The Erie County Health Department intends to inoculate as many as 460,000 people -- about half of all county residents -- because they are at high risk from swine flu, the county's health commissioner said Wednesday.
The county would be divided into seven geographic pods, with town, city and village emergency managers -- as well as school officials -- arranging times and places for people to receive the vaccinations.
"This is really about a community taking care of itself," said Dr. Anthony J. Billittier IV, the health commissioner. "They [local communities] need to figure out what works for them. We [the county] can't deal with every town, city and village individually."
The county itself would take responsibility for obtaining and administering the vaccine, which is expected to become available in the middle of next month.
"We've been dealing with plans for pandemic influenza for years, but we've never had to pull the trigger," Billittier told The Buffalo News.
The difficult and complex mass vaccination process becomes even more challenging because of the huge number of county residents who fall into the federal target groups of those most at risk from swine flu, also known as H1N1.
Last month, Billittier had estimated that those groups accounted for more than 300,000 people in Erie County. After further examination, he placed the figure Wednesday at 460,000, half the county's population.
By comparison, vaccinating 10,000 people following a hepatitis scare in February 2008 took the Health Department five days, and that "brought us to our knees," Billittier said.
The at-risk residents are prone to catching the swine flu, passing it along or suffering serious consequences from it.
The Centers for Disease Control and Prevention has recommended that the vaccination be administered to everyone from 6 months to 24 years old, pregnant women, caregivers for children younger than 6 months old, health care and emergency medical services workers and people 25 to 64 years old with a high risk of medical complications from influenza.
Billittier urged residents to get their shots from private physicians and urged hospitals, schools and nursing homes to vaccinate their own employees.
While stressing that the vaccination operations could vary considerably from pod to pod, Billittier said shots might be made available at schools, government buildings or community organizations.
Obstacles facing the vaccination effort include a state regulation that gives doctors and nurses the authority to give shots but prevents most others from doing so, Billittier said.
Despite repeated requests, Gov. David A. Paterson has not waived that restriction so that nurse's aides, emergency medical personnel or even trained lay people could administer the vaccinations, Billittier said.
"It will be our role to find people who can vaccinate," Billittier said.
That, he added, might include school nurses, instructors or students at health-related schools and "mass vaccinators" such as the Visiting Nursing Association of Western New York.
Initially, health authorities had believed that effective vaccination might require two separate doses. Now, however, health officials said one vaccination will be sufficient.
How many people actually will seek vaccinations and how much the program will cost the county remain unclear.
Billittier spelled out his proposal to educators Wednesday afternoon at Erie 1 Board of Cooperative Eduction Services in West Seneca.