With the change in the criteria on who can order and administer vaccines, large employers like Goldman Sachs and Citigroup have been able to order swine flu vaccines for their "high-risk" employees.  Is this really who will be getting the vaccine?  Well, due to the city's reporting requirements (i.e. every swine flu vaccine given has to be logged in a central database), maybe we'll find out.  However, there is no clear way to track this, and whether this is just another sign of corporations getting preferential treatment.  Let's step back, though.  These companies do tend to have multiple employees working in adjacent or nearby cubicles, so the likelihood of spread from one index case is high.  Just this week, a patient called me because of flu-like symptoms, and at least two of his office mates had the swine flu, several others had "bronchitis."  Well, as the flu season gets under full swing here in NYC, we will keep track of its spread as a barometer of the effectiveness of the citywide immunization program.  Meanwhile, I have yet to receive preservative-free single-dose prefilled syringe doses for my high risk patients.

Here is the latest from the World Health Organization:
"There were more than 440,000 laboratory-confirmed cases of H1N1 and more than 5,700 deaths reported as of Oct. 25 to the World Health Organization, which declared the outbreak a global pandemic in June. But because many countries have stopped counting individual cases, particularly when the effects have been milder, WHO says it's likely the actual count is significantly higher. Teenagers and young adults continue to account for the majority of cases around the world, while WHO says pregnant women are 10 times more likely than the general population to check into an intensive care unit. In a typical flu season, 90% of the deaths occur in the over-65 demographic, whereas the swine flu pandemic has taken the opposite course. "This is a younger people's flu," Frieden noted."  - BusinessWeek, November 2, 2009