1. Current Status National and California 2009 H1N1 Influenza and Vaccine Distribution Harvey Kayman, MD, MPH, PHMO III Senior Science Adviser Communicable Disease Emergency Response Branch Division of Communicable Disease Control California Department of Public Health

2. CDC’s FluView http://www.cdc.gov/flu/weekly/

4. Basic Reproductive Ratio Rº Definition: The mean number of new influenza infections created by a newly infected person in a population of susceptible people. Rº = Np N = the number of people a contagious person will encounter in a day. p =probability that the index person will pass the infection on to another person. Larson. RC. Pandemic Flu: Yes, We Can Do Something About It! Cal-OSHA Reporter April, 2008

5. Estimate of % of US Population susceptible to 2009 H1N1 Flu 12 15 09-Assumption 1(For 2 ill, 1 asympt)

6. Estimate of % of US Population susceptible to 2009 H1N1 Flu 12 15 09-Assumption 2 (For 1 ill, 6 asympt)

7. Age specific hospitalization/fatality rate (per 100,000 population) of 2009 H1N1 influenza in California, reported April 23 - December 5, 2009

8. Age specific mortality rate (per 100,000 population) of 2009 H1N1 influenza in California, reported April 23 - December 5, 2009

9. USA H1N1 vaccine supply and distribution Date of Prediction July 09October 20, 2009 Available for predicted date Mid-OctoberBy November By December Doses predicted 80 million to 120 million 50 million150 million Amount available 7 million24-48 million early to late November 59 million on Dec 1

10. Date Allocated OrderedShipped 12/14/09 86 Million 80 Million 76 Million Graph and Table of 2009 H1N1 Influenza Vaccine Doses Allocated, Ordered, and Shipped in U.S. Updated December 14, 2009, 5:00 PM ET http://www.cdc.gov/h1n1flu/ vaccination/supplygraph.htm

11. Why such a shortage of swine flu vaccine? Michael D. Shear and Rob Stein Washington Post October 27, 2009 Michael D. Shear and Rob Stein Health and Human Services Deputy Secretary, Nicole Lurie, said when the companies "hit some stumbling blocks, they sometimes thought the fix was around the corner and didn't always feel the needed to tell us, and then sometimes it turned out the fix wasn't around the corner." Representatives of the five companies: Sanofi Pasteur, Novartis, MedImmune, GlaxoSmithKline and CSL said they kept the government informed along the way about challenges, including a slower-than-expected growth of the vaccine inside chicken eggs. The current science of vaccine production is highly unpredictable and unreliable.