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H1N1 Vaccine Production Lagging Behind Expectations. Limited Initial Supply Means Priority Groups Go to Front of Line for Immunizations
American Family Physician, 08/21/09

Mitchell D – The CDC told its Advisory Committee on Immunization Practices, or ACIP, in late July that it hoped to have 120 million doses of vaccine for the novel influenza A (H1N1) virus available by October. Manufacturing issues, however, have slowed production of the new vaccine, and federal officials now expect only about 45 million doses to be available by mid–October. The ACIP planned for such circumstances during its July meeting, recommending that several groups receive the vaccine before others if supply is limited:

• pregnant women,
• people who live with or care for children younger than
• 6 months of age,
• care and emergency services personnel who have direct patient contact,
• children ages 6 months to 4 years, and
• children ages 5 to 18 years who have chronic medical conditions.

CDC officials have said the prioritized groups include about 42 million people. Physicians should take time to identify health care workers and patients in their practices who fall into priority groups. When vaccine becomes more widely available, in addition to the groups listed above, all health care and emergency services personnel receive the vaccine, as well as individuals 4–24 years of age and individuals 25–64 years of age who are at increased risk from novel H1N1 because of chronic health conditions or compromised immune systems. All of the recommended groups together include about 159 million people. Supply and demand also will be affected by how many doses are called for and how much antigen per dose is needed. The H1N1 vaccine is expected to be administered as a two–dose series, but clinical trials are ongoing to address that issue, as well as to determine whether or not adjuvant will need to be used to increase the vaccine's immunogenicity.

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