US readies H1N1 vaccine as mist spray, not shots
US readies H1N1 vaccine as mist spray, not shots
Medical service personnel, doctors, EMTs, nurses are to get first vaccines.

Las Vegas: The H1N1 vaccine will be arriving in Nevada sometime this week, health officials say. But the receipient's status in the flu shot queue depends on more than how early one shows up at the clinic.

Health officials are asking residents to follow the Centers for Disease Control and Prevention's priority recommendations, which list the groups most vulnerable to H1N1 -- people who should receive the vaccine first.

Nevada's initial order of about 28,000 doses of the vaccine will arrive early this week, according to officials with the Nevada State Health Division, with 20,000 doses going to the Southern Nevada Health District in Clark County.

The health district will then dispense the vaccine to public clinics, as well as to hospitals and physicians registered to receive the vaccine, officials said.

But it won't be immediately available to the general population.

The first priority group to be vaccinated will be medical service personnel -- doctors, EMTs, nurses -- who have more contact with patients, said Martha Framsted, spokeswoman for the state health division.

The second group will be household contacts and care-givers for children younger than 6 months of age.

''The idea is you cocoon the baby, so those folks who protect and care for them will be vaccinated," Framsted said.

Because the first shipment is limited, Framsted said she isn't sure whether anyone other than medical personnel will be vaccinated in the first few days it's available.

One of the highest priority groups, pregnant women, won't even be eligible for the first round of vaccinations, she said, because the first doses of the vaccine will not be "flu shots," but "flu mist," which is sprayed into the nostril.

''The flu mist can only be administered to healthy people between the ages of 2 and 49," Framsted said. "And it's not licensed for pregnant women."

The H1N1 flu shot, which is safe for pregnant women, will be available around mid-month, she said.

Stephanie Bethel, spokeswoman for the health district, said the first vaccinations will be expanded to the other priority groups when the shots arrive.

Those priority groups also include all people age 6 months through 24 years and people age 25 to 64 who have serious health conditions and are more susceptible to medical complications from the flu.

''As soon as we get the traditional shots, we will be able to open the clinics for individuals in the other priority groups," Bethel said.

Because more shipments of the vaccine are scheduled to arrive every week, eventually the vaccine will be widely dispensed to hospitals, private clinics and schools, she said. But for the time being, Bethel said, the health district hopes residents will be patient.

''We're really encouraging people to help us out," she said. "Eventually the vaccine will be available to anyone who wants it."

Bethel wouldn't say whether members outside the priority groups would be turned away in the first few weeks vaccinations are administered, but said the district is relying on the public to follow the guidelines.

It's not clear how many doses will be ordered each week, Framsted said, or whether there will be an increased demand for flu shots over time.

The recent ruling that medical assistants are barred from administering any injections has left some private physicians unsure whether they'll have the necessary staff to administer the amount of vaccinations they've registered for, and this could be a problem, she said.

Framsted said the original plan was to distribute 50 percent of the vaccine to private providers, but that number will probably drop significantly, and public health clinics will shoulder the burden.

''We realize this may cause a gap in service, and some people may be inconvenienced and leave the medical home they've established," Framsted said. "But there are other outlets to get the vaccine."

Dan Burns, spokesman for Gov. Jim Gibbons, said Friday that the governor has urged the Nevada State Board of Medical Examiners to move on the issue, and file a motion for District Judge Kathleen Delaney to reconsider her Tuesday ruling.

Delaney's decision, based on open meeting law violations, voided emergency regulations that would have allowed medical assistants to administer flu shots, but bans them from administering cosmetic injections, such as Botox.

He said the medical board has agreed there needs to be action, but isn't sure which avenue they are considering.

''The issue is we can't afford to sit and wait," Burns said. "Children need vaccines and immunizations."

Louis Ling, executive director of the medical board, said Friday that he couldn't comment because a decision hasn't been finalized.

''We're trying to come up with the best possible solution," Ling said. "Once we can, we'll make that decision."

In the meantime, it's important for the community to remember to get regular flu vaccinations, in addition to H1N1, Framsted said

''The regular flu is also circulating and will continue to," she said.

''And as well as we know, H1N1 is appearing to be mild, but some folks have had serious complications."

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