News & Events

Massachusetts: Dentists, pharmacists and paramedics to administer H1N1 (swine flu) vaccine


By Gintautas Dumcius

STATE HOUSE, BOSTON, AUG. 12, 2009…..Faced with budget cutbacks at the local level and the need to vaccinate 3 million Bay State residents against the H1N1 flu virus, state public health officials on Wednesday signed off on emergency rules allowing dentists, pharmacists and paramedics to administer the vaccine.

The Public Health Council held off on giving the same administrative ability to medical and nursing students but officials with the Department of Public Health said they would be reaching out and discussing the possibility with the state’s various medical schools.

Currently, licensed health care professionals such as physicians, nurses, physician assistants and nurse practitioners are allowed to administer the vaccine.

The emergency regulations, which also cover seasonal flu vaccinations, go into effect on Sept. 14. A permanent version of the regulations will undergo a public comment period between September and October, with a final vote by the Public Health Council in November before they go into effect in December.

This past spring saw 1,383 confirmed cases of the H1N1 virus and 10 deaths in Massachusetts.

The combination of both H1N1 and seasonal flu vaccinations – one for the seasonal flu and two for the H1N1 virus – means the state may need to administer as many as 9 million doses of vaccine between September and December, three times the number they’ve handed out in the past for the seasonal flu, department officials said during a three-hour presentation to the council. The seasonal flu vaccine is expected to arrive in late August through October; the H1N1 vaccine, from the federal government, is expected at the end of September.

“The message is we will have H1N1 circulating in our communities this fall,” said Lauren Smith, medical director for the state Department of Public Health. “The idea is we need to prepare for it ahead of time.”

First up to be vaccinated in the initial shipment of about 450,000 H1N1 doses: health care workers, pregnant women, individuals with chronic conditions and children ages six months up to 18 months.

Alan Woodward, a member of the council and past president of the Massachusetts Medical Society, said he was concerned that expecting people to go to doctors’ offices for multiple vaccinations is “unrealistic.”

Smith acknowledged it would be “tricky,” but said the department will push an economic impact message, with the vaccinations necessary to prevent school closings and parents missing work.

The department has also upped its purchases of seasonal flu vaccine to 885,000 doses from 810,000 doses last year. Another 2.2 million doses are expected to come from the private sector, including commercial vaccinators, health care providers and health care facilities.

For the H1N1 virus, the department will specifically focus on students and schools, since 64 percent of H1N1 cases involved individuals under the age of 18. The median age of someone with H1N1 was 14 years old. “This was really an illness confined to young people,” Smith said.

The department is partnering with the Department of Elementary and Secondary Education to hire a specialized clinical staffer. Ahead of the start of the school year next month, the two departments are also are also expected to issue a joint letter to school officials and school health staff on the H1N1 virus and develop a “tool kit” that will include a list of frequently asked questions and a flu symptom check list in multiple languages.

The Department of Public Health also plans on partnering schools with local boards of health, which are suffering from smaller budgets because of lower levels of local aid sent to cities and towns, to set up vaccination clinics within school buildings, according to Smith.

Public Health Commissioner John Auerbach said he will have a “concrete plan” in place for vaccine distribution by the end of August, after discussions with large health care providers, health centers and hospitals.

Massachusetts can expect $10.4 million in federal funds for the cost of handling distribution of the vaccine, officials said.

The 15-member council also tabled a move to include nursing and medical students among health care workers who would be given the power to vaccinate.

“I think we’re going to need them,” said Barry Zuckerman, chief of pediatrics at Boston Medical Center.

Auerbach said the department may already have the power to deputize nursing and medical students, but department staff would contact the medical schools about the issue and report back in time for the council’s September meeting.