H1N1 & My Famiy

We'd talked about it earlier in the week, but hadn't really made a definite decision to go. Then, Sunday morning I came downstairs to find this Washington Post story [1] on the computer monitor.

On Wednesday, Oct. 7, 6-year-old Heaven Skyler Wilson dragged herself off the school bus that dropped her in front of her home on a rural road in Jetersville, just south of Richmond. The little girl, who had never had so much as an ear infection in her life, was pale and feverish and complained of an upset stomach.

The next day, Heaven's grandmother, Pat Sparrow, took her to a nearby clinic. Heaven, usually a bright, bubbly girl with blond pigtails, dimples and effusive energy, had a sore throat and a 103-degree temperature. The doctor swabbed her for the flu, and the test was positive.

It was just something going around, Sparrow said she was told. The doctor told Sparrow to take Heaven home, give her Tylenol and chicken broth, and let her rest.

By the next morning, Heaven couldn't breathe. Sparrow called 911.

...Two weeks later, on Oct. 21, ravaged with double pneumonia and a staph infection that deprived her brain of oxygen, Heaven was disconnected from the respirator. She lived for four minutes.

At 11:18 p.m., Heaven died in the arms of her mother, Sara Wilson. "You never heard such an awful scream from someone who loved her child so much," Sparrow said, her voice shaking.

He was already packing the kids lunches at that point. So I knew that after swimming lessons, we'd be headed to the H1N1 vaccine clinic held this Sunday in Montgomery County [2]. The end of our H1N1 saga — that is, the saga of getting the kids vaccinated — was finally in sight. And, as my husband said when he asked if I saw the article, "You just want to know you've done everything you can to protect your children."

But, until Sunday, there wasn't much we could do.

It's been months. First, Parker's school was going to have a vaccine clinic — appropriate since at least a few children at his school (that we know of) had come down with H1N1. Not to mention that some kids at Dylan's daycare had it too. But the school clinic was cancelled due to a shortage of the vaccine [3].

We called the kids' pediatrician and were told that they had the nasal spray vaccine. That would would work for Parker, but Dylan was too young. Then we got the kids there only to find out that they had the nasal spray for the regular flu virus. Not H1N1. There was a swine flu vaccine clinic earlier, but we weren't able to make it in time, and we found out later the if we had made it we'd have had to contend with long lines [4] and chaos [5].

BETTY ANN BOWSER: That pretty well summed up the situation outside a Montgomery County public health clinic in suburban Washington, as some 2,000 area residents lined up to get vaccinated against the H1N1 virus.

It's a scene playing out across the country, demand outstripping supply. It was a particularly dramatic at this Rockville, Maryland, clinic today, as lines snaked around the building, through the parking lot, and down the block.

Within minutes of opening its doors, health care officials let the crowd know that swine flu shots were going fast to the people most at risk: pregnant women, children under the age of 2, and people with underlying health conditions.

And probably would have gone through that only to have them run out of vaccine [6].

The only thing more infuriating that the wait was learning that my kids would've had the vaccine by now, if they worked on Wall Street [7].

While thousands of at-risk Americans wait, some big Wall Street banks have already secured the hard-to-find H1N1 vaccine for their employees.

Building on a story that BusinessWeek broke [8], NBC reports that employees at the New York Stock Exchange, bankers at Goldman Sachs and Citigroup, and employees at the Federal Reserve have all received swine flu vaccine doses to administer to their employees.

In particular, NBC reports that Goldman Sachs has received 200 doses of the vaccine -- the same amount as Lenox Hill Hospital in New York. Wall Street banks, like many other companies, put in requests for the vaccine but seem to have had something of a leg up on securing doses.

Dr. Nancy Schnyderman, NBC's chief medical editor, chimed in on this seeming disparity:

"I think they probably played by the rules, there are corporations all over the country who put in there dibs...But, what a sore eye for Wall Street. Wouldn't have been lovely if they had said, look we put it in our dibs, we played by the rules, but we're going to donate our 200 doses."

Most infuriating, perhaps, is the idea that the reasons for the shortage are some kind of mystery [9].

County health departments around Maryland are receiving doses of the 2009 novel H1N1 vaccine and administering it to people in target groups, but the supply is still not what health officials would like it to be, and the reasons for the continued slow distribution pace aren't entirely clear.

"(We) have not yet gotten to the point where we're turning that trickle (of vaccine) into a stream, and certainly not at the point where we're turning that stream into a river," said David Paulson, spokesman for the Department of Health and Mental Hygiene.

Earlier this year, health officials were optimistic about having sufficient supplies of vaccine for everyone who wanted it, but their initial estimates now seem to have been greatly overestimated.

A shortage has caused vaccine seekers to wait in long lines, while others have been turned away. Vaccine clinics in Montgomery County at the end of October closed less than an hour after opening when demand far outpaced supply.

Or perhaps it's that the shortage is the result of some kind of government mix-up, or even Obama's fault [10] (by the same congressmen who voted against an appropriations bill that contained special funding to fight H1H1, because they didn't want to vote for Cash for Clunkers).

Comments on news stories and blog posts usually include a few reading "This is the face of government-run health care." The truth is, this is what you get with the private sector handling public health [11].

According to Health and Human Services Secretary Kathleen Sebelius, the government was misled by these companies, which failed to report manufacturing delays as they arose. Her department, she says, was "relying on the manufacturers to give us their numbers, and as soon as we got numbers we put them out to the public. It does appear now that those numbers were overly rosy."

If, in fact, there's a political parable here, it's about Big Government's sweetly trusting reliance on Big Business to safeguard the public health: Let the private insurance companies manage health financing; let profit-making hospital chains deliver health care; let Big Pharma provide safe and affordable medications. As it happens, though, all these entities have a priority that regularly overrides the public's health, and that is, of course, profit—which has led insurance companies to function as "death panels," excluding those who might ever need care, and for-profit hospitals to turn away the indigent, the pregnant, and the uninsured.

As for Big Pharma, the truth is that they're just not all that into vaccines, traditionally preferring to manufacture drugs for such plagues as erectile dysfunction, social anxiety, and restless leg syndrome. Vaccines can be tricky and less than maximally profitable to manufacture. They go out of style with every microbial mutation, and usually it's the government, rather than cunning direct-to-consumer commercials, that determines who gets them. So it should have been no surprise that Big Pharma approached the H1N1 problem ploddingly, using a 50-year old technology involving the production of the virus in chicken eggs, a method long since abandoned by China and the European Union.

Chicken eggs are fine for omelets, but they have quickly proved to be a poor growth medium for the viral "seed" strain used to make H1N1 vaccine. There are alternative "cell culture" methods that could produce the vaccine much faster, but in complete defiance of the conventional wisdom that private enterprise is always more innovative and resourceful than government, Big Pharma did not demand that they be made available for this year's swine flu epidemic. Just for the record, those alternative methods have been developed with government funding, which is also the source of almost all our basic knowledge of viruses.

So, thanks to the drug companies, optimism has been about as effective in warding off H1N1 as amulets or fairy dust. Both the government and Big Pharma were indeed overly optimistic about the latter's ability to supply the vaccine, leaving those of us who are involved in the care of small children with little to rely on but hope—hope that the epidemic will fade out on its own, hope that our loved ones have the luck to survive it.

You'd think the meltdown and the bailout would have been a lesson to the government about trusting big business with the public good. And in the midst of a health care debate, it's worth noting that millions of Americans who had the greatest need for the vaccine had to wait for it and continue to wait for it, while the highest bidders (Wall Street) gets waved to the front of the line. More personally, my kids — and thousands like them — have been waiting while Wall Streeters got their shots first. Had I known, I'd have put them in business suits and taken them to New York to try passing them off as brokers. (Junior Associates, maybe? The very, very new guys from accounting?)

Speaking of lines and waiting, we were indeed among the hundreds waiting in line [12] for the vaccine on Sunday.

The Centers for Disease Control says cases of the swine flu are decreasing, but it's still asking people to get vaccinated. Hundreds tried to do that Sunday at a vaccination clinic in Montgomery County (web | news) .

Some people said it was a never ending line for the first weekend clinic in Montgomery County. Hundreds of people spent part of their Sunday filling the Montgomery County campus in Rockville hoping to get the mist or shot. The vaccine was offered to those considered to be high risk, including anyone age six months to 24 years, pregnant women and people taking care of young children.

For Suvita Melehy and her family, finding a place to get the H1N1 vaccine, hasn't been easy.

Suvita Melehy said, "We have been looking for a long time to try and find some place that we would be able to give them the vaccination."

After a few anxious hours, they were finally successful at getting the vaccine.

[13]

The wait turned out not to be so bad. We raced over after swimming lessons to find a depressingly long line. After parking the car, we raced to get to the en of the line, with the hubby carrying Dylan and me bringing up the rear along with Parker. The hubby grabbed the necessary forms while I made Dylan a bottle and gave Parker the PB&J we'd packed for him. Then I went in search of the volunteer who'd been handing out clipboards and pens (to fill out the forms).

By the time I got back, we heard the two hour wait was actually more like an hour. Fortunately, that was correct. Within an hour, we were in the building and from there, it was a short wait to get the kids vaccinated. I don't know how chaotic the previous clinic was. (Though I've heard armed guards were present at the earlier clinic, I only saw a few police officers on Sunday.)

Based on what I saw, either the county government learned from the mistakes of the previous clinic, or perhaps government is perfectly capable of distributing a vaccine once if finally get it from the producers. I can only imagine that perhaps the shortage (and the ensuing parental panic) might have been less intense (and less of a surprise) if the government had more say in the production.

[14]

Why would parents be anxious? I'll refer you again to the Washington Post story above. We want to do everything we can to protect our children. But when it comes to something like H1N1 — or toxic toys in the toy box, or e. coli in the grocery cart — we can't do all that much. We can button up over coats, hand out more chewable vitamins, tell our kids to cover their coughs and sneezes (and just hope their classmates do the same), insist our kids wash their hands (and wash ours) every hour on the hour, and just hope our kids don't get sick — or that they can get treatment if they do get sick.

But we don't want them to get sick. Wanted them to get the vaccine.

And they did. Parker was nervous, but very brave and only winced a little as the needle went in and came back out so quickly he wasn't sure it was over. Dylan's vaccine happened so fast that he didn't have time to react until it was over (partly because Parker and I were doing our best to distract him). With that, I became the only member of my family (being over 24, under 64, not a health professional, and not having a chronic condition) who hasn't gotten the vaccine. My doctor's office has a sign on the door saying they don't have the H1N1 vaccine and don't know when they're going to get it. So I wait. That fine, so long as my kids aren't still waiting.

After wiping a few tears, and putting jackets back on, we went back to the car and Dylan promptly fell asleep on the way home. My husband and I breathed a sigh of relief. We're not entirely out of the woods. Both boys will need follow-up vaccines in 28 days in order to get the benefit of the vaccine. They have a pediatrician's appointment between now and then. I just hope their doctor gets the vaccine, and has it to give to them.

After all, you want to know you've done everything you can for your children, and that when you do all you can they will be able to get the help they need.