Rationing for the H1N1 vaccine is already recommended by the CDC, especially if you’re over 64, an age group previously considered as vulnerable.

Compare and contrast the priority status for who should receive the seasonal influenza vaccine vs the H1N1 vaccine.  Some contradictions here.  If you’re over 50, you should get the generic shot, but if you’re 65 or older, you should not get the H1N1 if quantities are limited.  However, the Texas Department of State Health Services DOES recommend that people over 65 receive the H1N1 vaccine.

Novel H1N1 Vaccination Recommendations – CDC
*  Pregnant women because they are at higher risk of complications and can potentially provide protection to infants who cannot be vaccinated;
* Household contacts and caregivers for children younger than 6 months of age because younger infants are at higher risk of influenza-related complications and cannot be vaccinated. Vaccination of those in close contact with infants less than 6 months old might help protect infants by “cocooning” them from the virus;
* Healthcare and emergency medical services personnel because infections among healthcare workers have been reported and this can be a potential source of infection for vulnerable patients. Also, increased absenteeism in this population could reduce healthcare system capacity;
* All people from 6 months through 24 years of age
• Children from 6 months through 18 years of age because we have seen many cases of novel H1N1 influenza in children and they are in close contact with each other in school and day care settings, which increases the likelihood of disease spread, and
• Young adults 19 through 24 years of age because we have seen many cases of novel H1N1 influenza in these healthy young adults and they often live, work, and study in close proximity, and they are a frequently mobile population; and,
* Persons aged 25 through 64 years who have health conditions associated with higher risk of medical complications from influenza.

We do not expect that there will be a shortage of novel H1N1 vaccine, but flu vaccine availability and demand can be unpredictable and there is some possibility that initially, the vaccine will be available in limited quantities.  So, the ACIP also made recommendations regarding which people within the groups listed above should be prioritized if the vaccine is initially available in extremely limited quantities. For more information see the CDC press release CDC Advisors Make Recommendations for Use of Vaccine Against Novel H1N1.
2009-10 Seasonal Influenza Vaccine Updates – CDC recommendations for ordinary flu
People recommended for seasonal influenza vaccination during the 2009-10 season remain the same as the previous season:
* Children aged 6 months up to their 19th birthday
* Pregnant women
* People 50 years of age and older
* People of any age with certain chronic medical conditions
* People who live in nursing homes and other long-term care facilities
* People who live with or care for those at high risk for complications from flu, including:
o Health care workers
o Household contacts of persons at high risk for complications from the flu
o Household contacts and out of home caregivers of children less than 6 months of age (these children are too young to be vaccinated)

CDC Guidance for State and Local Public Health Officials and School Administrators for School (K-12) Responses to Influenza during the 2009-2010 School Year with Texas Specific Notes from DSHS – published by the Texas Department of State Health Services
Texas Note:
Box 2. Persons at Higher Risk for Complications of Novel H1N1 and Seasonal Influenza

* Children younger than 5 years old. The risk for severe complications from seasonal influenza is highest among children younger than 2 years old.
* Pregnant women
* Adults 65 years of age and older.
* Persons with the following conditions:
o Chronic pulmonary (including asthma), cardiovascular (except hypertension), renal, hepatic, hematological (including sickle cell disease), neurologic, neuromuscular, or metabolic disorders (including diabetes mellitus);
o Immunosuppression, including that caused by medications or by HIV;
o Persons younger than 19 years of age receiving long-term aspirin therapy and who might be at risk for experiencing Reye syndrome after influenza infection;
o Residents of nursing homes and other chronic-care facilities.