2009-2010 Influenza Season Update #3
H1N1 Vaccination of School-Aged Children

To:   Health Care Providers, Hospitals, Infection Control Practitioners, Schools,        Home Health Agencies
From: Wendy Davis, MD, Commissioner of Health
Date: October 19, 2009

– Please Distribute Widely –

H1N1 Vaccine Supply

Last week, the Centers for Disease Control & Prevention (CDC) alerted states that vaccine manufacturers are experiencing ongoing delays in the production of 2009 H1N1 vaccine. This means that states will not be receiving vaccine shipments – in the amounts that had been expected – as early as expected. These delays are not safety related. The vaccine will continue to go through all the normal testing and FDA clearances, and will be shipped to states as soon as it is available.

We are working now to determine exactly how the timing of school clinics will be affected, and will keep you up to date on developments.

School-based vaccination clinics

Many public and private K-12 schools around Vermont are working with the Vermont Department of Health and Department of Education to offer H1N1 vaccination for children in schools. School clinics had been planned to start as early as the last week of October, and continue through the end of December. This schedule may now be adjusted due to news of vaccine production delays.

We are pleased to be able to reach students with this preventive service in the school setting, but want to make it clear that, as vaccine becomes available, there will be several options for vaccinating school-age children. We encourage health care providers to vaccinate school-age patients when that is the parent’s preference.

Many parents have questions about the vaccine and vaccine safety. The 2009 H1N1 vaccine is produced in the same way as the regular seasonal flu, which has a long safety record. Extensive information about the vaccine and more can be found at: www.HealthVermont.gov and www.flu.gov .

Attached is the most current list of schools that are planning to offer H1N1 clinics. Schools are grouped by Health Department district office service area. Some school clinics are organized by the Vermont Department of Health, and others by the school or supervisory union. Some schools are hosting clinics, and others are busing or walking students to school sites that are hosting clinics. Parents are being notified of the specific arrangements their schools are making.

2009 H1N1 vaccination in the school setting will be offered to all students who attend that school, children who attend co-located pre-schools, home-schooled students who live in the school district, and school staff who are among the groups recommended by CDC to be vaccinated first:

For logistical reasons, only the flu shot – and not the nasal mist – will be offered in the school setting. Vaccination is entirely voluntary, and will be offered for no charge. For school-age children, parents must provide written consent for their child to be vaccinated in a school clinic.

Parents are encouraged not to attend school clinics organized by the Health Department. Experience shows that having extra people in the clinic will slow clinic flow, and may result in some students not getting vaccinated on clinic day. Nurses are well prepared to attend to the needs of students of all ages.

Parents may be able to volunteer to work at the school clinic. Interested parents should contact their child’s school to learn if they can be assigned a role, such as helping students move to and from classrooms, supporting vaccinator staff or students being vaccinated, overseeing the waiting area, etc. Some parents may choose to have their child vaccinated by his or her usual health care provider (see below), however – due to ongoing supply issues – we are hearing from some providers that they may not be able to immediately accommodate all patients in districts where school-based clinics are held.

More information about Vermont’s school-based vaccination effort will soon be available at: www.HealthVermont.gov

Provider office vaccinations

School-aged children may not all get vaccinated at a school H1N1 vaccination clinic, for various reasons:

For these reasons, the Vermont Department of Health is planning a variety of avenues for school-aged children to receive the vaccine. 

IMPORTANT: We encourage providers to offer vaccine to anyone age 6 months to 24 years, even if the child or young adult attends a school that is participating in the school-based vaccination effort. Please do not miss an opportunity for early vaccination. Provide all vaccine recipients with the record card that documents they received the 2009 H1N1 flu vaccine.

Hospitals that distribute vaccine to their affiliated provider offices have been asked to work with their providers to ensure that they administer vaccine to both their health care providers as well as their patients. We know that many provider offices and hospitals have agreed to help make H1N1 vaccine available in these ways.

You can still enroll as a participating 2009 H1N1 flu vaccine provider. Call the Health Department’s Immunization Program at 802-863-7638.

Public vaccination clinics

Another option is to refer patients to public 2009 H1N1 vaccination clinics planned for the coming months. The first public clinics are for people who are in one of the groups that should receive vaccine early. Later clinics will offer vaccine to anyone else who wants to be vaccinated. Clinics are likely to be held in December or January, as vaccine supplies allow. As public clinics are scheduled, their locations and times will be posted on the Health Department’s H1N1 flu clinic finder at http://healthvermont.gov/prevent/flu/flu_clinics.aspx

If you have any questions about how to support H1N1 vaccination of any of the populations that are recommended to be vaccinated first, contact your Health Department district office.

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