Mass. tops nation in flu shots, report says

By Elizabeth Cooney Boston Globe Correspondent

Thirty-six percent of residents were inoculated against the swine strain, also known as H1N1, compared with 21 percent nationally. Seasonal flu vaccinations were administered to 57 percent of the state’s population, compared with 37 percent of the country.

“The mobilization in Massachusetts against H1N1 was a very successful one, as indicated by our immunization rates. We think that is a very significant finding and an indication that the approaches that we took were effective in reaching a large number of residents of the state in a short amount of time,’’ John Auerbach, commissioner of the Massachusetts Department of Public Health, said in an interview.

The state report was based on data from the US Centers for Disease Control and Prevention. Swine flu emerged almost a year ago in Mexico and quickly spread around the world. While the novel virus was officially declared a pandemic, H1N1 didn’t cause anywhere near the number of deaths that was initially feared — even after a second wave in the United States last fall.

As of March 18, 32 deaths had been confirmed in Massachusetts, all but five among people who had underlying medical conditions, according to the state.

Once a vaccine against H1N1 was formulated and distributed in October, limited amounts were allocated to high-risk groups first, including children and pregnant women. Children accounted for most cases of swine flu and pregnant women were also vulnerable, in a reversal of seasonal flu, which typically fells more people older than 65. Supplies didn’t come quickly enough or in the quantities needed at first, but about 2 million doses of vaccine were eventually given out in Massachusetts.

Auerbach said years of pandemic planning paid off, as did working across government agencies with local heath departments and school systems as well as with doctors and hospitals. Public health messages were disseminated through new vehicles, including online forums, Twitter feeds, 30-second videos in movie theaters and at checkout counters, and brochures in different languages.

Polls found that awareness of H1N1 was high and people were familiar with hand-washing and coughing into their sleeves as ways to prevent the spreading the virus.

While immunization levels were high in Massachusetts, the state still has a long way to go before reaching the near-universal vaccination federal officials recently recommended. The CDC’s Advisory Committee on Immunization Practices suggests that everyone older than 6 months get inoculated against flu. Next season’s vaccine will include protection against the H1N1 strain.

Auerbach said two important lessons were learned about H1N1. First, following updated CDC guidance, school closures in Massachusetts dropped from 44 in the spring to seven in the fall without harm. Second, people who are members of ethnic or racial minorities were hit disproportionately hard by H1N1. African-Americans and Hispanics were hospitalized at more than three times the rate of whites, state figures show.

Health officials said they do not know why there were such differences, but one reason could be where the virus was concentrated. Cases were clustered in urban areas, which have higher minority populations.

Another explanation could be the higher rates of chronic diseases such as asthma and diabetes among minority groups. Both conditions make people more vulnerable to flu and its complications, Auerbach said.

Nationally, African-American and Hispanic people were also hospitalized at higher rates than whites, according to data collected by the CDC, although people became sick with flu-like illnesses and sought health care at similar rates across racial and ethnic groups.

“It’s very important to ensure that we try to work with all our partners to encourage vaccination against influenza and try to be sure that people of specific racial and ethnic groups, especially with underlying conditions, are encouraged to be vaccinated with H1N1 and seasonal vaccine,’’ said Dr. David Swerdlow of CDC.

Cases of flu — either H1N1 or seasonal — have fallen off sharply since the start of the year, with flu activity now far below typical levels for this time of year.

The chances of coming down with H1N1 are diminishing in Massachusetts, Auerbach said. About one-third of the population has already had H1N1, and another third has been vaccinated. That level approaches what public health specialists call “herd immunity,’’ when there aren’t enough people sick with or susceptible to the illness for it to easily spread.

“That’s our hope anyway,’’ he said.

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