Request Guidance for Prioritization Pandemic Influenza Vaccine

There isn’t much time left to participate in this request.

[I'm always skeptical of any group or official who uses the term "stakeholders". Usually it signifies the agency or institution is the one in charge and the community gets to act simply as supplicant or endorsement, i.e., one holds the stake and the other gets stuck.]

However, even if you don’t submit comments, please do the thought experiment. I would suggest community groups, even individuals, sit down and think of specific people in your Village (or neighboring villages) including friends, family, and strangers. Make a list, then select only 5 or 10 people. Write down how you decided on these folks. Were they family members; elders; health care providers? Were they the strongest, so they could help care for others? If elders are unlikely to get pandemic H5N1 illness, should vaccines therefore go to young adults? Should children be vaccinated if they end up as orphans? Should fluent language speakers not get the vaccine? Should vaccines only go to Bethel and other hub communities because they are easier to get to? How many women to vaccinate? What if the vaccine only partially works? Should tundra villages but not coastal villages?

Should no one be vaccinated? (instead of people selecting, let the virus itself select who is vulnerable)

Previously, the state of Alaska has said there would be a supply of antivirals (e.g., Tamiflu) available

• Alaska wants enough doses to cover a fourth of the population -
  http://ykalaska.wordpress.com/2006/07/07/alaska-wants-1in4-antivirals/

“If we get to 2007, we will be on our road of having a reasonable supply,” Mandsager said….

State health officials this summer will come up with a map for distributing the drugs quickly if there is an outbreak. The plan calls for moving some of the antivirals from Anchorage…

Did your community decide how the state’s antivirals will be distributed? How will the vaccines or antivirals be delivered, especially if the airports are closed? How will these sensitive items be stored? (in Bethel, the seasonal flu and pneumonia vaccine storage might have been faulty, making this year’s earlier vaccines ineffective)

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Request for Information (RFI): Guidance for Prioritization of Pre-pandemic and Pandemic Influenza Vaccine

Closing date for the comment period will now be February 5, 2007 deadline

Influenza viruses have threatened the health of animal and human populations for centuries. A pandemic occurs when a novel strain of influenza virus emerges that has the ability to infect and be passed between humans. Because humans lack immunity to the new virus, a worldwide epidemic, or pandemic, can ensue. Three human influenza pandemics occurred in the 20th century. In the U.S., each pandemic led to illness in approximately 30 percent of the population and death in between 2 in 100 and 2 in 1000 of those infected. It is projected that a modern pandemic, absent effective control measures, could result in the deaths of 200,000 to 2 million people in the United States alone. Extensive information on federal government strategic and implementation plans for pandemic flu is available at

• http://www.pandemicflu.gov

A critical part of the United States Government (USG) strategy to control the spread of a pandemic and reduce its health and societal impact is through the use of vaccines. The U. S. Government is working toward a goal of expanding domestic influenza vaccine surge capacity for the production of pandemic influenza vaccines for the entire population within six months of a pandemic declaration. However, at the beginning of a pandemic, the scarcity of pre-pandemic influenza vaccine and pandemic influenza vaccine (which could include up to two doses) will require that the limited supply be prioritized for distribution and administration. Pre-pandemic vaccine refers to influenza vaccine that is produced against a virus strain that is believed to have pandemic potential and is maintained in a national stockpile. Depending on what influenza strain actually causes the pandemic, stockpiled pre-pandemic vaccine may provide some protection. Total quantities of pre-pandemic vaccines will be limited.

Accordingly, the federal government has initiated a process to provide guidance to assist State and local governments, communities, tribal and territorial governments and the private sector in defining groups that should be considered for priority access to scarce vaccine. Guidance will be drafted by a federal interagency task force that will seek information and advice from relevant individual stakeholders, a public engagement process in selected communities across the country, and through this Request for Information (RFI). The federal government plans to issue draft guidance resulting from this process for public comment before finalization.

With this RFI, the Department of Health and Human Services (HHS) requests input from the public on considerations in developing guidance for prioritization of the distribution and administration of both pre-pandemic and pandemic influenza vaccines based on various pandemic severity and vaccine supply scenarios. Specifically, HHS is seeking input on pandemic influenza vaccine prioritization considerations from all interested and affected parties, including but not limited to public health and health care individuals and organizations, as well as those from other sectors of the economy including, for example, travel and transportation, commerce and trade, law enforcement, emergency management and responders, other critical infrastructure sectors and the general public. Previous reports relating to pandemic influenza vaccine prioritization issues are available at

• http://www.pandemicflu.gov/vaccine#vprioritization

* Request for Information (RFI): Guidance for Prioritization of Pre-pandemic and Pandemic Influenza Vaccine
* Extension of Comment Period
* E-mail Comments Now (click to send)
* Read Comments (when available)

Note: Please see the Federal Register notice for instructions and the deadline for submitting comments. Electronic comments submitted via e-mail are preferred. E-mail attachments are permitted.

• http://aspe.hhs.gov/PIV/RFI/

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