Local health officials ‘policing’ H1N1 supply

With a shortage of the H1N1 vaccine, some local health officials are being forced to act as vaccine police. Health officials in Los Angeles County feel they need to question the masses of people waiting in line at public clinics to ascertain if patients have a real need for the vaccine.

Dr. Jonathan Fielding, director of public health for Los Angeles County, is the county’s top public health official, and has worked those vaccine lines. He spoke to Alina Cho on CNN’s “American Morning” Thursday. Below is an edited transcript of that interview.

Alina Cho: Before we get to what's happening on the ground there, I want to remind our viewers – and some people may not know – you're vaccinating people on what's being called a priority list right now. Remind everybody, who should be standing in line to get the vaccine right now and who should wait.

Jonathan Fielding: Yes, the ones who should be in the priority groups are pregnant women or anybody caring for a child under six months of age, health care workers, emergency medical service workers, children and young adults from 6 months up through 24 years, and those 25 to 64 who have underlying conditions that would put them at higher risks for the complications of this H1N1 novel strain.

Cho: I want to talk a little bit about the situation on the ground there in L.A. County. I know that there's a shortage and there are reports that people are begging to get the vaccine, that they're lying about being pregnant to get the vaccine. What have you experienced there on the ground?

Fielding: Well, I've been working the lines. We have had, certainly, more people than we have vaccine, and that's obviously of great concern and frustration to a lot of people. But when you explain to people who would usually be getting the vaccine on a priority basis – those over 65, for example – for most other kinds of seasonal flu, and you explain to them that right now it's the kids and pregnant women who are at the highest risk, and if they take a shot or they don't provide accurate information because they want to get one, they're taking it away from somebody, a child or a pregnant woman who's much more likely to have a serious problem. When you say it that way, most people usually say, I can wait. And we say there's going to be plenty of vaccine, you just have to wait a bit.

Cho: That sounds rational, but the reality is that in some cases, people are panicked about this. 1,000 people in the United States alone have died from Swine Flu. So, you know, some have suggested that policing is really next to impossible. For example, you look at somebody, a woman comes in and says that she's pregnant, you really have one of two choices. Either you're going to believe her and vaccinate her, or call her a liar. What do you do in those types of situations and how, really, can you police people?

Fielding: Well, our job in public health is to protect the public's health. Everybody in my department is an emergency public health first responder and we want to help people. But we also want to make sure those in the priority groups get the vaccine. So we’re asking people, if they say they have a chronic medical condition, what is it, what kinds of medicines are you taking, what does your doctor say, and a number of people have fallen out on that. And most women who are pregnant actually show that they are pregnant. But there are some that come and say, I'm pregnant, and we have to take their word for it. I don't think that's been a major issue, but there certainly is some of that. We're not the police. We're here to help people.

Cho: Well said. You know, you talk about these chronic conditions, these health conditions, but it's a little vague. I mean, what kind of conditions are you talking about that would allow someone who otherwise might not qualify in the priority group to get vaccinated right now?

Fielding: Well, we have a whole list of them and our people working the line, our doctors and nurses, have that. Cardiac problems, certainly serious lung disease, people on immunotherapy getting chemotherapy, people with HIV, people who have other very serious underlying problems, kidney problems, liver problems. The kind of things that would more likely put them in harm's way if they got the flu.

Cho: I do want to talk a bit about your son, because I know he was recently diagnosed with Swine Flu. When was he diagnosed, how's he doing right now, and how'd you handle it?

Fielding: Well, a couple of weeks ago, he was very sick, had very bad coughing, a terrible headache, throwing up a lot, which is something we do see sometimes with this, got very dehydrated, needed a lot of intravenous fluid, wound up in student health and then the emergency room, but recovered very well. And let’s remember, the average case of this flu is no worse than the average case of other seasonal flues. The only difference is there’s a small percentage of people who get very sick and obviously we're concerned about those and that's why we're working very hard to get high-risk groups immunized.