Over 65 Waiting Longer for Flu Vaccine
November 23, 200
New York Times
By Donald G. McNeill Jr.
Life is unfair. Or, at least, it sure can look that way.
For example, consider this: Who of these four is first in line for a swine flu shot:
1. A great-grandmother in a nursing home with lung problems?
2. A hospital cafeteria worker being treated for AIDS?
3. An overweight department-store Santa with a line of children waiting for his lap?
4. A healthy Wall Street banker whose trophy wife is pushing a new baby in a $600 Bumbleride jogging stroller?
Answer: The banker.
Normal flu seasons have accustomed Americans to an “old people first” ethic, but swine flu has reversed that. It’s pregnant women and children first, and in the rush for the lifeboats, elbows are beginning to fly.
Mostly, as in any panic, confusion has reigned. Older people are still first in line for seasonal flu shots, but all the media attention has been on swine flu. Both kinds of shots are in short supply. More swine vaccine is being made, but slowly. All the seasonal vaccine has already been made — but much of it was taken up by middle-aged people who didn’t know one shot from another and bared their arms for any available needle.
Now that the health authorities are cracking down on the swine flu vaccine and real triage has begun, some older Americans are finding the new realities pretty harsh. Breathing problems and heart conditions are common among people over 50, and some have been calling their Congressmen to complain. Those older Americans and their advocates point to studies indicating that elderly people rarely catch swine flu but, when they do, their outcomes are just as grim as they are for seasonal flu, which kills 36,000 mostly elderly people a year.
“We’re not used to this in the U.S.,” said Jeffrey Levi, executive director of Trust for America’s Health, a nonpartisan group that works to prevent epidemics, and who testified before Congress last week, essentially defending the Centers for Disease Control and Prevention’s choices. “When there’s a limited supply of a scarce resource, you have to give it to those who are most at risk and who will benefit the most.”
So why the banker? He gets the shot not for his sake — many Americans would be pleased to see him roast on a spit — but to save his baby. Infants under six months old are at very high risk but too young for a flu shot.
The hospital employee does not have direct patient contact; if he is taking his anti-AIDS drugs, his immune system is not suppressed. And even if Santa is morbidly obese — though that could create a lap problem — he is presumably over 18.
And the great-grandmother? She was born before 1957, probably caught H1N1 flus several times growing up, and may still have protective antibodies. True, if she is unlucky enough to catch swine flu anyway, she is at risk. But public health is a numbers game and her probability is low. Also, flu shots don’t protect the aged well, since their immune systems may be too weak to build new antibodies. Studies suggest it is more effective to inoculate their nurses and visitors.
On the AARP Web site, some people are complaining. “I’m 70 and my wife is 69 and we are last on the list for H1N1. I thought there was no death panels,” wrote one.
But Dr. J. T. Howell, a geriatric specialist in Bucks County, Pa., said most of his older patients were taking their back-of-the-line status in stride.
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