The new year has arrived with a reduced level of concern about the swine flu pandemic. The H1N1 virus has entered what health officials call a lull, as fewer new cases occur. But they also say this is an ideal time to increase vaccinations and immunity to try to stop another wave of infection.
The flu is a virus that comes in infectious waves which you try to anticipate and prepare for. Dr. Wilma Wooten is the San Diego County health officer. She said we've already seen two waves of the swine flu, one in April and another in October of last year. She said past flu pandemics tell us that a third wave may be on its way.
"If we go back historically to what happened with the 1918 pandemic influenza, the third wave did occur in Spring of the following year... about March," she said. "And it was much worse than the previous two waves."
It's past 4 p.m. outside a public health clinic in San Diego where there's still a line of people trying to get swine flu inoculations. Prior to this month, San Diego County clinics restricted swine flu vaccine in order to save the limited supply for vulnerable populations. Young kids, pregnant women, and people with underlying health problems were allowed to get their shots. Now the county has entered what some call phase two of the vaccination effort when you simply try to inoculate as many people as possible.
According to Wooten, "this just basically means that anyone who wants or is interested in getting it, can inquire about getting it and we're not limiting it to the priority groups."
The early focus on vaccinating children was based on the fact that H1N1 infections were more common in younger populations. Dr. Bela Matyas, who's with the California Department of Health, said there was another reason for it: Kids are much more likely than adults to spread the flu.
"If we can achieve a high enough level of immunity among the spreaders, in other words, in children, then we're actually protecting large numbers of adults as well," said Matyas.
Last year, there was concern and frustration over the slow rate of producing and shipping the swine flu vaccine. Dr. John Talarico is chief of the immunization branch of the state health department. He said the vaccine shortage is no longer a serious concern. In fact, his biggest concern is the possibility that available vaccine supplies will sit on the shelves as fear of the flu subsides.
"What we don't want to see is demand for the vaccine to drop, because this is the perfect time for people to get vaccinated to prevent a third wave, if possible," said Talarico.
At this point, an estimated 40 percent of Californians are largely immune to the swine flu, by way of either vaccination or previous infection. Matyas says nobody can say a third wave of swine flu is inevitable. But even though we cannot predict, we must prepare.
"Even with 40 percent having some degree of immunity, that still leaves the majority of Californians are still vulnerable," said Matyas. "And that figure may be far higher in some communities than in others."
The greatest concern about the swine flu is that it may mutate into a virus that's much more virulent and deadly. The good news, said Matyas, is even if it does that doesn't mean the vaccine will be rendered ineffective.
"Could it change into something more virulent? Yes," he said. "Would the vaccine be protective? It depends. Because if the change is in certain genes of the virus, the ones the vaccine is attacking, then the vaccine would become less effective. If the change is in the virulence factors, then it could become more virulent but the vaccine would still be equally effective."
Doctors don't expect the swine flu to go away, but it will soon have a new name. The genetics of the H1N1 virus will almost certainly form the basis of next year's seasonal flu vaccine. So next year it won't be the swine flu anymore. It'll just be another seasonal flu.
