Missouri Provides Option Of Mercury-Free Vaccines

Wally Kennedy
The Joplin Globe
Oct. 27, 2009

In a move that is sure to generate controversy, Missouri’s top public health official granted an exemption Thursday that allows pregnant women and parents of children younger than 3 to choose whether to receive H1N1 flu vaccine containing a mercury-based preservative.

Critics of the mercury-based vaccine lobbied the state Legislature a few years ago to prevent its use because of alleged connections to childhood autism.

Dr. Keith Grebe, medical director at McCune-Brooks Regional Hospital, praised the relaxation of the rule on Friday.

Clinic canceled

“We had a clinic scheduled for (Friday) at McCune-Brooks where up to 80 patients, including pregnant women, would have received the (H1N1) vaccine with the preservative in it because the supply of vaccine without the preservative is in very short supply,’’ he said.

“We had to cancel the clinic scheduled for today because we were technically breaking the law.’’

Grebe said the Missouri Department of Health and Senior Services received pressure from all across the state to release the vaccine for pregnant women.

“The vaccine now will be available to pregnant if they choose to take it,’’ he said. “They may choose to wait for the preservative-free vaccine that will come out, but at least they can make that choice now.’’

Grebe said a national obstetric association on Oct. 20 said the preservative in the H1N1 vaccine is safe for pregnant mothers.

Grebe said there is no doubt this is a serious issue for pregnant women.

“Some of our patients have been very emotionally upset that this vaccine was not available to them,’’ he said. “I am not certain of the latest numbers, but as best as I can recall there have been at least 26 H1N1 deaths among pregnant women in this country.’’

Grebe said pregnant schoolteachers are especially concerned about the unavailability of vaccine to them because they are encountering sick children in their schools every day.

“I know half a dozen people who have gone to get the vaccine,” he said. “A large percentage of pregnant women we see will obtain it as soon as possible.’’

Temporary exception

Margaret Donnelly, director of the state Department of Health and Senior Services, determined that a shortage of preservative-free vaccine was preventing pregnant women and young children from obtaining the new H1N1 vaccine.

Donnelly’s action temporarily sets aside a statute that prohibited pregnant women and children younger than 3 from receiving vaccine with this preservative.

The statute also allows the health director to set aside the ban in certain circumstances, including a pandemic or a shortage of vaccine. The waiver will remain in effect until the preservative-free vaccine becomes available.

“The H1N1 flu is now widespread throughout Missouri,” Donnelly said. “We know that pregnant women and young children are the most susceptible to this illness. But delays in vaccine production have created a situation where the most vulnerable people were left without vaccine protection.”

Donnelly urged women and the parents of young children to consult their health care provider to determine whether any vaccine is appropriate for them.

Trickle of vaccine

Vaccine is trickling into the Joplin area, but it is being distributed directly to local medical providers who are getting it to high-priority patients, including pregnant women.

“We encourage our residents to be patient, and continue to practice the preventive measures to help protect themselves and others from this flu, as well as the seasonal flu,” said Dan Pekarek, director of the Joplin Health Department.

“Because we have a multitude of medical providers that provide services to the high-risk populations daily, the local vaccine allocations are being sent to them first to try and meet their needs,” he said. “More rural counties around us, with fewer medical providers, do not have that issue, and their health departments are the primary flu vaccine providers.”

Shipments of the vaccine to this area will continue, but local health officials do not have control over the quantities they receive.

“This is a week-to-week issue for us,’’ he said. “Our allocation this week was less than the previous week. We are being told production and distribution will catch up.’’

Local ERs busy

A spokesman for St. John’s Regional Medical Center in Joplin on Friday said the emergency department is seeing between 30 to 50 flu-like patients per day. That rate remains unchanged from last week.

At Freeman Hospital West, a spokeswoman said the emergency department last week was seeing 18 to 20 patients per day with flu-like symptoms and that roughly seven patients per day were being diagnosed with influenza. This week, the hospital is seeing about 35 to 37 patients per day with flu-like symptoms and that roughly 11 patients per day are being diagnosed with influenza.