GA pH1N1 Hospitalizations Not Linked To Vaccination Coverage



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H1N1 Consulting Paradigm Shift Viral Evolution Intervention Monitoring Vaccine Screening Vaccine Development Expression Profiling Drug Discovery Custom Therapies Patents	Audio:Feb2 Feb13 Feb18 Mar18 twitter Live feed of underlying pandemic map data here Commentary GA pH1N1 Hospitalizations Not Linked To Vaccination Coverage Recombinomics Commentary 18:39 April 1, 2010 Anne Schuchat: The southeastern states are seeing more -- there are three southeastern states reporting regional disease, one step below wide spread disease. The hospitalization for Georgia appears to be maybe the most complete information we have available right now because it's based on laboratory testing and that's not necessarily done everywhere. In terms of pockets of immunity, we do think there are geographic differences in the proportion of people that are already immune to this virus. You can become immune by becoming sick from the virus either by being vaccinated. And we know there are geographical differences in vaccination right now. And, of course, there are differences of when communities were hit by the viruses last summer and fall. It could be that the southeastern states were hit relatively early in the late summer and early fall. And it could be that their coverage would be a bit lower than some of the other parts of the country because the vaccine came after they had disease and demand may not have been as high. So it's possible the two factors contribute to perhaps more vulnerability in this part of the -- in the southeastern part of the country. But it's way too early for us to say we're not going to see increases in other places. And i think it's important to know that being vaccinate suicide a safe and effective way to reduce your chances of ending up in the hospital with the flu that could have been prevented. Mike Stobbe: Was the vaccination numbers lower in Georgia? Anne Schuchat: We'll release information. But Georgia was among the lower states, that's right. The above comments from the Monday CDC press briefing suggested that low vaccination rates in the south in general and in Georgia in particular may have contributed to the spike in hospitalizations and deaths. However, tomorrow’s MMWR has little data supporting a major role for low vaccination coverage. For children, the lowest rates are largely across the south, from Georgia to Texas, but South Carolina is not in that group, even though they have regional levels for H1N1. For adults, low coverage (10.0%-19.9%) is widespread, and although the states in the south have low coverage, similar low vaccination levels are in the west, as well as many northern states, including New York, Pennsylvania, and Michigan, which have low levels of reported H1N1. Moreover, the hospitalized patients are adults, not children. The correlation is better for the time differential between the start of the fall wave and the start of the spring wave. Recent past pandemics have had a spring wave and the longer time gap allows for more H1N1 evolution. The southeast states were among the first to show increases in H1N1 in the fall, which were linked to the start of school in early August. Moreover, the transmission of Tamiflu resistance and D225G/N at Duke Medical Center in the fall may have contributed to more severe cases in the spring. Although the CDC stated that they did not see changes in the sequences, but they also claimed that the D225G in fatal cases in Ukraine were not significant, and in spite of overwhelming evidence to the contrary, the CDC continues to discount the significance. Similarly, their antigenic characterization data is inconsistent. Some samples with G158E are designated as “low reactors” while others are not. Similarly, they do not designate samples with D225G as low reactors, although Mill Hill does. Thus, the CDC’s analysis of significant changes or antigenic characterization data is controversial, so release of sequences from the severe and fatal cases in Georgia would be useful. To date only one 2010 sequence from Georgia (from February) has been made public. The spike in hospitalizations and deaths in Georgia, as well as regional levels in Alabama and South Carolina signal the start of a new wave, which is more likely due to changes in the H1N1 sequences than minor differences in vaccination rates. Media Links Recombinomics Presentations Recombinomics Publications Recombinomics Paper at Nature Precedings

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