Paul Wellman

SHORT SUPPLY: A limited number of the H1N1 vaccines, shown here, will be administered in the coming days to children with underlying medical conditions and pregnant women.

As swine flu infections rapidly increase in Santa Barbara County and beyond, so do concerns surrounding the infamous H1N1 influenza strain. To address residents’ mounting worries, the Public Health Department held a press conference on Monday to explain that an estimated 60,000 county residents — pregnant women and “medically fragile children” — are at the greatest risk of developing serious health problems should they become infected with swine flu. (“Medically fragile children” includes those with “substantial, physically disabling conditions affecting the respiratory and immune systems.”) But also announced was that the plan to shield these high-risk people is far from complete — for the time being, only 4,400 individuals will be able to receive the H1N1 vaccine.

The county’s interim health officer Dr. Peter Hasler explained that a large number of vaccines were ordered months ago from the Centers for Disease Control and Prevention (CDC), but only 4,400 vaccines in shot form were actually received on October 23. These vaccines, which Hasler admitted are “far less than necessary,” have been doled out to all obstetricians and pediatricians who have promised to quickly disseminate the vaccine to pregnant women and children with underlying medical conditions. Because the Public Health Department is most concerned about pregnant women, it has also scheduled three special clinics throughout for them to get vaccinated, regardless of insurance standing or prior pre-natal care. Children and young adults with physically disabling conditions can get doses from their healthcare providers. The vaccines will be free of charge, although some private providers may charge an administration fee. “I'm confident that, over time, we will have enough vaccine for the patient who wants it,” said interim Public Health Department director Michele Mickiewicz.

Once those vaccines run out, then the waiting game begins. The county tentatively expects to receive another shipment of doses — this time around 40,000 — by mid-November, but no one can say for sure. As explained by Mickiewicz, the Public Health Department is essentially at the mercy of CDC and cannot expedite the process. In the meantime, officials are encouraging area residents to exercise good hygiene and common sense to prevent further spread of the virus; consistent hand washing and not touching the eyes, nose, and mouth were particularly stressed. Mickiewicz highly recommended that residents visit sbcfluinfo.org for an abundance of flu-fighting tips and answers to common swine flu questions. Residents can also call a nurse at 888-722-6358.

The good news, according to Hasler, is that the swine flu doesn’t appear to be any deadlier than the seasonal flu. Each year, the regular flu typically kills 36,000 people nationally. To date, 1,000 have died from the swine flu since it appeared in the United States last April, including three in Santa Barbara County. So while the ratio of deaths to infection cases isn’t especially high for H1N1, said Hasler, the sheer number of people who are expected to become sick could greatly increase the mortality rate. In Santa Barbara, 31 people have been hospitalized with H1N1 since June 3, and 20,000 people have been hospitalized across the country. While health officials ask those who suspect they have swine flu to ride it out on their own, residents are encouraged to contact their physician if they become concerned about worsening symptoms.

The vaccine shortage is related to a number of unforeseen manufacturing issues. Vaccine makers discovered that their initial egg incubation process — a method used to extract the viable vaccine — had not yielded the amount of doses per egg originally predicted, with only about 1.5 doses per egg harvested compared to the three or four doses anticipated. Though since rectified, that dilemma put the production timeline way behind schedule. Additionally, many of the companies manufacturing H1N1 vaccines have also been harvesting regular flu vaccines within the same system, and the competition for time and space reduced efficiency. Of the 30 million vaccines promised by the end of October, only 16 million are currently available.

On top of the shortage, it appears that the 4,400 vaccines that did arrive are “not perfect,” said Hasler, explaining that most of the doses thus far contain a mercury-based preservative called thimerasol. In 2004, the state banned that preservative for pregnant women and children under the age of three due to a tentative link between it and autism. But not wanting to limit an already limited supply, the California Health and Human Services Agency recently lifted the ban with an exemption will remain in place until November 30, when supplies will be re-assessed. No conclusive studies ever proved a link between thimerasol and autism, and the rate of autism has not declined since the preservative was banned. “We believe and are convinced that the scientific evidence is overwhelmingly in favor of using this vaccine as opposed to declining it,” explained Hasler.

Luckily, most residents will have no need for the H1N1 vaccine because swine flu — although everyday gathering a more daunting stigma — manifests itself most commonly as nothing more than a serious case of the seasonal flu. “Most people who are healthy, who don’t have a chronic condition, won’t need special medical treatment to recover,” said Mickiewicz, noting that the three who died in Santa Barbara had chronic underlying health complications. As such, it’s impossible to say how many residents have already contracted and recovered swine flu, as testing only occurs after hospitalization or death. Treatment, meanwhile, is similar to a bad cold: sleep, fluids, and isolation from others.

Out at UCSB, swine flu is already so widespread that Dr. Elizabeth Downing, director of student health services (SHS), estimated that five to 10 percent of the roughly 20,000 students have been affected, meaning hundreds to thousands of students are either currently sick or have already recovered from it. Of those, only one student has been hospitalized, confirmed Downing. She worries, however, that the already rising number of students flooding SHS in recent weeks will spike dramatically in the wake of this weekend’s Halloween celebrations. “Isla Vista will be one giant culture medium for H1N1 flu,” said Downing, who is now discouraging students from visiting the doctor due to the risk of exposing others. “If you want a case of the flu, check it out.”

SHS has ordered hundreds of hand sanitizers to be placed throughout the campus — Mickiewicz noted on Monday that “college students are as effective as toddlers at spreading viruses” — but is still awaiting the shipment along with 15,000 requested vaccinations whose arrival date is also unknown. UCSB’s widespread infection rate reflects the age trend throughout the county, said Downing, explaining that while the regular seasonal flu typically targets older people, the swine flu appears to disproportionally affect young people. In Santa Barbara at large, more than 45 percent of those hospitalized have been between five and 24 years old. While there isn’t any hard scientific data to support the theory yet, some health experts hypothesize that older people have developed an immunity to the swine flu because of past exposures to similar influenza strains.

At Cottage Hospital, spokesperson Janet O’Neill told The Independent that while the hospital system is prepared for an increase in swine flu patients as well as those with “influenza like illnesses,” no special precautions have been taken beyond the normal emergency plans. Like her medical professional counterparts throughout the county, O’Neill encourages residents to stay home if they aren’t feeling well and practice typical flu-avoidance measures.

4•1•1

Visit sbcfluinfo.org for more info or call a nurse at 888-722-6358. The H1N1 vaccine will be distributed for free to pregnant women in Santa Barbara County at the following locations and times:

• Santa Maria: 2115 S. Centerpointe Parkway, Wednesday, October 28, 1–7 p.m.

• Santa Barbara: Franklin Center, 1136 East Montecito Street, Wednesday, October 28, 3-7 p.m.

• Lompoc: Wellness Center, 301 North R Street, Thursday, October 29, 3-7 p.m.

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