WASHINGTON Deployed military troops, emergency
workers, pregnant women and children will be among the first to
get scarce vaccinations if a pandemic strain of flu breaks out,
U.S. officials said.
A long-awaited report to be issued on Tuesday lays out who
would be first in line to get vaccinated against H5N1 bird flu
or any other strain of pandemic influenza.
The Health and Human Services report proposes creating four
categories of people, and vaccinating the top tier of each
category first. The categories are homeland and national
security, critical infrastructure, health and community support
services and the general population.
"Certain military personnel like deployed forces would get
vaccinated before certain other military personnel," HHS
science adviser William Raub said in a telephone interview.
Virtually all health experts agree that the world is
overdue for a pandemic of some sort of influenza.
No one can predict when one might come, how bad it would be
or which strain of influenza virus may be responsible. But the
H5N1 bird flu virus that has infected 331 people since 2003,
killing 203 of them, is the current chief candidate.
Companies are working to make a vaccine against H5N1 but
the process takes months and it is not clear if vaccines
formulated to match the current strain would protect well
against whatever mutated version emerges to cause a pandemic.
"We won't be able to start making a true vaccine against
the actual pandemic virus until that virus appears, until we
have samples," Raub said.
"No matter how rapidly we build up our production capacity
we won't have 300 million doses of vaccine overnight. The
material will come off the line in successive lots.
"So therefore it means we need to have in hand a
well-thought-out, transparent framework as to how we hope
states and communities would make the decision about who gets
The plan, to be released at public meetings and on the
Internet at pandemicflu.gov, is not final and will be
revised after comments from experts and members of the general
public, Raub said.
Much depends on how severe the pandemic actually is. The
1918 pandemic killed hundreds of millions of people globally,
but two others, in 1957 and 1968, were much milder.
Raub said it also is not clear if people who are vaccinated
with the so-called pre-pandemic vaccines being prepared now
should go to the back of the line.
Level "A" people to get vaccinated first include "deployed
and mission-critical personnel" under the homeland and national
security category. Level A in the critical infrastructure
category include emergency medical services workers, law
enforcement and fire personnel, flu vaccine and drug makers and
key government leaders.
Under health, those first in line include public health and
direct health care providers, while under the general public
category, pregnant women and infants and toddlers come first.
"In past pandemics, groups at increased risk for serious
illness and death have differed by age and health status," the
"Because the high-risk groups in the next pandemic are not
known, this guidance will be reassessed and may be modified at
the time of the pandemic."