Flu vaccine clinic turnout lower than expected

Kyle Kelley of West Roxbury put on a brave face as a public health nurse wiped a spot on his arm and gave him a quick shot of the H1N1 vaccine.

“Good boy’’ said his mother, Tracey, patting his back as her other two children watched in amazement.

But try as he might, Kyle could not hold back the tears.

“It didn’t hurt at first,’’ explained the 8-year-old. “Usually [the needle] stays in four seconds, but I counted it and it was two seconds. But it didn’t hurt that much.’’

Inside the gymnasium at Hyde Park High School, there were squeals, tears, brave faces, and shirt sleeves rolled up as hundreds came out to get the H1N1 vaccine.

Boston public health officials had hoped to inoculate 5,000 residents in Hyde Park yesterday against H1N1 - and another 5,000 today in West Roxbury - as part of a community vaccination drive that targets people most at risk for getting swine flu. The H1N1 vaccine is only being offered to those at greatest risk of complications and viral illness - people age 3 to 24, and adults 25 through 64 who suffer from asthma, heart disease, diabetes, and other chronic conditions. Regular seasonal flu shots were not offered this weekend.

By 3 p.m. yesterday, 715 people in Hyde Park had gotten their shots or nasal spray.

Ann Scales, spokeswoman for the Boston Public Health Commission, said the turnout was lower than expected because fewer reported cases of flulike illnesses have been reported recently and because many city residents are already vaccinated.

“That has suppressed interest in the vaccine,’’ she said.

Panic about the swine flu is waning as many people with symptoms are opting to stay home and ride out the illness rather than going to their doctor, she said.

For the past two months public health officials have been teaming with the city’s community health centers to hold free H1N1 flu clinics, and more than 12,000 Boston residents have received shots or nasal sprays to fight swine flu, said Barbara Ferrer, the health commission’s executive director.

Public health officials decided to hold the massive flu clinics in Hyde Park and West Roxbury because neither have health centers.

“These residents want easy access to public clinics,’’ said Ferrer. “Many people can go to see their health care providers . . . but in every neighborhood we’ve promised public clinics.’’

Since April, 1,867 confirmed cases of swine flu have been reported in Massachusetts, and 25 people have died from it, according to the latest flu report from the Massachusetts Department of Public Health last week.

For about five hours yesterday, a steady stream of Boston residents lined up, filled out health-related questionnaires, and got shots or nasal spray.

To keep the lines moving, more than 150 health workers in blue and green vests answered questions in multiple languages and steered residents in the right direction. They also posted reminders and updates, along with photographs, on Twitter.

The weekend flu clinics come two days after the state released a report that showed swine flu is loosening its grip on Massachusetts patients. According to the report from the Department of Public Health, the number of patients complaining of flu-like symptoms has fallen to its lowest level in a month.

Last week, influenza accounted for 3.55 percent of visits to a representative sampling of Massachusetts physicians. In early November, nearly 10 percent of the visits were attributed to the flu, the Globe recently reported.

Illness, death and the impact of the H1N1 pandemic will differ dramatically from country to country

Dr. Margaret Chan, Director-General of the World Health Organization, said Tuesday that this disparity is because the pandemic is spreading in a world where differences in health status, in access to care, in quality of that care, and in resources for health, are greater than at any time in recent history.

The Swine Flu pandemic will be a public health turning point around the globe because the consequences are likely to be so uneven and so unfairly felt depending on where you are.

Speaking to the WHO’s Regional Committee of the Americas, the director predicted that the overwhelming majority of cases will experience mild illness with spontaneous recovery.

However, she cautions that as the illness increases, this somewhat rosy picture will differ because of extremes in the clinical spectrum of disease, in public opinion, in access to vaccines, in ability to respond and in impact.

“The world will see proof of the validity of arguments public health has been making for decades,” she said and added that “Weak health systems cost lives. Equity matters in health in a life-and-death way.”

She calls H1N1 a “virus of extremes” that doesn’t “seem to have a middle ground.”

At one extreme are the mild cases, she said. At the other extreme is a small subset of patients who rapidly fall seriously ill, sometimes going from normal respiratory function to multi-organ failure within 24 hours

When exactly the same virus causes manageable disruption in wealthy countries, but devastation for health care elsewhere, we will see what inequity really means in a measurable way, the physician explained.

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