The H1N1 vaccine campaign is gradually picking up speed in Minnesota, but health officials fear that the doses may be arriving too late for some people who think the worst of the outbreak has passed.
The level of influenza-like illness dipped last week in many areas of the state. Schools reported fewer absences and more than two-dozen clinics that monitor outbreaks say their flu cases dropped significantly.
Public health officials say these could be signs that H1N1 has peaked, but they aren't sure. So they are still recommending that people get vaccinated against the virus.
"It's good news to see the school-based outbreaks decreasing," said Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota. "But we've also seen in some cases that adult cases tend to actually lag behind in terms of their peak from school kids."
That may not matter much though to people who are fatigued by their search for the H1N1 vaccine. The worry is that they'll give up their search if it takes much longer to get vaccine. By some estimates, only 40 percent of the vaccine that was projected by this date has actually arrived in the state.
Osterholm said it's not anyone's fault that the vaccine couldn't be made more quickly. But, he said it was a mistake to give people such rosy predictions about the number of doses that would be available this fall.
"I think for too long we approached this more like a campaign as opposed to an information effort," he said. "As such, we told people we were going to have a lot more vaccine than we really should have at the government level. That's been the problem. We've really left people hanging out there thinking there was going to be a lot more and I'm not surprised where we're at."
“I think for too long we approached this more like a campaign as opposed to an information effort.”Michael Osterholm
So far Minnesota has ordered more than 460,000 doses of vaccine from its share of the federal supply. The manufacturers ship it directly to private clinics and hospitals, but due to the limited supply of the vaccine the Health Department has hand-picked some of the hospitals that received doses.
The agency has been using a random lottery system to select sites from among thousands of clinics. The system factors in geographic location to make sure the doses are spread equitably around the state.
The Health Department's decisions are based on immunizing certain priority groups first including young kids, people with health conditions including pregnancy, health care workers and caretakers of infants less than 6 months of age.
Some states have taken a different approach to distributing their vaccine. Until this week, Wisconsin allowed some of its mass public clinics to dole out vaccine on a first come, first served basis - meaning that clinics didn't have to distinguish between people in the high-risk priority groups and those who were lower on the priority list.
The state changed its policy after it received a lot less vaccine than expected. Now they are recommending that public vaccine clinics turn away folks who are not in priority groups for at least the next few weeks.
In Minnesota, there are tentative plans to open some public vaccination clinics the week of November 16. Many counties say they are finalizing date and location details for clinics that would serve kids age 6 months to 9 years old.
"If supplies aren't adequate then we will put this on hold," said epidemiologist Kris Ehresmann, director of infectious disease at the Minnesota Department of Health. Ehresmann said the number of doses available for the public clinics will be limited at first.
"So we will likely have to work with counties to do some sort of randomization," she said. "As with all the other vaccination efforts we will keep filling in as more vaccine becomes available."
About 80 percent of the vaccine that's expected to be available to counties that week will be FluMist, which can only be used in healthy people. Kids under two or those with asthma and other medical conditions might have a hard time finding a public clinic that's offering the injectable version of the vaccine.
Information about the public clinics should start filtering out in the next few days. Public health officials want to get the message out quickly so people don't start losing interest in the vaccine.
Many of the counties say they will post information on their Web sites as soon as the clinic details are finalized. The state Health Department is also planning to keep an updated list of public vaccination clinics on its Web site.