http://www.navytimes.com/news/2009/09/airforce_swineflu_090509w/

Service members around the world will begin receiving vaccinations for the H1N1 swine flu virus as early as October, officials said Sept. 1.

The Defense Department has ordered 2.7 million doses, and the first shipment of about 1 million is expected to be available in early October, said Army Lt. Col. (P) Wayne Hachey, director of preventive medicine for the Office of the Assistant Secretary of Defense for Health Affairs, Force Health Protection and Readiness.

The remaining 1.7 million doses are expected to be available in late October, Hachey said.

“As soon as installations have the vaccine, they should be administering it,” he said. “The mantra is, the best storage depot for this vaccine is in an arm rather than on a shelf.”

All uniformed personnel must be vaccinated, Hachey said.

“When you come on active duty, you belong to us and we take care of you,” he said. “Part of taking care of you is making sure you are protected, so that includes your Kevlar and it includes your flu shot.”

Atop the priority list to receive the vaccine are deployed troops, those on ships or submarines, health care workers and those in large training venues such as basic training, Hachey said.

“The places we’re always more concerned about are those places that have a higher risk of disease transmission,” he said. “Any time you take anybody, whether they wear a uniform or not, squash them into a confined space and put them under a stressful environment, the chances of disease are going to go up.”

It won’t be known for one or two months if the vaccine will have to be administered in one or two doses, but Hachey said the Defense Department will use the same distribution system for this vaccine as it does for the seasonal flu vaccine.

“DoD does mass immunization with our seasonal flu vaccine,” he said. “On a very bad year, we cover about 95 percent of the active force in a matter of a few months.”

When the H1N1 stocks arrive, they will be sent directly from the manufacturer to a depot in Europe for troops stationed in the U.S. Central Command, European Command and African Command areas, and then to the installations or medical assets in theater for distribution to the troops, Hachey said.

Vaccines destined for stateside troops and those in U.S. Pacific Command will go to a supply depot in Pennsylvania for distribution, he said.

More than 3,849 cases of H1N1 have been recorded since April 17 among active-duty troops, family members, trainees and retirees. But the Defense Department, along with the World Health Organization and the Centers for Disease Control and Prevention, stopped counting individual cases in late July, Hachey said.

“Most of the cases have been mild, with the lion’s share not being tested for confirmation,” he said. “And a lot of those people didn’t even go to the clinic because it was acting like a mild case of the flu, so the numbers didn’t have any real meaning as far as the true number of cases.”

But the Defense Department continues to monitor any possible cases, especially among people who require hospitalization, Hachey said.

Experts continue to examine samples from patients with flu symptoms, and their findings are shared with the CDC and sometimes the WHO, he said.

Defense Department health care providers also download data every day on the types of symptoms exhibited by their patients, so officials can track which locations and areas have concentrations of people showing flu-like symptoms, he said.

“It’s a pretty big net that we cast on a day-to-day basis, looking for either lab-confirmed flu or people showing up in the clinic with flu symptoms,” Hachey said.

The Defense Department takes any communicable disease seriously, he said.

“We want to know if something is showing up and we want to know early so we can intervene early,” he said. “Any of these diseases can be potential show-stoppers for DoD, and that’s why, on the medical side, we’ve been doing pandemic flu prevention for over a decade.”

In addition to the vaccine, the Defense Department is using anti-viral medication such as Tamiflu and Relenza, screening troops for flu-like symptoms before they board a plane to deploy and after they land, and encouraging common-sense measures such as covering coughs and sneezes and telling troops to stay home if they’re sick, Hachey said.

The military also has bought 7 million syringes and stockpiled gowns, masks and gloves for its health care providers.