In sharp contrast to last year's flu season, Los Angeles has plentiful supplies of the flu vaccine on hand and the public should get vaccinated early, the county’s top health official said this week.

“That’s good news. It’s certainly here, and there’s certainly a lot of offices that have it,” said Dr. Jonathan Fielding, director of the Los Angeles County Department of Public Health.

Federal officials strongly recommend that anyone 6 months of age or older receive a flu shot or nasal mist as soon as they can. 

Last year, many who sought to be vaccinated instead found long lines, confusion about the need to get two vaccinations, one for H1N1 and one for seasonal flu, and frustration as vaccine shortages amid the spread of H1N1 caused a frenzy.

This fall’s supply is far more robust and pharmacies are already broadcasting advertisements about flu shots on the radio. Flu cases typically peak in January or February but can continue into May, according to federal health officials.

One shot this year protects against the H1N1 strain, previously referred to as swine flu, as well as two other strains. It is the same mix that was used in the Southern Hemisphere for the winter season there. 

Few African Americans were vaccinated at Los Angeles County H1N1 flu clinics, despite outcry from county leaders last fall and a million-dollar county-funded public outreach campaign.

“We did not reach the number of African Americans we would like to,” said Dr. Jonathan E. Fielding, the county’s public health director.

African Americans, who make up 9% of the county population, received 2.96% of the 200,000 vaccinations the county distributed at 109 public clinics through Dec. 8,  according to figures released last week by the county’s Public Health Department.

At the same time, Asians were “over-represented” at county clinics, Fielding said, receiving 27.62% of the vaccinations, although they make up about 13% of the county population.

The figures surprised Supervisor Mark Ridley-Thomas, who had complained in December that too few African-Americans were getting vaccinated. At his urging, on Dec. 15 supervisors approved plans to double the public health department’s contract with Clear Channel Communications to $1 million to increase H1N1 flu outreach to minorities, especially African Americans.

Public health officials designed H1N1 billboards, public service announcements that aired on HOT 92.3 FM and Black Entertainment Television, and H1N1 presentations for churches, schools and community groups like Black Women for Wellness. After Dec. 31, those efforts were ramped up.

California Latinos have been nearly twice as likely as whites to die of H1N1 flu since the pandemic began last spring, according to statewide figures released this morning by the California Department of Public Health.

Over the same months, blacks in the state have been 50% more likely to die of H1N1 flu than whites, according to the report.

“Not everybody has been impacted equally” by H1N1, said state epidemiologist Dr. Gilberto Chavez during a briefing this morning. Chavez said statistics have shown "very important racial disparities” in H1N1 mortality and hospitalization rates.

Chavez said blacks were three times as likely as whites to be hospitalized with H1N1 flu, and Latinos twice as likely. He said Native Americans, who make up most of the “other” category in state H1N1 data, are also more likely to be hospitalized and die of H1N1 flu than whites.

There are several reasons for the higher mortality and hospitalization rates among those minorities, Chavez said. Blacks and Latinos have high rates of chronic health conditions, such as diabetes and obesity, that studies by the Centers for Disease Control and Prevention indicate put them at greater risk of catching the flu, Chavez said. They also tend to have less access to healthcare and wait longer to seek help, he said, which reduces the chances for successful treatment with antiviral medication.

“For cultural reasons, they may be waiting too long to seek care,” Chavez said. “This gives us an idea of who we need to target for outreach and immunizations.”

Virtually all communities in California now have an abundance of H1N1 vaccine, Dr. Mark Horton, the state health officer, said today. 

In a conference call with reporters, Horton said California has received about 15 million doses of the inoculation, approximately two-thirds of the supply the state is expected to get of the H1N1 vaccine this season. Almost all jurisdictions are reporting that they have enough vaccine to inoculate the general public, instead of just the priority groups most at risk to H1N1, also known as the swine flu. 

Numerous production delays last year affected communities nationwide, leading to long lines and complaints of poorly run vaccination clinics until supply caught up with demand.

Currently, fewer than half of California’s local public health departments are reporting active H1N1 flu outbreaks, Horton said. Overall, recent reports of flu are about normal for this time of year, according to a state staff report. Still, Horton said it remained important that people continue to get inoculated, as a third wave of the H1N1 flu is still possible and the traditional flu season does not taper off until spring.

Free H1N1 flu shots will be offered to the 3,700 taxicab drivers licensed through the city of Los Angeles, beginning today through Thursday.

Nine franchised taxicab companies have banded together to provide the vaccinations and ensure their drivers remain flu-free.

“The reason we’re doing this for all of our drivers is -- for lack of a better word -- they are on the front line,” said Michael Calin, general manager of Bell Cab. “Taxicab drivers are in constant contact with the public at large, and we feel this is an important service for our drivers and for the customers they serve.

“This is for their protection and for the protection of the public.”

Cases of H1N1 flu illness reported to California health officials have fallen to normal seasonal expectations, officials said today.

"Most indicators suggest that illness may be declining, with levels of illness approaching the normal range for this time of year," the California Department of Public Health said in its weekly H1N1 staff report.

Officials said 72 new H1N1 cases that resulted in hospitalizations or deaths were reported to California health authorities for the week that ended Dec. 26. That figure was significantly down from the 209 new cases reported the previous week.

The number of flu-related fatalities reported to the state last week dropped to 12, down from 32 the previous week.

The trend in California is consistent with what is being seen nationally with H1N1, or swine flu.

A new study by California health officials says pregnant women with flu-like symptoms should promptly undergo “aggressive antiviral treatment,” even if a preliminary test shows that the patient tests negative for the flu.

The study, published online today by the New England Journal of Medicine, is the latest urging physicians to consider prescribing antiviral drugs like Tamiflu to patients earlier, even in the absence of lab tests that confirm a flu diagnosis.

Last month, the U.S. Centers for Disease Control and Prevention said antiviral treatment of hospitalized patients was “suboptimal,” with as many as one in four hospitalized patients with lab-confirmed H1N1 not receiving antiviral medication.

A preliminary flu test, which can be completed in minutes, has a high rate of error and can mistakenly lead doctors to believe a patient does not have the flu. Out of 153 women of child-bearing age who were tested and hospitalized with H1N1 virus between April and August in California, nearly 40% received an incorrect preliminary test result. Erroneous test results may cause doctors to delay prescribing antiviral drugs.

 

Los Angeles County public health officials have opened up distribution of H1N1 flu vaccines to the general public and plan to increase efforts to vaccinate African Americans.

High-risk “priority groups” were given early access to the vaccine by private healthcare providers and county-sponsored clinics. They included pregnant women, caregivers for infants under 6-months-old, healthcare workers, youths 6 months to 24 years old and those age 25 to 64 with chronic illnesses.

Dr. Jonathan E. Fielding, director of the county’s Department of Public Health, said today that the department was opening up vaccines to the public because of their increased availability among local doctors, clinics and pharmacies.

“Given there’s more vaccine, it makes sense to open it up,” Fielding said.

Local healthcare providers have received about 2 million H1N1 vaccines so far this flu season, Fielding said. He said more vaccine shipments are expected in coming weeks, although he does not know how much is being shipped or how soon it will arrive.

The shortage of H1N1 flu vaccine appears to be improving in California, prompting a few counties to begin offering inoculations to the general public, health officials said today.

Sacramento and Ventura counties now have no limitations on who can receive the vaccination for H1N1, also known as the swine flu. Los Angeles, Orange, Riverside and San Bernardino counties are still reserving their vaccine for children, young adults, pregnant women and the chronically ill, among other priority groups. But officials indicated that, for the most part, the vaccine shortage has eased.

In Long Beach, for example, turnout was disappointing Saturday, when officials held the city’s last mass vaccination clinic at City Hall, said Michael Johnson, a spokesman for the Long Beach Department of Health and Human Services.

“There are no more long lines,” said Sheila Murphy, spokeswoman for the Ventura County Health Care Agency, which opened up its vaccine supply to all county residents this week. “It was the right time to open it up to everyone.”

The first of the final dozen county-sponsored H1N1 flu vaccination clinics opened this morning in Santa Clarita with faster-moving lines as Los Angeles County health officials applied many of the lessons learned from previous clinics, which had been criticized as chaotic and inefficient.

“It’s pretty smooth,” said Jonathan Williams, a minister at Pomona Church of Christ, who brought 4-year-old daughter Jiana to get vaccinated. By about 9:30 a.m., they were approaching the front of the line of about 100 people, having waited about half an hour.

“It’s not bad,” Williams said, “There’s a cost for everything, and if you just have to be patient, that’s pretty cheap.”

Anthony Deraps and Isabelle Servant, both 25, came to get vaccinated to protect their 5-month-old son, Liam, who is too young to get the vaccination. Within 20 minutes of arriving, they were pushing his stroller close to the entrance.

“It’s very fast -- I’m surprised how the line’s moving,” said Deraps, a quality engineer with IKEA.

By the time the county finishes its last batch of clinics on Dec. 8, it will have distributed nearly 200,000 doses of vaccine at 109 clinics. County leaders say they refined their strategy after facing criticism for mismanaging past clinics, where long lines led to daylong waits for those most at risk, including small children, pregnant women and those with chronic illnesses. Some left or were turned away, and lined up at later clinics in the wee hours of the morning.