85% in Forsyth subject to H1N1

In health-care facilities, doctors' offices and drugstores across the Triad, thousands of doses of H1N1 vaccine are waiting.

How many residents get those doses will determine how quickly and extensively the region is protected -- or unprotected -- from the swine flu, both now and well into next year.

Although there has been a decline in swine-flu cases recently, local health officials expect a third wave to sweep through the Triad in January and February.

"No one really has built up an immunity to the H1N1 virus," said Dr. Christopher Ohl, an infectious-disease specialist at Wake Forest University Baptist Medical Center.

"That will change over the next two years, but that's why there's a need for a vaccine and the need for people to take it once it's available."

The Centers for Disease Control and Prevention estimates that the virus has struck about 50 million Americans -- or about 16 percent -- and claimed about 10,000 lives since it was first identified in April. Children under age 18 account for about 10 percent of those deaths.

The N.C. Department of Health and Human Services said that as of last Tuesday, there have been 76 North Carolina deaths related to swine flu.

More than 100 million doses are available nationwide, with 10 million more arriving every week. Although the local response for people in the targeted groups was strong last month, health officials say that interest has waned since doses became available to most people on Dec. 8.

The targeted groups are pregnant women, children and young adults from 6 months to 24 years, caregivers of children younger than 6 months, health-care workers, and people ages 25 to 64 who have such chronic health conditions as asthma, diabetes, anemia, other blood disorders, heart, lung, kidney or liver disease.

Among the reasons for the dwindling sense of urgency is fewer recent cases of swine flu, increased availability of vaccine, procrastinators, and some people who believe that they have already beaten the odds.

For example, the Forsyth County Health Department administered 5,552 doses at last week's flu clinics -- the first time that the vaccine was available for most residents.

"We had vaccine supplies and staffing capacity to have vaccinated nearly twice as many on Tuesday and Wednesday as showed up," said Dr. Tim Monroe, the county health director.

"Whenever the specter of a shortage is on the horizon, people rush to get in line," Monroe said. "If assured that supplies are available, they are more casual."

Officials estimate that Forsyth County has administered up to 50,000 doses. That number includes booster shots for children between ages of 6 months and 9 years.

As impressive as 50,000 doses may sound, it really means that no more than 15 percent of Forsyth residents have been vaccinated against swine flu.

Ohl said that even when including residents who were sick with the swine flu this year -- thus building up a level of immunity-- the local community remains vulnerable to a major epidemic.

"You would need to see 40 percent of the community either have the vaccination or gain a level of immunity from getting swine flu before you can say there is a reasonable level of protection," he said.

With the latest estimation of 343,028 people in Forsyth County, that means that about 137,000 residents would have to be vaccinated or have contracted swine flu to reach that level of protection.

"Right now, we're nowhere close to that level, and we're not likely to get there at the current dose-intake levels," Ohl said.

The ratio of college students statewide who have been vaccinated mirrors the rate among Forsyth residents at 13 percent, according to the N.C. Division of Public Health. There are more than 495,000 students enrolled in colleges in North Carolina.

State officials are urging teenagers and college students to get an H1N1 vaccination during the holiday break since it has had "a disproportionate impact on young, healthy people."

"The holidays are a perfect time for parents to ensure that their teens and college students are vaccinated against H1N1," said Dr. Jeffrey Engel, the state's health director.

Dave Marley, the president and chief executive of Marley Drug in Winston-Salem, is preparing an advertising blitz to raise awareness that his pharmacy has 700 H1N1 doses to administer on a walk-in basis.

"My guess is that once people are aware, we'll do about 50 doses a day, and it'll be eaten up within two weeks," Marley said. The pharmacy also has 300 doses of seasonal-flu vaccine.

Marley said that the main reason for his concern is the possibility that the H1N1 virus could mutate with the seasonal-flu virus to form a harder-to-treat strain of influenza.

Health officials expect that cases of seasonal flu will peak


in late January and early February.

"When you get the seasonal flu and the H1N1 flu in the same person, it could be nothing serious or something serious," Marley said.

CVS Pharmacy is providing H1N1 and seasonal-flu vaccines on a walk-in basis at its MinuteClinics at 2770 Lewisville-Clemmons Road in Clemmons, 1101 S. Main St. in Kernersville, and 3325 Robinhood Road in Winston-Salem.

"Even though the demand has waned recently, we're still encouraging people to get the shots since it takes weeks for the immunity to build up," said Susan Dipert Scott, the operations manager for CVS in the Triad and Triangle.

"We recognize that December is a busy month for most people, which is why we're trying to be as accommodating as possible with these shots."

Monroe said that although the health department has no current plans for another major clinic, it may schedule one if a third wave of swine flu hits hard.

On Dec. 28, the department will be providing free doses on a walk-in basis during regular clinic hours -- 8:30 a.m. to 3:45 p.m. Mondays, Tuesdays and Thursdays; 9:30 a.m. to 6:45 p.m. Wednesdays; and 8:30 to 11:45 a.m. Fridays.

"I have been somewhat surprised that so many people outside the risk groups -- who regularly get the seasonal-flu vaccine -- are less motivated to receive the H1N1 vaccine," Monroe said.

"People are still at increased risk, and a safe vaccine is readily available to reduce their risk," he said, "but that message does not filter through."

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