Patients who want the H1N1 vaccine need to be triaged

by Kairol Rosenthal

I am a young adult cancer patient who waited five and a half hours for the H1N1 vaccination along with 1200 other Chicagoans in a city college hallway. I do not have the trained eye of a public health analyst, yet it was easy to spy the glaring flaws that occurred in the whimsical distribution of this short supply vaccine. One of these oversights was the absence of trained workers screening citizens to determine if they actually needed a shot.

In the midst of what the government is calling a pandemic, there was a stunning lack of triage. Anyone could wait in line and receive a shot no questions asked. The public health department merely instructed citizens to use a common sense approach: If you consider yourself high-risk, get a vaccination.

I am an extremely aggressive patient with a high level of health literacy. As the author of a book on young adult cancer, I strongly advocate for patients participating in our care and knowing our bodies. However, I am not a doctor and medical practice is not common sense knowledge. Determinations of whether a patient’s underlying medical condition puts them at high-risk for complications from influenza should have been made by trained medical professionals, not by citizens making nebulous judgment calls.

Tensions ran high in the hallway of the makeshift walk-in clinic as my linemates and I vied for low cue numbers. People cut in front of each other, police mediated shouting matches, and camera crews interviewed desperate patients. My linemates and I began discussing our ailments, each defending our high-risk need for the shot. The 51-year-old man in front of me thought he was at risk due to high blood pressure that sometimes limits his use of over the counter medications. One woman in her late fifties boasted she thought she had a predisposition for bronchitis. Were these accurate self-determinations of the need for the vaccination or were my linemates pilfering from the short supply?

A look of guilt crossed their faces when I told them I am a cancer patient. “You should stand in front of me,” the gentleman said. But who should stand in front of me? Are toddlers and asthma patients at the end of the line less needy than me, a refractory thyroid cancer patient with two incurable tumors in my neck? And did the man with high blood pressure belong in line at all?

I did not have to second-guess my decision about whether to receive a vaccination; my primary care physician recommended I get vaccinated. But many Americans do not have the luxury of access to a primary care physician. This is why we need public health workers screening patients at walk-in clinics and prioritizing risks. As we scrutinize the government about the availability of H1N1 vaccination, we also need to question the lack of discretion they are using in distributing this much needed serum.

Kairol Rosenthal is the author of Everything Changes: The Insider’s Guide to Cancer in Your 20s and 30s, and blogs at Everything Changes.

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