Thursday, December 20, 2007
Draft guidelines issued by the United States Department of Health and Human Services in November have established a series of tiers and categories for distribution of scarce vaccine in the event of pandemic flu. These guidelines give strong preference for emergency responders, military and national security personnel, and socially important occupations, such as top politicians, energy sector and communications personnel, bankers, and newborn infants. Distribution of vaccine to the elderly occupies a low priority, especially in the event of a severe pandemic with a case-fatality rate of 2% or more causing more than 1.8 million deaths. The scheme differs significantly from that proposed in Britain in 2005, which gave high priority to the elderly, noting that most of the deaths in recent years – ranging from 12,000 to 29,000 annually – were in elderly patients.
| U.S. 2007 | Britain 2005 |
|---|---|
| Tier 1. Deployed/mission critical national security, health care providers, police, fire, vaccine manufacturers, top politicians | Priority 1. Health care workers, nursing home staff |
| Tier 1*. Pregnant women, infants (*Sub-tier plan places at lower priority than other Tier 1) | Priority 2. Fire, police, security, communications, utilities, undertakers, armed forces |
| Tier 2. Intelligence, border, national guard, other domestic national security, community support, electricity, natural gas, communications, water, critical government personnel, children, household contacts of infants | Priority 3. High medical risk (e.g. diabetes, immunosuppressed) |
| Priority 4. All over 65 years of age | |
| Tier 3. Other active duty military, important health care, transport, food, banking, pharmaceutical, chemical, oil sector personnel, postal and other government, children | Priority 5. Selected industries, e.g. pharmaceuticals |
| Tier 4. High risk conditions, all over 65 years of age | Priority 6. Children |
| Tier 5. General public | Priority 7. General public |
The plan is open to public comment under U.S. Federal Register guidelines until December 31.