FarmerJohn
Has No Life - Lives on TB
65? Back of the Line for the Swine Flu Vaccine, Pal
Life is unfair. Or, at least, it sure can look that way.
Related
For example, consider this: Who of these four is first in line for a swine flu shot:
1. A great-grandmother in a nursing home with lung problems?
2. A hospital cafeteria worker being treated for AIDS?
3. An overweight department-store Santa with a line of children waiting for his lap?
4. A healthy Wall Street banker whose trophy wife is pushing a new baby in a $600 Bumbleride jogging stroller?
Answer: The banker.
Normal flu seasons have accustomed Americans to an “old people first” ethic, but swine flu has reversed that. It’s pregnant women and children first, and in the rush for the lifeboats, elbows are beginning to fly.
Mostly, as in any panic, confusion has reigned. Older people are still first in line for seasonal flu shots, but all the media attention has been on swine flu. Both kinds of shots are in short supply. More swine vaccine is being made, but slowly. All the seasonal vaccine has already been made — but much of it was taken up by middle-aged people who didn’t know one shot from another and bared their arms for any available needle.
Now that the health authorities are cracking down on the swine flu vaccine and real triage has begun, some older Americans are finding the new realities pretty harsh. Breathing problems and heart conditions are common among people over 50, and some have been calling their Congressmen to complain. Those older Americans and their advocates point to studies indicating that elderly people rarely catch swine flu but, when they do, their outcomes are just as grim as they are for seasonal flu, which kills 36,000 mostly elderly people a year.
“We’re not used to this in the U.S.,” said Jeffrey Levi, executive director of Trust for America’s Health, a nonpartisan group that works to prevent epidemics, and who testified before Congress last week, essentially defending the Centers for Disease Control and Prevention’s choices. “When there’s a limited supply of a scarce resource, you have to give it to those who are most at risk and who will benefit the most.”
So why the banker? He gets the shot not for his sake — many Americans would be pleased to see him roast on a spit — but to save his baby. Infants under six months old are at very high risk but too young for a flu shot.
The hospital employee does not have direct patient contact; if he is taking his anti-AIDS drugs, his immune system is not suppressed. And even if Santa is morbidly obese — though that could create a lap problem — he is presumably over 18.
And the great-grandmother? She was born before 1957, probably caught H1N1 flus several times growing up, and may still have protective antibodies. True, if she is unlucky enough to catch swine flu anyway, she is at risk. But public health is a numbers game and her probability is low. Also, flu shots don’t protect the aged well, since their immune systems may be too weak to build new antibodies. Studies suggest it is more effective to inoculate their nurses and visitors.
On the AARP Web site, some people are complaining. “I’m 70 and my wife is 69 and we are last on the list for H1N1. I thought there was no death panels,” wrote one.
But Dr. J. T. Howell, a geriatric specialist in Bucks County, Pa., said most of his older patients were taking their back-of-the-line status in stride.
“There’s been, if anything, a little more concern about lack of ability to get the regular seasonal vaccine, which has also been in short supply in our area,” he said. “But, again, they’re doesn’t seem to be a great deal of concern with respect to H1N1.”
The ground for all these decisions was laid on July 29, when the C.D.C. released guidelines saying which Americans should be first in line.
The first swipe at the problem comprised 159 million Americans — half the population. It included everyone under 25, all health care workers and everyone of any age with heart or lung problems, diabetes, obesity or a list of other ills.
Now, just as the pandemic’s fall wave has peaked, there are only 42 million doses of swine flu vaccine to go around — by coincidence, the same number that the C.D.C. said were at top risk and should be the first of the first should there be a shortage of the vaccine. They are pregnant women, people caring for infants less than six months old, health care workers with direct patient contact, children six months through 4 years old and children 5 through 18 with chronic medical problems.
Who was left out in the narrower reslicing of the cake? Everyone over age 18, unless they are pregnant, have an infant at home or treat patients.
That means that about 117 million Americans have been told: Yes, you are officially at risk. Please step to the rear anyway until more of this slow-growing vaccine is ready.
Some understand; many are upset. They want their shot, or they want someone’s head to roll. Politicians are responding to their anger, dragging health officials before Congress to explain their priorities.
“We just have to tolerate the fact that these decisions are not going to satisfy some folks,” said Dr. William Schaffner, director of preventive medicine at Vanderbilt University’s medical school and a member of the C.D.C. advisory committee that picked the guidelines.
“Some people are going to be waving their hands and saying ‘What about us?’ and some are going to be grumpy,” he said. “You just have to tell them — hold tight, wash your hands, avoid sick people, rent a movie instead of going out, and wait for more vaccine to be made.”
And, while the elderly and sick may feel vulnerable, they also often have a sense of self-sacrifice.
A few years ago, preparing for a possible pandemic of fatal bird flu, the C.D.C. held focus groups around the country to set vaccine priorities. Some were composed mostly of seniors.
Janice Zalen, director of special programs at the American Health Care Association, which represents 11,000 nursing homes, recalled the reaction.
While nearly everyone wanted the shots if there were plenty, she said, “The elderly said, ‘Well, if it comes down to it, if there aren’t enough, I don’t need it — give it to my grandson.’ ”
http://www.nytimes.com/2009/11/22/weekinreview/22mcneil.html?scp=5&sq=Donald G. McNeil, Jr.&st=cse
Life is unfair. Or, at least, it sure can look that way.
Related
For example, consider this: Who of these four is first in line for a swine flu shot:
1. A great-grandmother in a nursing home with lung problems?
2. A hospital cafeteria worker being treated for AIDS?
3. An overweight department-store Santa with a line of children waiting for his lap?
4. A healthy Wall Street banker whose trophy wife is pushing a new baby in a $600 Bumbleride jogging stroller?
Answer: The banker.
Normal flu seasons have accustomed Americans to an “old people first” ethic, but swine flu has reversed that. It’s pregnant women and children first, and in the rush for the lifeboats, elbows are beginning to fly.
Mostly, as in any panic, confusion has reigned. Older people are still first in line for seasonal flu shots, but all the media attention has been on swine flu. Both kinds of shots are in short supply. More swine vaccine is being made, but slowly. All the seasonal vaccine has already been made — but much of it was taken up by middle-aged people who didn’t know one shot from another and bared their arms for any available needle.
Now that the health authorities are cracking down on the swine flu vaccine and real triage has begun, some older Americans are finding the new realities pretty harsh. Breathing problems and heart conditions are common among people over 50, and some have been calling their Congressmen to complain. Those older Americans and their advocates point to studies indicating that elderly people rarely catch swine flu but, when they do, their outcomes are just as grim as they are for seasonal flu, which kills 36,000 mostly elderly people a year.
“We’re not used to this in the U.S.,” said Jeffrey Levi, executive director of Trust for America’s Health, a nonpartisan group that works to prevent epidemics, and who testified before Congress last week, essentially defending the Centers for Disease Control and Prevention’s choices. “When there’s a limited supply of a scarce resource, you have to give it to those who are most at risk and who will benefit the most.”
So why the banker? He gets the shot not for his sake — many Americans would be pleased to see him roast on a spit — but to save his baby. Infants under six months old are at very high risk but too young for a flu shot.
The hospital employee does not have direct patient contact; if he is taking his anti-AIDS drugs, his immune system is not suppressed. And even if Santa is morbidly obese — though that could create a lap problem — he is presumably over 18.
And the great-grandmother? She was born before 1957, probably caught H1N1 flus several times growing up, and may still have protective antibodies. True, if she is unlucky enough to catch swine flu anyway, she is at risk. But public health is a numbers game and her probability is low. Also, flu shots don’t protect the aged well, since their immune systems may be too weak to build new antibodies. Studies suggest it is more effective to inoculate their nurses and visitors.
On the AARP Web site, some people are complaining. “I’m 70 and my wife is 69 and we are last on the list for H1N1. I thought there was no death panels,” wrote one.
But Dr. J. T. Howell, a geriatric specialist in Bucks County, Pa., said most of his older patients were taking their back-of-the-line status in stride.
“There’s been, if anything, a little more concern about lack of ability to get the regular seasonal vaccine, which has also been in short supply in our area,” he said. “But, again, they’re doesn’t seem to be a great deal of concern with respect to H1N1.”
The ground for all these decisions was laid on July 29, when the C.D.C. released guidelines saying which Americans should be first in line.
The first swipe at the problem comprised 159 million Americans — half the population. It included everyone under 25, all health care workers and everyone of any age with heart or lung problems, diabetes, obesity or a list of other ills.
Now, just as the pandemic’s fall wave has peaked, there are only 42 million doses of swine flu vaccine to go around — by coincidence, the same number that the C.D.C. said were at top risk and should be the first of the first should there be a shortage of the vaccine. They are pregnant women, people caring for infants less than six months old, health care workers with direct patient contact, children six months through 4 years old and children 5 through 18 with chronic medical problems.
Who was left out in the narrower reslicing of the cake? Everyone over age 18, unless they are pregnant, have an infant at home or treat patients.
That means that about 117 million Americans have been told: Yes, you are officially at risk. Please step to the rear anyway until more of this slow-growing vaccine is ready.
Some understand; many are upset. They want their shot, or they want someone’s head to roll. Politicians are responding to their anger, dragging health officials before Congress to explain their priorities.
“We just have to tolerate the fact that these decisions are not going to satisfy some folks,” said Dr. William Schaffner, director of preventive medicine at Vanderbilt University’s medical school and a member of the C.D.C. advisory committee that picked the guidelines.
“Some people are going to be waving their hands and saying ‘What about us?’ and some are going to be grumpy,” he said. “You just have to tell them — hold tight, wash your hands, avoid sick people, rent a movie instead of going out, and wait for more vaccine to be made.”
And, while the elderly and sick may feel vulnerable, they also often have a sense of self-sacrifice.
A few years ago, preparing for a possible pandemic of fatal bird flu, the C.D.C. held focus groups around the country to set vaccine priorities. Some were composed mostly of seniors.
Janice Zalen, director of special programs at the American Health Care Association, which represents 11,000 nursing homes, recalled the reaction.
While nearly everyone wanted the shots if there were plenty, she said, “The elderly said, ‘Well, if it comes down to it, if there aren’t enough, I don’t need it — give it to my grandson.’ ”
http://www.nytimes.com/2009/11/22/weekinreview/22mcneil.html?scp=5&sq=Donald G. McNeil, Jr.&st=cse
