Health Advisory
EXEMPTION TO MERCURY LAW AND PRIORITIZATION OF MERCURY-FREE H1N1 VACCINE FOR THE 2009-2010 FLU SEASON

H1N1 vaccine is slowly becoming available in Delaware. Based on information received from the Centers for Disease Control and Prevention, mercury-free vaccine will likely be in short supply.

The purpose of this memo is to:

• Inform providers that the Director of the Division of Public Health has determined that a shortage of mercury-free H1N1 flu vaccine currently exists and has declared an exemption to the Mercury-Free Vaccine Act specific to H1N1 flu vaccine.
• Encourage providers to continue to maximize the use of mercury free H1N1 flu vaccine for children less than eight (8) years of age and pregnant women.
• Encourage providers to prioritize H1N1 flu vaccine so that all individuals 8 years and older (except pregnant women) are preferentially offered mercury containing H1N1 flu vaccine.

Delaware law requires that a provider administering a mercury-containing vaccine to children less than 8 years of age and pregnant women, inform the patient or legal guardian that the vaccine contains mercury, that they believe the vaccine to be medically necessary, and that the Director of the Division of Public Health has made a formal determination that the vaccine may be administered due to the existence of the shortage of mercury-free vaccines.

Background

In 2005, the Delaware General Assembly passed legislation intended to phase out mercury from all vaccines administered to children younger than 8 years old and to pregnant women within the state of Delaware by January 2008. The law provides the Director of the Division of Public Health (DPH) the authority to:

• determine when a shortage of mercury-free vaccine exists which could threaten the health of groups of individuals within the State including children less than eight (8) years of age and/or pregnant women, and that additional mercury-free vaccine cannot be made available from other means;
• declare an exemption to the Mercury-Free Vaccine Act for use by medical providers that administer the affected vaccines.

Pregnant women and children less than 8 years of age are a high priority for H1N1 vaccination. The schedule of vaccine shipments creates a shortage in Delaware during the projected duration of the epidemic at a time when vaccination of pregnant women and children under 8 years of age is urgent and should not be delayed. The exemption to the Mercury-Free Vaccine Act provides an opportunity for healthcare providers and patients to discuss the advantages and disadvantages of using mercury-containing vaccine and to proceed with vaccination options accordingly.

For More Information

A copy of the exemption to the Mercury-Free Vaccine Act specific to H1N1 flu vaccine is available at flu.delaware.gov. Providers who have questions may contact the immunization program at 1-800-282-8672 or 302-744-1060.

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