in an e-mail that that "will likely include regional meetings for public input as well as electronic receipt of comments."

In many states, that type of input has been largely absent. Groups of doctors, lawyers and ethicists have hammered out the plans with little engagement with the public or with groups that represent children, the elderly and those with chronic illnesses or disabilities.

When Utah tested a similar plan in late August, the drill revealed difficulties that Florida clinicians and patients are likely to encounter.

Utah family physician Pete DeWeerd had to tell a mock patient's mother that her 7-year-old daughter, who had cerebral palsy and was suffering from the flu, would be turned away from the hospital and likely die.

"I don't like to tell you this," he said he told her, "it feels unfair, but our list is our list is our list." He added: "It was awful. You get a huge lump in your throat."

Dr. Tom Kurrus, medical director of St. Mark's Hospital in Salt Lake City, called it "emotionally draining" when mock patients and family members yelled, screamed and took issue with who was denied treatment.

"The major weakness in our preparedness had to do with security," he said.

Kurrus said that although the exercise was covered widely in Utah's media, the public isn't aware that the disaster plans call for rationing.

"Even with the scenarios played out and the discussions entertained, they still don't understand," he said. "It's, 'Why can't I get into the hospital, why can't grandma get put on a respirator?'"

Goodman, the University of Miami ethicist, said open conversation about the complex, value-laden decisions that will determine who receives treatment in the most extreme circumstances is crucial, and that hospital, state or federal guidelines should always be subject to revision.

"This should be an ongoing process that includes new evidence as it becomes available and that includes, in an open society, the participation of citizens," he said.



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Sources: MSNBC, Politico, Sun Sentinel.com, CDC, Google Maps