VA Medical Center Internal Swine Flu Memo

This is an e-mail sent out to employees of the Veterans Affairs (VA) Medical Centers
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Last updated 7/23/09

VA is likely to face a challenging, rapid, intensive influenza vaccination season.

The U.S. government, through the Department of Health and Human Services, is developing a vaccine for the 2009 novel H1N1 'swine' influenza (H1N1 vaccine) that should become available fall 2009. As of July 23, 2009, a decision about whether this vaccine will be given has not been made by the Federal government. A decision will be made when there is more information about:

H1N1 vaccine safety and effectiveness from clinical trials, and
the impact and epidemiology of influenza illness, especially in the Southern Hemisphere, where it is peak wintertime influenza season.

Possible H1N1 Vaccination of VA Staff and Patients and Non-VA Federal Workers
The following points assume the vaccine will be used:

Logistics: Administration, Timeframe, Supply

This vaccine will only be for H1N1 influenza. There will be a different vaccine for seasonal influenza to be administered separately from the H1N1 influenza vaccine and possibly at a different time.

Projected timing is currently that H1N1 vaccination in the US would begin around October with all of the US population being offered vaccine by around March 2010.

The H1N1 vaccine will be owned by the U.S. government and will be distributed at no cost to the public and private sectors, including VA. The vaccine will not be available for sale.

Effectively immunizing people of all ages with H1N1 vaccine will require two injections, administered approximately 21 to 28 days apart.

The Department of Veterans Affairs will receive an allotment of H1N1 vaccine and supplies to administer vaccine to its staff and its patients. States and territories will receive allotments as well.

Federal Prioritization Plan

H1N1 vaccine will become available from manufacturers in increments, not all at once. Because of this, individuals at risk of exposure because of their occupations or because of potential for severe illness will be prioritized to receive vaccine earliest. A Federal committee representing many U.S. departments and agencies has developed prioritization guidance with input from the public, academia, and private sectors.

The current prioritization plan puts these three groups of individuals in the highest priority category, that is, they will receive H1N1 vaccine first: health care workers, emergency responders, and pregnant women. (Children comprise a fourth group in the high priority category, but because VA does not routinely vaccinate children, they are not included in VA H1N1 vaccine planning documents.) The prioritization plan will be revised, if needed, as more is learned about H1N1 illness and vaccine.

VA intends to follow the Federal prioritization guidance, interpreted for our staff and patient populations, but our goal is to eventually vaccinate all staff and patients who are eligible for and want to receive the vaccine. Staff who will be eligible to receive vaccine from VA include employees, trainees, and volunteers.

Federal Coordination and VA's Role

Since it is likely that health care workers, emergency responders, and pregnant women will need to rapidly receive H1N1 vaccine as soon as it becomes available, VA has been asked to develop H1N1 vaccination plans in conjunction with the Department of Health and Human Services/Centers for Disease Control and Prevention (CDC) and Department of Homeland Security.

Note: Part of the current U.S. government plan for H1N1 vaccination is for VA to vaccinate approximately 180,000 non-VA Federal workers who are in the highest priority categories to receive vaccine. The numbers, locations, and means of identification and tracking of these people are being developed, but every VA health care site that administers vaccine should be prepared to also vaccinate non-VA prioritized Federal workers.

A group composed of VHA field and VACO representatives and coordinated by the Office of Public Health and Environmental Hazards is working on plans for vaccinating non-VA Federal workers in addition to VA staff and patients. The expert teams of staff in VA facilities involved in VA's successful seasonal flu programs will be asked to carry this program out.

We will keep VA staff and patients informed as plans and information become available. Please begin planning for an intensive vaccination season at your health care site.