April 1, 2010 -- Nearly one in four U.S. residents got the H1N1 swine flu vaccination, the CDC reports.
"If we had more vaccine earlier, more people could have received it," Anne Schuchat, MD, CDC director of immunization and respiratory diseases, said at a news conference. "We know we did prevent a lot of disease and death with our program, but if we'd had it sooner it would have been better."
Vaccination rates were highest in Rhode Island (38.8%) and lowest in Mississippi (12.9%). The median state vaccination rate was 23.9%. The numbers are based on self-reports in nationwide surveys of more than 214,000 U.S. residents.
H1N1 swine flu vaccination rates were much higher in children, who were among the high-risk groups sent to the front of the line when the vaccine was in short supply last fall.
Overall, 36.8% of U.S. kids got the vaccine by the end of January. Child vaccination rates ranged from 21.3% in Georgia to an amazing 84.7% in Rhode Island.
"It is premature to know exactly why some states did much better than others," Schuchat said. "Several factors likely contributed. Certainly when diseases are very visible, it is natural to have great demand for vaccines. Since New England saw their big upswing in November, they were able to take advantage of the increased supply that was then available."
However, Schuchat noted that states with school-based vaccination programs tended to vaccinate more of their children.
Millions of Doses Go Unused
Early last summer, federal health officials made the decision to purchase enough H1N1 swine flu vaccine to vaccinate nearly the entire U.S. population. It soon became apparent that the vaccine would not be available before schools opened in the fall.
Sure enough, schools in some Southern states opened in late August and H1N1 swine flu hit its peak well before large quantities of vaccine could be manufactured and delivered.
The CDC now estimates that 162.5 million doses of H1N1 swine flu vaccine have been "filled and finished" -- that is, packaged and ready for use, with expiration dates ticking away.
So far, between 81 million and 91 million doses have been given to between 72 million and 81 million U.S. residents (young children need two doses).
That means a lot of vaccine is left over. Some of that vaccine, about 25 million doses, has already been donated to poor nations. But millions of doses of leftover vaccine will have to be thrown out. That isn't unusual -- lots of flu vaccine gets discarded every year -- but the scale is unprecedented.
Schuchat defended the decision to purchase massive quantities of vaccine.
"We had to decide: Do we want more than enough or less than enough? And we decided to protect the American people," she said.
Since flu is unpredictable, CDC officials were very aware that the H1N1 vaccine supply would never match demand.
"Early on, CDC Director [Thomas] Frieden predicted there would be times when we will have less H1N1 vaccine than we need and times we will have more than we need -- and 12 seconds when we will have exactly enough," Schuchat said.
Schuchat pointed to the ongoing uptick in serious flu cases in Georgia as a reminder that people are still getting sick from H1N1 swine flu -- some of them very sick.
While next year's seasonal flu vaccine will protect against H1N1 swine flu, it won't be ready until next fall. Over the summer and early fall, H1N1 swine flu will still be with us. And the new flu season is just starting in the Southern Hemisphere, where it will threaten unvaccinated residents as well as unvaccinated travelers.
H1N1 Swine Flu Vaccine: State-by State Rates
Based on CDC surveys, here are the state-by state H1N1 swine flu vaccination rates through January 2010 (rankings added by WebMD; CDC does not rank states):
Rank | State | Entire Population | Children | Adults |
1 | Rhode Island | 38.8 | 84.7 | 26.6 |
2 | Massachusetts | 37.0 | 60.3 | 27.8 |
3 | South Dakota | 36.9 | 45.8 | 34.4 |
4 | Maine | 36.7 | 60.2 | 32.0 |
5 | Hawaii | 34.6 | 55.4 | 23.4 |
6 | Vermont | 34.2 | 72.3 | 25.9 |
7 | Iowa | 31.9 | 47.7 | 27.4 |
8 | Minnesota | 31.1 | 44.2 | 28.5 |
9 | North Dakota | 29.4 | 42.1 | 25.6 |
10 | Nebraska | 28.7 | 40.8 | 24.0 |
11 | New Hampshire | 28.0 | 45.5 | 22.9 |
12 | Arkansas | 27.6 | 50.0 | 15.7 |
13 | Kansas | 27.5 | 39.4 | 21.0 |
13 | New Mexico | 27.5 | 39.3 | 23.7 |
13 | North Carolina | 27.5 | 44.7 | 21.4 |
14 | Indiana | 26.5 | 46.7 | 19.7 |
15 | Washington | 26.4 | 36.6 | 23.4 |
16 | Illinois | 26.1 | 37.5 | 21.6 |
16 | Virginia | 26.1 | 39.9 | 22.6 |
17 | Maryland | 26.0 | 41.3 | 21.4 |
18 | Alaska | 25.0 | 26.6 | 24.5 |
18 | Delaware | 25.0 | 45.4 | 18.8 |
19 | Arizona | 24.9 | 40.3 | 20.1 |
19 | Utah | 24.9 | 31.0 | 21.4 |
20 | West Virginia | 24.2 | 47.3 | 18.2 |
21 | Colorado | 23.9 | 35.2 | 20.4 |
21 | Oregon | 23.9 | 35.3 | 20.9 |
22 | Wyoming | 23.8 | 32.6 | 21.0 |
23 | Montana | 23.4 | 33.6 | 20.2 |
24 | Wisconsin | 22.9 | 30.6 | 21.2 |
25 | Connecticut | 22.6 | 43.2 | 15.2 |
25 | Ohio | 22.6 | 33.5 | 18.0 |
26 | Tennessee | 22.5 | 34.5 | 19.5 |
27 | New York | 22.0 | 34.0 | 18.3 |
28 | California | 21.4 | 31.2 | 17.7 |
29 | Idaho | 21.2 | 29.5 | 17.8 |
30 | South Carolina | 20.6 | 37.6 | 14.6 |
31 | Oklahoma | 20.0 | 25.2 | 18.0 |
32 | Kentucky | 19.9 | 31.8 | 17.1 |
33 | District of Columbia | 19.7 | 38.7 | 14.6 |
34 | Florida | 19.5 | 32.3 | 16.1 |
34 | Pennsylvania | 19.5 | 36.8 | 14.5 |
35 | Michigan | 19.2 | 31.2 | 15.3 |
36 | Nevada | 18.1 | 25.2 | 15.8 |
37 | New Jersey | 17.8 | 32.7 | 13.1 |
38 | Georgia | 16.6 | 21.3 | 15.3 |
39 | Texas | 16.1 | 24.9 | 13.7 |
40 | Alabama | 15.7 | 29.2 | 10.7 |
40 | Missouri | 15.7 | 27.5 | 12.7 |
41 | Louisiana | 14.6 | 24.1 | 11.9 |
42 | Mississippi | 12.9 | 28.2 | 8.7 |
The CDC's report on the H1N1 vaccination program appears in the April 2 issue of Morbidity and Mortality Weekly Report.