Pollen counts will resume in the spring.

UPDATE ON REGULAR FLU SHOTS AND SWINE FLU VACCINE September 2, 2009 Many of you have been following the swine flu story as it unfolds in the lay press. More on that in a moment. Last month, much earlier than usual, we began administering regular influenza vaccine, as we had been advised to do. Approximately 80% of that supply has been dispensed, and we expect to run out soon (days, not weeks). We have just been advised by our supplier of regular vaccine that further delivery of this vaccine will be delayed, since manufacturers are apparently being urged to focus their efforts on swine flu vaccine production. We will notify you when we have another shipment of regular vaccine. There have been estimates that as much as half of the U.S. population might contract swine flu this fall and winter, since so very few people have immunity. That is many times the usual flu incidence in our population. Distribution of swine flu vaccine will reportedly begin by mid-October, with an initial emphasis on vaccinating the elementary school age population. Other high priority groups include household contacts of infants under 6 months of age, pregnant women, persons between 6 months and 24 years of age, health care personnel, and persons less than 65 years of age with complicating medical conditions, such as asthma or diabetes. Distribution details have not yet been announced. Private medical practices such as ours can sign up for vaccine to administer to our patients, and we have done so. However, we have no idea at what point such swine flu vaccine will trickle down to us. We will notify you when we receive it. Parting swine flu thoughts: • The vaccine appears to be safe, but it might not be clear how effective it is until we see an epidemic unfold. The risk of disease outweighs theoretical or practical risks from vaccine. • There might be epidemic swine flu in various communities before adequate vaccine supply arrives. • We have received conflicting information as to whether a nasal mist version of swine flu vaccine will be available; and, if so, when. • Vaccine will require a booster dose for everyone, assuming there is enough to go around. • Private offices will charge a modest administration fee for vaccination, but large public sites will be free. • Regular flu vaccine offers no protection against swine flu. • Tamiflu can lessen severity of both regular and swine flu only if begun within 48 hours of symptom onset. However, its use will be restricted to those at risk for complications to lessen the chance of development of virus resistance, something that has already been occasionally seen. Drs. Banks and Andrews

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