In the battle against swine flu, the first line of defense for Maryland's vaccine czar is a blue highlighter pen.
That's what Greg K. Reed used this week to mark orders for vaccine against the H1N1 virus that he planned to fill. But with limited supplies, there were tough choices for the man at the center of the state's logistical effort to stem a pandemic.
Reed, 42, who runs Maryland's Center for Immunization on behalf of the federal Centers for Disease Control and Prevention, has been hunkered down with state health department officials in their Preston Street offices, combing their lists for places that could administer vaccine the fastest to those considered most vulnerable to swine flu - children, health care workers, pregnant women and adults with chronic conditions or compromised immune systems.
Reed had to consider that rural counties have fewer pediatricians to do vaccinations, so health departments there would need more doses. Hospitals need large amounts. But practices that cater to pregnant women should not get the first doses shipped, because they will be nasal spray made with live virus.
Boxes started to trickle in Tuesday to 114 providers given first priority to receive the vaccine across the state. In late afternoon, state officials walked a few doses from their offices to nearby Maryland General Hospital and began administering them to health care workers to show reporters how the spray would be given.
Alexis Braxton, a nurse in the hospital's emergency room, said she was getting the vaccine because she has young children at home and wants to protect patients. "I work with a lot of people who can't get the vaccine themselves, and it's important to help protect them and protect the community," she said.
The decisions made daily since Sept. 30, when the federal government began giving states their quotas of the vaccine, will result in a total of about 60,500 people being inoculated in every Maryland county and Baltimore this week. It is just a fraction of those who will likely want to be vaccinated.
"We'll keep pushing out doses until everyone who wants a vaccination gets one," Reed said. "We'll be getting shipments on almost a daily basis."
Unlike the seasonal flu vaccine, for which orders are usually filled immediately each year from federal supplies generated well in advance of the start of influenza season, the surprise spread of the H1N1 virus meant that the vaccine-making process was ramped up late. Doses are being shipped in groups of 100 to states from five manufacturers as they are produced and approved. Shots won't be available until next week.
