The Big Flu Shot Post

Flu shot or flu spray? Those who get a vaccination every season may already know the difference. The flu spray form is a live attenuated influenza vaccine. This means that it prompts the immune system response without triggering the influenza disease. However, this form of the vaccine can be shed -- that is, the attenuated virus can be transported from individual to individual. That's not a problem, unless the person who receives the transmitted flu virus is sick. People who find themselves near cancer patients or immune-compromised individuals, for example, should not receive the flu spray. The flu spray is an ideal vaccination for folks aged 2 through 49.

The flu shot, on the other hand, uses a not-alive attenuated flu vaccine. It comes in a needle, so it hurts, but it cannot be shed.

For seasonal flu, both of these vaccines are already available and have been for a few weeks. You can get a vaccine through a private provider, pharmacy, supermarket, or clinic. (Never take vaccinations from someone offering them out of a trench coat or car trunk. That is probably drugs or, like, bleach in that needle.)

For H1N1 virus, it's a little trickier. The production from the Centers for Disease Control and Prevention has been somewhat slower than what health officials might have hoped for. In D.C., the Department of Health is planning a rolling schedule of vaccinations, by Ward, according to list of priority populations. It will take most of the month of October to roll out the vaccine.

"I want to make it clear," explained Dr. Vigilance, "we're not making people wait four to six weeks to get vaccinated. We are vaccinating priority people on the way."

The schedule for H1N1 vaccinations is available at flu.dc.gov. You're probably going to find that you're not eligible to get a vaccination for at least a month. The vaccine stock that D.C. receives first is reserved for first-care responders, hospital workers, clinicians, fire/EMS workers, and health-care workers employed by the District. Children and at-risk populations within other demographics -- people with HIV, for example -- are next in line.

The large population with HIV/AIDS in DC, unrivaled in the U.S., presents a special challenge for vaccinations. Dr. Vigilance said that these groups are not more difficult to vaccinate than others. "It's been my experience that a decent percentage of the [HIV/AIDS] population has access to some care, so they are looped in with a provider of some sort," he said. "So there's a good knowledge about what's needed in terms of seasonal flu and H1N1 as well."

When the H1N1 vaccinations are rolled out for children during the week of October 19, they won't be available everywhere at once. Instead, the Department of Health will work to provide vaccinations at schools on a Ward-by-Ward basis. On one evening each week after October 19, vaccinations will be available in two Wards. Then on another evening, vaccinations will be another two Wards. On the weekend, vaccinations will be offered at the remaining four Wards. So on any one given day, the entire District won't be covered -- but over the course of every week, vaccinations will be available in every Ward. That schedule is not yet available, pending confirmation of final details with D.C. Public Schools and Parks & Recreation.

What happens if Things Go Wrong? Dr. Vigilance -- seriously, what a comforting name in times of unease -- reports that health officials know a great deal more now about H1N1 than they did in the spring and are reacting to the disease differently. There is no plan to close schools, for example; instead, the city will be working with DCPS to ensure that schools remain open. D.C. has in place its (terrifying-sounding) continuation of operations (COOP) plans, which identify essential personnel and how agencies hard hit by influenza may continue working. And for reasons both practical and alarmist, people are taking the flu more seriously this fall than in years past.

"Sick colleagues are staying home and that's okay in the workplace now. That is a responsibility," said Dr. Vigilance. "That's one thing. The other thing is preparation versus panic."