Limited amounts of the new H1N1 swine flu vaccine are expectedto begin arriving in Brookhaven later this month, but it couldstill be some time before the bulk of the general public has achance to be inoculated.

In fact, the first local people to receive the vaccination won’tbe patients, but doctors.

Health care providers around the city are preparing to followfederal guidelines for administering the vaccine, which designatefive specific groups that have priority for the first shipments.The federal Centers for Disease Control and Prevention hasidentified pregnant women, people who live with or care for infantsyounger than 6 months of age, health care and emergency medicalpersonnel, anyone from the age of 6 months to 24 years and anyonefrom 25 through 64 with certain chronic conditions or weakenedimmune systems as the first groups that will receive thevaccination.

Healthy adults aged 25 through 64 and adults 64 and older arethe last two groups in the pecking order. The vaccine will beissued to the public by the Mississippi State Department of Healthwhen shipments arrive.

“There’s limited access with physicians’ offices being able toobtain limited supplies, which primarily is the goal to go aheadand immunize health care workers in offices,” said Dr. Edward Moakof the Moak-Massengill Clinic. “We have a small supply we’veordered through the CDC/(Mississippi) State Department of Healthfor our office staff and those of us who are in directcontact.”

Moak said the government would be the predominate distributor ofthe vaccine for public use.

At nearby Brookhaven Internal Medicine, office manager DianePrice said her office would not offer the vaccine for the publicand would refer inquiries to the health department. The majority ofBIM’s patients are over 65 and will be last in line for thevaccination, she said.

King’s Daughters Medical Center Chief Regulatory Officer CathyBridge said the hospital is developing a priority list for which ofits employees will be inoculated first. With more than 500employees, not all the hospital’s staff will receive the vaccine iflimited amounts are shipped, she said.

“People like me, who are in the office all day, will be at thebottom of the list, while nurses and clinical staff will be at thetop of the list,” Bridge said.

Bridge said the hospital would vaccinate patients and emergencyroom visitors who fall into the appropriate category as suppliesbecome available.

The hospital chose not to order any of the existing nasal mistvaccine currently being offered before the traditional vaccinesarrive, Bridge said. She said a poll of hospital employees showedan unwillingness to use the spray, which includes a live butweakened H1N1 virus rather than a dead one, like the comingtraditional vaccine.

MDH Communications Director Liz Sharlot said there are 10,000does of the nasal mist available to hospitals now. She saidtraditional vaccines should begin arriving “in the comingweeks.”

Moak said the vaccines could arrive in Brookhaven by the end ofthe month, but a more realistic date would be early November. Whenshipments do arrive, Moak is recommending that people take thevaccine.

“My recommendation has been fairly emphatic – the vaccination,by all indications, appears to be perfectly safe,” he said.”There’s an individual immunity effect, as well as a herd immunityeffect. Each individual can make a contribution to the societalimpact, because the vaccination of that individual has a largerimpact on society.”

Moak stressed the “herd” effect of mass immunizations to preventthe spread of swine flu early next year, when conditions for thenumber of cases to increase in the South will be highest.

“None of us believe the current outbreak levels are anywherenear what we would anticipate seeing midwinter,” he said. “I thinkthe numbers are going to expand unless we see really diligentadministration of the vaccine during November and probably intoearly December.”

Moak said Brookhaven Academy officials are planning to offerinoculations at the school in early November when supplies are madeavailable.

Brookhaven School District Superintendent Lea Barrett said herschool board held a special-called meeting to discuss thepossibility of offering the vaccine. But the board decided they didnot have enough information to proceed.

Officials with the Lincoln County School District could not bereached for comment.

A bigger concern could be next season’s outbreak level, Moaksaid. Though swine flu has not become the killer originallypredicted, he said medical officials are worried about the virus’ability to mutate as it expands across the country.

“The concern is really not so much the virulence oraggressiveness of the virus, but the concern that either this fluseason or next flu season the virus, if not contained aggressivelyat this point, may show some of the same mutation patterns we’veseen in the 1918-19 or 1957-58 flu pandemic,” Moak said. “If we cancontain the number of cases this season, then we have a reasonablybetter chance that in the flu season in 2010, we would not see amutant strain that would be much more aggressive in nature.”

In the meantime, Moak said traditional flu treatments work wellfor treating swine flu. He said patients have responded well toTamiflu, Tylenol and anti-inflammatories, as well as traditionaltreatments like chicken soup, steady hydration and plenty ofrest.