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<recommendedContent xmlns="http://api.mspoke.com">
    <recommendedItem id="20100101_19_414"
                     title="H1N1 Vaccination Still a Good Idea, CDC Says"
                     score="0.012"
                     href="http://www.medpagetoday.com/InfectiousDisease/SwineFlu/tb/18325?impressionId=1265804515210"
                     
      &lt;p&gt;Although pandemic H1N1 influenza activity appears to have leveled off, the CDC remains wary of what the future may hold.&lt;/p&gt;
&lt;p&gt;No states were reporting widespread influenza activity, and only six  --  Alabama, Georgia, Maine, New Jersey, New Mexico, and Virginia  --  were reporting regional activity, Anne Schuchat, MD, director of the CDC&apos;s National Center for Immunization and Respiratory Diseases, told reporters on a conference call today.&lt;/p&gt;
&lt;p&gt;Influenza-like activity remained below the baseline level for this time of year for the third straight week, Schuchat said.&lt;/p&gt;
&lt;p&gt;&quot;That&apos;s fairly similar to what we would normally see at this time of year with seasonal flu,&quot; she said.&lt;/p&gt;
&lt;p&gt;However, she said that the H1N1 virus continues to circulate, causing severe disease and death in some cases.&lt;/p&gt;
&lt;p&gt;Although total activity is down, Schuchat noted that the proportion of deaths attributed to either flu or pneumonia is higher than the epidemic threshold, and has been for the past three weeks. The reasons were unclear, but she said there are no indications that the virus has become more virulent.&lt;/p&gt;
&lt;p&gt;But, she said, &quot;H1N1 vaccination remains a good idea.&quot;&lt;/p&gt;
&lt;p&gt;The most recent results of the CDC&apos;s National H1N1 Flu Survey revealed that about 70 million people, or 23.4% of Americans, have been vaccinated so far. About 76 million doses of the vaccine have been used because of the requirement that children younger than 10 get two.&lt;/p&gt;
&lt;p&gt;About 37% of children up to age 18 have been vaccinated. For those younger than 10, 37% have received their second dose.&lt;/p&gt;
&lt;p&gt;Vaccine supply remains ample, Schuchat said, with about 124 million doses shipped around the country up to this point.&lt;/p&gt;
&lt;p&gt;Citing an &quot;unprecedented&quot; effort to monitor safety, she said there have not been any major safety concerns identified.&lt;/p&gt;
&lt;p&gt;&quot;So if safety was the reason that you were waiting, I think you can be reassured on that front.&quot;&lt;/p&gt;

    </recommendedItem>
    <recommendedItem id="20100101_19_302"
                     title="WHO Calls H1N1 Response Imperfect"
                     score="0.004"
                     href="http://www.medpagetoday.com/InfectiousDisease/SwineFlu/tb/18165?impressionId=1265804515210"
                     
      &lt;p&gt;The World Health Organization says its response to the H1N1 pandemic could have been better, but was not unduly swayed by drug manufacturers.&lt;/p&gt;
&lt;p&gt;&quot;We are under no illusions that this response was the perfect response,&quot; Keiji Fukuda, MD, the agency&apos;s top flu expert, told a hearing being held by the Council of Europe&apos;s health committee.&lt;/p&gt;
&lt;p&gt;But he added, &quot;The influenza pandemic policies and responses recommended and taken by WHO were not improperly influenced by the pharmaceutical industry.&quot;&lt;/p&gt;
&lt;p&gt;The council&apos;s hearing is a response to criticism by some European politicians, as well as elements of the media, that the danger of the H1N1 pandemic was exaggerated, perhaps to allow drug companies to score multimillion-dollar contracts for vaccines and antivirals.&lt;/p&gt;
&lt;p&gt;In North America, many experts defended the response to the outbreak, which WHO last April declared a phase six pandemic  --  the highest level. The phases reflect that an infectious agent is widely spread and causing disease in the community, but they say nothing about the severity of the disease.&lt;/p&gt;
&lt;p&gt;&quot;I do not believe that the record supports the claim that health officials in the U.S. or WHO exaggerated the threat,&quot; said Andy Pavia, MD, of the University of Utah in Salt Lake City.&lt;/p&gt;
&lt;p&gt;Pavia said in an e-mail that health officials had a choice  --  to assume the threat was minor or to react strongly.&lt;/p&gt;
&lt;p&gt;&quot;The choice is obvious,&quot; Pavia said, &quot;and I would not want to be in a position of explaining to the families of victims why we planned for the mildest outcome.&quot;&lt;/p&gt;
&lt;p&gt;For the most part, illness caused by the disease has been mild, although several thousand people have died around the world and many more were sick enough to require intensive care.&lt;/p&gt;
&lt;p&gt;But the relatively low number of deaths has prompted Wolfgang Wodarg, MD, a German member of the council&apos;s Parliamentary Assembly, to dub the outbreak a &quot;false pandemic&quot; and call for this week&apos;s hearing.&lt;/p&gt;
&lt;p&gt;&quot;What we have experienced now is that millions of people have been vaccinated unnecessarily,&quot; Wodarg said. &quot;This is damage done to people, in order to earn money.&quot;&lt;/p&gt;
&lt;p&gt;Fukuda, on the other hand, said today the pandemic &quot;is a scientifically well-documented event.&quot;&lt;/p&gt;
&lt;p&gt;&quot;The labeling of the pandemic as &quot;fake&quot; is to ignore recent history and science,&quot; he said, &quot;and to trivialize the deaths of over 14,000 people and the many additional serious illnesses experienced by others.&quot;&lt;/p&gt;
&lt;p&gt;Utah&apos;s Pavia echoed that sentiment. Ask any front-line doctor if the H1N1 flu was mild, he said, &quot;and prepare to get your head handed to you.&quot;&lt;/p&gt;
&lt;p&gt;One of them was Daniel Hinthorn, MD, of the University of Kansas Medical Center in Kansas City, Kan. &quot;As a physician who saw many patients with this disease, I believe it was very serious in many people,&quot; he wrote in an e-mail. &quot;The threat was not exaggerated, at least to my mind.&quot;&lt;/p&gt;
&lt;p&gt;Even last month, as flu activity in the U.S. declined, he said his hospital treated 11 inpatients for the flu, including six in intensive care, while &quot;lots of others&quot; were being seen in emergency wards and clinics.&lt;/p&gt;
&lt;p&gt;On the other hand, to say the threat was exaggerated &quot;is merely to say the obvious,&quot; argued Philip Alcabes, PhD, of City University of New York City. By the time a vaccine was available, &quot;this outbreak was far less serious than feared,&quot; he said in an e-mail.&lt;/p&gt;
&lt;p&gt;But &quot;reality-based skepticism about swine flu&quot; doesn&apos;t mean that people would refuse immunization  --  not if an outbreak was a real public danger, caused by a &quot;highly transmissible agent, likely to be virulent, highly preventable with reliably effective vaccine.&quot;&lt;/p&gt;
&lt;p&gt;He warned that public health professionals must avoid &quot;falling in love with the most dire forecast and then pushing high-tech precautions against the worst-case scenario.&quot;&lt;/p&gt;
&lt;p&gt;When that happens, &quot;people have to be excused for wondering whether the officials, the media, and the pharmaceutical companies were in cahoots on swine flu,&quot; he said.&lt;/p&gt;
&lt;p&gt;But several experts argued that preparing for a worst-case scenario was the responsible thing to do.&lt;/p&gt;
&lt;p&gt;Sometimes, &quot;mother nature throws us a break,&quot; argued Howard Markel, MD, PhD, of the University of Michigan in Ann Arbor.&lt;/p&gt;
&lt;p&gt;&quot;We responded to a threat without knowing the future,&quot; he said in an e-mail. &quot;A far worse outcome might have occurred if we did not take the threat seriously and H1N1 turned out to be worse than we initially predicted.&quot;&lt;/p&gt;
&lt;p&gt;The public health response should be compared to the use of seat belts or auto insurance, according to Gregory Poland, MD, of the Mayo Clinic in Rochester, Minn.&lt;/p&gt;
&lt;p&gt;Every day, he said in an e-mail, he puts on his seat belt before driving. &quot;I don&apos;t finish each day and say &apos;What a waste, I didn&apos;t have an accident,&apos;&quot; he said.&lt;/p&gt;
&lt;p&gt;&quot;It is (and remains) unpredictable as to whether this virus could further mutate or change in a manner such that it could literally turn deadly within weeks,&quot; he said. &quot;If this pandemic had been deadly (and you don&apos;t know until you are into it) and we weren&apos;t prepared, the criticism would have been overwhelming.&quot; Poland said.&lt;/p&gt;
&lt;p&gt;He and others also noted that the flu season isn&apos;t over yet.&lt;/p&gt;
&lt;p&gt;&quot;This argument should be taking place at the end of the flu season in late March, not now,&quot; said Peter Katona, MD, of the University of California Los Angeles. &quot;Flu is unpredictable, and this is the heart of the argument.&quot;&lt;/p&gt;
&lt;p&gt;&lt;em&gt;This article was developed in collaboration with ABC News. &lt;/em&gt;&lt;img src=&quot;http://www.medpagetoday.com/upload/2009/10/1/14357_1.jpg&quot; mce_src=&quot;http://www.medpagetoday.com/upload/2009/10/1/14357_1.jpg&quot; alt=&quot;&quot;&gt;&lt;/p&gt;
    </recommendedItem>
    <recommendedItem id="20100101_19_169"
                     title="Hospitals Post Gains in Evidence-Based Care"
                     score="-0.005"
                     href="http://www.medpagetoday.com/HospitalBasedMedicine/Hospitalists/tb/17989?impressionId=1265804515210"
                     
      &lt;p&gt;WASHINGTON  --  The latest report from the nation&apos;s official hospital oversight agency, the Joint Commission, found more good than bad  --  overall, hospitals are following evidence-based standards for treatment of myocardial infarction, heart failure, and pneumonia.&lt;/p&gt;
&lt;p&gt;The annual report, &quot;Improving America&apos;s Hospitals: The Joint Commission&apos;s Annual Report on Quality and Safety,&quot; found that hospitals provided evidence-based heart attack treatments  --  including giving patients aspirin when they admitted  --  nearly 97% of the time in 2008, up 10% from the rate in 2002.&lt;/p&gt;
&lt;p&gt;Adherence was even better for treating heart failure. Back in 2002, hospitals treating heart failure patients were only following about 60% of evidence-based recommendations, but in 2008 hospitals were providing evidence-based treatment, including offering smoking cessation counseling and testing left ventricular systolic function, about 92% of the time.&lt;/p&gt;
&lt;p&gt;But mixed in with the glowing words there was a handful of cautions about areas where hospitals still fall short of the mark.&lt;/p&gt;
&lt;p&gt;Hospitals are still often doing too little, too late when it comes to the use of fibrinolytic therapy for MI  --  door-to-needle time only makes the 30-minute threshold about half of the time. A single but important pneumonia measure, initiation of antibiotics within 24 hours of admittance, was also disappointing, with just 60% of hospitals adhering to that measure.&lt;/p&gt;
&lt;p&gt;The Joint Commission&apos;s report tracks hospital use of 31 evidence-based measures.&lt;/p&gt;
&lt;p&gt;On the plus side, hospitals did improve overall adherence to care measures for pneumonia patients, following evidence-based treatment recommendations 93% of the time in 2008, versus 73% in 2002.&lt;/p&gt;
&lt;p&gt;Current guidelines recommend that smokers who are admitted for treatment of acute coronary syndromes, heart failure, or pneumonia should receive smoking cessation counseling, a recommendation that had often been ignored.&lt;/p&gt;
&lt;p&gt;In 2002 hospitals reported providing smoking cessation counseling to about 67% of heart attack patients, 42% of heart failure patients, and 37% of pneumonia patients  --  in 2008 the counseling rate for each of those three admitting diagnoses had climbed to 96% to 99%.&lt;/p&gt;
&lt;p&gt;In the report Mark R. Chassin, MD, Joint Commission president, wrote that improved adherence to evidence-based guidelines should not only improve outcomes, but also save money by reducing both complications and readmissions.&lt;/p&gt;
&lt;p&gt;The report also found that hospitals adhered to quality measures relating to inpatient treatment of childhood asthma  --  which includes giving relievers and systematic corticosteroids for asthmatic kids  --  in nearly 100% of eligible cases. &lt;ul&gt; &lt;/ul&gt;&lt;/p&gt;

    </recommendedItem>
    <recommendedItem id="20090101_19_3501"
                     title="IDSA: Retracted Mask Study Adds to H1N1 Confusion"
                     score="-0.005"
                     href="http://www.medpagetoday.com/MeetingCoverage/IDSA/tb/16745?impressionId=1265804515210"
                     
      &lt;p&gt;PHILADELPHIA  --  For workers on the front lines of the battle with H1N1 pandemic flu, the retraction of a study on protective masks adds to the confusion over how to guard against infection, experts said.&lt;/p&gt;
&lt;p&gt;Two recent studies have looked at the issue and  --  until this weekend  --  were split on the results, according to Andrew Pavia, MD, of the University of Utah, chair of the pandemic flu task force for the Infectious Diseases Society of America.&lt;/p&gt;
&lt;p&gt;The retracted study  --  conducted in China by Australian researchers  --  originally suggested that the expensive N95 respirators were effective and offered better protection than standard surgical masks.&lt;/p&gt;
&lt;p&gt;On the other hand, a Canadian study found no difference between the two masks. (See &lt;a href=&quot;http://www.medpagetoday.com/MeetingCoverage/IDSA/16729&quot; mce_href=&quot;http://www.medpagetoday.com/MeetingCoverage/IDSA/16729&quot; target=&quot;_blank&quot;&gt;IDSA: N95 versus Surgical Mask Findings Retracted&lt;/a&gt;)&lt;/p&gt;
&lt;p&gt;Many healthcare workers may still think &quot;the score is one to one,&quot; Pavia told &lt;em&gt;MedPage Today&lt;/em&gt;. But, in fact, &quot;it&apos;s 0 and 2, with no evidence of a benefit&quot; for N95 respirators, he said.&lt;/p&gt;
&lt;p&gt;Researchers here at the annual meeting of the infectious diseases society were startled when the Australian researchers said their original analysis was in error, and they could not demonstrate a benefit for the N95 masks.&lt;/p&gt;
&lt;p&gt;After a reanalysis prompted by questions from peer reviewers, the findings no longer demonstrated a significant benefit for the N95 respirators, reported Holly Seale, PhD, of the University of New South Wales in Sydney, Australia.&lt;/p&gt;
&lt;p&gt;Pavia said there was &quot;dismay that the perception remains out there that this study showed something that it didn&apos;t show.&quot;&lt;/p&gt;
&lt;p&gt;There was &quot;a little bit of shock&quot; that the results had changed so dramatically, said Neil Fishman, MD, of the University of Pennsylvania, president-elect of the Society for Healthcare Epidemiology of America.&lt;/p&gt;
&lt;p&gt;The two societies have consistently argued that N95 respirators are not the best way to guard against H1N1 infection and that their use has serious detrimental effects in terms of costs, patient care, and side effects for healthcare workers.&lt;/p&gt;
&lt;p&gt;A committee of the infectious diseases society met the morning after the retraction to discuss the issue, according to Robert Guidos, JD, the society&apos;s vice-president for public policy and governmental affairs.&lt;/p&gt;
&lt;p&gt;&quot;The evidence is now even more supportive of our position,&quot; Guidos told &lt;em&gt;MedPage Today&lt;/em&gt;, adding the retraction is likely to create &quot;greater confusion&quot; among healthcare workers.&lt;/p&gt;
&lt;p&gt;But the two societies were undercut by the original Australian study results, and most experts think those results influenced an Institute of Medicine recommendation that N95 respirators be used. (See &lt;a href=&quot;http://www.medpagetoday.com/HospitalBasedMedicine/WorkForce/15518&quot; mce_href=&quot;http://www.medpagetoday.com/HospitalBasedMedicine/WorkForce/15518&quot; target=&quot;_blank&quot;&gt;IOM Panel Hears How to Protect Healthcare Workers from H1N1&lt;/a&gt;)&lt;/p&gt;
&lt;p&gt;The lead author of the study, Raina MacIntyre, PhD, also of the University of New South Wales, presented the preliminary findings to the institute even before their first public presentation. (See &lt;a href=&quot;http://www.medpagetoday.com/MeetingCoverage/ICAAC/16006&quot; mce_href=&quot;http://www.medpagetoday.com/MeetingCoverage/ICAAC/16006&quot; target=&quot;_blank&quot;&gt;ICAAC: Surgical Masks Don&apos;t Prevent Infection&lt;/a&gt;)&lt;/p&gt;
&lt;p&gt;On the other hand, the Canadian study  --  published in the &lt;em&gt;Journal of the American Medical Association&lt;/em&gt; in October  --  was not part of the evidence considered by the IOM panel.&lt;/p&gt;
&lt;p&gt;The institute&apos;s panel &quot;did not necessarily get all of the appropriate data,&quot; Pavia said.&lt;/p&gt;
&lt;p&gt;The episode illustrates the danger of making policy based on preliminary studies, he said.&lt;/p&gt;
&lt;p&gt;&quot;Everything at a meeting like this has to be considered somewhat preliminary,&quot; he said. &quot;You can&apos;t draw real conclusions from 12 slides.&quot;&lt;/p&gt;
&lt;p&gt;The &quot;good news,&quot; Pavia said, is that the peer review process forced the researchers to reconsider their data and change their conclusions.&lt;/p&gt;
&lt;p&gt;But &quot;detrimental consequences&quot; remain, according to Fishman, including the following: &lt;ul&gt; &lt;li&gt;CDC guidance suggesting the respirators be used&lt;/li&gt; &lt;li&gt;The cost of complying with the guidance&lt;/li&gt; &lt;li&gt;Side effects of wearing N95 respirators&lt;/li&gt; &lt;li&gt;Adverse effects on patient care associated with the extra level of protection&lt;/li&gt; &lt;/ul&gt;&lt;/p&gt;
&lt;p&gt;The CDC guidance  --  which does not mention the IOM panel report  --  urges the use of masks &quot;at least as protective as a fit-tested disposable N95 respirator for healthcare personnel who are in close contact with patients with suspected or confirmed 2009 H1N1 influenza.&quot;&lt;/p&gt;
&lt;p&gt;It says the basis for the recommendation is &quot;the unique conditions associated with the current pandemic.&quot;&lt;/p&gt;
&lt;p&gt;The agency did not immediately respond to a request for comment.&lt;/p&gt;
&lt;p&gt;The guidance has several drawbacks, Pavia said, including the cost. Depending on variables such as the size of an order, a single N95 respirator costs about $4, he said, while surgical masks are &quot;several for a dollar.&quot;&lt;/p&gt;
&lt;p&gt;Supply is also limited, which may mean the masks are harder to come by for applications where evidence supports their use, such as for protection against tuberculosis.&lt;/p&gt;
&lt;p&gt;Healthcare workers may find the N95 masks difficult to use, Pavia added, and there&apos;s evidence of such adverse effects as headache, sore noses, and difficulty breathing.&lt;/p&gt;
&lt;p&gt;In addition, he said several studies have shown that when healthcare workers must use such protection, they tend to give less care to patients. &quot;It&apos;s a downside we&apos;re acutely aware of,&quot; he said.&lt;/p&gt;

    </recommendedItem>
    <recommendedItem id="20090101_19_2550"
                     title="IOM Panel Hears How to Protect Healthcare Workers from H1N1"
                     score="-0.005"
                     href="http://www.medpagetoday.com/HospitalBasedMedicine/WorkForce/tb/15518?impressionId=1265804515210"
                     
      WASHINGTON  --  An Institute of Medicine (IOM) panel heard divergent views on how much gear a healthcare worker should wear to protect against H1N1 (swine flu) virus.
&lt;p&gt;With an expected resurgence of H1N1 this fall, the agency is hearing testimony this week to help it draft final guidelines on personal protective equipment (PPE) standards for healthcare workers, including goggles, surgical masks, N95 respirators, gloves, and gowns.&lt;/p&gt;
&lt;p&gt;Other than preliminary data from a Chinese trial indicating that the N95 respirator offered significantly more protection than standard surgical masks, the testimony was largely anecdotal.&lt;/p&gt;
&lt;p&gt;One emergency room physician asked the panel to scale back the guidelines, arguing that doctors  --  especially in the emergency department  --  don&apos;t have time to don and doff layers of protective gear.&lt;/p&gt;
&lt;p&gt;But a director of a union that represents 2 million healthcare employees said more protection is needed, nothing that the virus might require healthcare workers to take personal protection more seriously than in the past.&lt;/p&gt;
&lt;p&gt;The 14-member ad hoc&lt;em&gt; &lt;/em&gt;committee, chaired by former IOM president Kenneth Shine, MD, (1992 to 2002), will issue a final report on guidelines to the CDC by Sept. 1.&lt;/p&gt;
&lt;p&gt;In April, after the H1N1 outbreak was detected, the agency backed strict protective measures, including recommending that the patient who is exhibiting flu-like symptoms wear a surgical mask, and the healthcare worker wear gloves, a gown, goggles, and an N95 respirator.&lt;/p&gt;
&lt;p&gt;The guidelines were based on a better-safe-than-sorry approach and are being revised in light of new information about how H1N1 is transmitted.&lt;/p&gt;
&lt;p&gt;After Wednesday&apos;s hearing, Dr. Shine told&lt;em&gt; MedPage Today&lt;/em&gt; that many of the presentations were based on anecdotal evidence and opinions, rather than data.&lt;/p&gt;
&lt;p&gt;For instance, Alexander Isakov, MD, MPH, associate director of emergency medicine at Emory University in Atlanta, compared the protection protocols at the two hospitals in which he sees patients.&lt;/p&gt;
&lt;p&gt;Emory University Hospital, a large teaching institution, followed the initial IOM recommendations and took great pains to protect its employees from H1N1 with full equipment (and thus to protect patients from catching the virus from staff). But as the H1N1 threat diminished over time, Isakov recalled, the staff weren&apos;t as compliant about donning PPE for every encounter with a potentially infected patient.&lt;/p&gt;
&lt;p&gt;Isakov said requiring so much protective gear resulted in suspected H1N1 patients having to wait longer to see a doctor while their physicians were seeing other patients for whom they did not have to don so much gear.&lt;/p&gt;
&lt;p&gt;He also sees patients at	Grady Health System, which he described as a a public &quot;safety-net&quot; hospital, which elected to follow less stringent recommendations from the World Health Organization (WHO), which do not call for an N95 respirator.&lt;/p&gt;
&lt;p&gt;A dearth of data on the effectiveness of the N95 will make the IOM&apos;s final decision on their use difficult. To date, there are no published clinical trials comparing the N95&apos;s virus-blocking efficacy with that of plain old surgical masks.&lt;/p&gt;
&lt;p&gt;The N95 designation is an efficiency rating indicating that the mask blocks 95 percent of particles which are 0.3 microns in diameter or larger.&lt;/p&gt;
&lt;p&gt;One researcher disclosed yet-to-be published data comparing surgical masks, fitted N95 respirators, and nonfitted N95 respirators among nearly 2,000 healthcare workers in Beijing.&lt;/p&gt;
&lt;p&gt;The full data will be presented in September at the Interscience Conference on Antimicrobial Chemotherapy in San Francisco, but the researcher&apos;s sneak peak at the findings indicated that surgical masks offered no influenza protection, while the N95 offered 75% protection against lab-confirmed flu. It made no difference whether the N95s were fitted or not.&lt;/p&gt;
&lt;p&gt;That study was conducted in Beijing, where there is a high compliance rate among healthcare workers regarding protective masks, lead researcher Raina MacIntyre, PhD, of the University of New South Wales in Australia, told the panel.&lt;/p&gt;
&lt;p&gt;In the U.S., protective gear compliance rates are low, in part because healthcare workers have no &quot;culture of safety,&quot; said Bill Borwegan, Occupations Health and Safety Director of Service Employees International Union (SEIU).&lt;/p&gt;
&lt;p&gt;The Occupational Health and Safety Act of 1970 (OSHA) requires employers to take feasible steps to reduce the risk inhalation of airborne particles.&lt;/p&gt;
&lt;p&gt;A surgical mask falls short of the standard, but a N95 respirator meets the standard, Borwegan said. He said a surgical mask is about 2.5 times better than no mask, while an N95 is 17.5 times better than no mask.&lt;/p&gt;
&lt;p&gt;The IOM&apos;s final recommendations will likely apply to healthcare workers dealing with any patient who presents with any acute respiratory symptoms.&lt;/p&gt;
&lt;p&gt;Others reminded the panel that healthcare workers exposed to H1N1 go beyond doctors and nurses, and will include nurses&apos; aides, receptionists, food preparation staff, nursing home workers, home healthcare workers, EMTs, and, in some cases, even firefighters and police.&lt;/p&gt;
&lt;p&gt;In July, the WHO said the healthcare workers should be the first to be vaccinated against H1N1 once a vaccine is available, because of their high exposure rates to the virus.&lt;/p&gt;
&lt;p&gt;The H1N1 vaccine is currently being tested at sites around the country and is expected to be available in October. (See &lt;a href=&quot;http://www.medpagetoday.com/InfectiousDisease/SwineFlu/15053&quot; mce_href=&quot;http://www.medpagetoday.com/InfectiousDisease/SwineFlu/15053&quot; target=&quot;_blank&quot;&gt;WHO Says Healthcare Workers Are H1N1 Vaccine Priority&lt;/a&gt;)&lt;/p&gt;

    </recommendedItem>
</recommendedContent>
