Maryland Gov. Martin O’Malley (D) on Wednesday said it was residents’
"patriotic duty" to get seasonal flu shots in coming weeks to make it
easier for health officials to determine if outbreaks are related to
H1N1, or swine flu.

If residents do not get vaccinated against seasonal strains and
later get sickened by them as a result, there will be little way to
determine if those falling ill this fall and winter have been infected
by less worrisome strains, or by the more contagious H1N1 virus,
O’Malley said.

The governor characterized that scenario as serious because it could
stress supplies of antiviral treatments and other resources needed to
care for swine flu victims, since only those Marylanders sick enough to
be hospitalized may undergo tests to confirm the presence of swine flu,
state health officials said.

"You’ll be doing your patriotic duty to get your seasonal flu shot
this year," O’Malley said. If you’ve never received one, "by golly,
this is a very good year to do it for the first time," he said.

O’Malleys plea for state residents to voluntarily get seasonal flu
shots in advance of a larger effort this fall to vaccinate children,
pregnant women, health-care workers and others against swine flu
followed a closed-door meeting with his cabinet and leaders from state
public-safety and health-care agencies. The meeting came one day after
those and other agencies were required to submit contingency plans for
how to keep the state government working should thousands of
transportation workers, state police, hospital employees or others fall
ill with H1N1.

Maryland, home to the nations swine flu summit in July at the
National Institutes of Health, was notably aggressive compared to
Virginia and other states during the initial H1N1 scare this spring in
terms of releasing information to the public about possible and
confirmed swine-flu cases. The state has since enhanced its own
contingency plans for dealing with the virus, adding to, for example,
its web of backup operations centers, should sickened employees force
officials to close key offices.

John M. Colmers, secretary of Health & Mental Hygiene, likened
Marylands share of the upcoming mass swine-flu vaccination campaign to
a "military operation," and said much remains unknown about exactly how
the state will carry it out. Unlike seasonal flu shots, which are
available now, swine flu vaccines will not be ready until at least
mid-October, and even then only in limited quantities.

"We’re trying to match what we know about the supply of the vaccine
and its particular formulation with the target populations and when we
believe it will arrive," Colmers said. He stressed that the only thing
the state knows for sure is that it won’t initially have enough doses
to vaccinate the roughly 2.9 million state residents considered most at
risk.

Colmers said the state is waiting for precise directions from the
Centers for Disease Control as to whether pregnant women, school-age
children, toddlers or others will be first in line for vaccinations.

Greg Reed, head of the Maryland Center for Immunization, said that
once that decision is made, Maryland will have direct authority to
instruct McKesson, the nations sole distributor for the vaccine, to
send shipments to the appropriate doctorsoffices or other
immunization centers.

"If its pregnant women, we’ll send those initial doses directly to
OB/GYN and others who specialize in their care. If its children less
than 4 years old, we’ll send them straight to pediatriciansoffices,"
Reed said.

Whichever group goes first, the effort will be far different from the annual flu shot campaign, which typically targets seniors.

Roughly 30 percent of residents in Maryland opt for seasonal flu
shots each year, health officials say, and theres little overlap with
that population and the one that will be asked to vaccinate against
H1N1. Just 42 percent of Maryland health care workers, for example, now
take flu shots.