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ANCHORAGE - Insulated cardboard boxes designed for shipping fish are carrying Alaska's first doses of swine flu vaccine to cities and villages.
State health officials Monday received 4,200 doses of H1N1 nasal flu vaccine in refrigerated boxes. They immediately began repackaging them into smaller seafood boxes marked "Perishable. Keep refrigerated," covered by stickers that said "vaccine."
The boxes are destined for state health centers.
"This is the first salvo," said Greg Wilkinson, spokesman for the Alaska Department of Health and Social Services.
The nasal spray is made from weakened viruses that do not cause the severe symptoms associated with the flu. It must stay refrigerated between 35 and 46 degrees.
Workers on Monday maneuvered in and out of a walk-in refrigerator to remove cartons of vaccine, insert them into the fish boxes, add a cold pack and a destination label, and then tape them up again.
Cartons carried 10 vials of vaccine. Workers added both warm and cold markers, said Della Fisher, a state health program associate.
"We can tell if they get too warm or too cold on their journey," Fisher said as she packed vaccine destined for Cordova.
It was a scene expected to be repeated frequently in the next weeks. Behind the health department workers, hundreds of larger boxes and plastic foam containers stood ready for additional batches of vaccine to arrive.
"We're set and ready," Fisher said.
Wilkinson said Alaska will order more vaccine from the Centers for Disease Control as it becomes available.
"The CDC will tell us daily whether there's any vaccine allotted for us that day," he said. "As soon as we have something, we'll order it."
Anchorage municipal officials were expected to take delivery of vaccine Monday. Vaccine for the Matanuska-Susitna Borough was to be trucked. Vaccine for most other communities was to be delivered by airplane, possibly by late today.
"We're getting it back on the planes as fast as possible," Wilkinson said.
It will be up to each community to decide how to use the nasal spray vaccine, which is licensed for healthy people age 2 to 49, but state health officials were recommending it be administered to children age 2-4.
Children in that age range are at increased risk for hospitalization compared to older children and the state epidemiologist said it would be the best investment, Wilkinson said.
"You got a nickel's worth," he said. "What are you doing to do with it?"
He could not say who would be in line for the next batch.
"It depends on what kind is available," Wilkinson said.
The nasal spray cannot be used on pregnant women or people with pre-existing health conditions.
The state eventually will receive enough H1N1 vaccine for all Alaskans who want it. Until then, priority groups include pregnant women, people in contact with children younger than 6 months old, health care and emergency medical workers, people from 6 months to 24 years old, and people from 25 to 64 with medical conditions that put them at risk of complications from the flu.