By Thomas B. Langhorne, Evansville Courier & Post

- Some Vanderburgh County residents who tested positive for the H1N1 swine flu virus have died, according to the Vanderburgh County Health Department.

A state law prevents local officials from releasing details of the deaths or the identities of the deceased, said Chris Allen, Health Department spokesman on H1N1 issues.

Allen said the county has no information on the individuals other than they died and had positive H1N1 test results.

"There is not necessarily a correlation," he said. "With most of the (H1N1) deaths in Indiana, and in general, there have been underlying health concerns."

Citing the deaths, health officer Dr. Ray W. Nicholson Jr. told the County Council on Wednesday that area residents and people across the country have taken the H1N1 virus "too lightly."

"It's not letting up. It's getting worse," Nicholson said. "The big problem is that there's a lot of complacency among the citizens."

Nicholson cited a Nov. 10 Health Department vaccination clinic for pregnant women at which staffers were prepared for more than 1,000 women, but only about one-tenth of that number showed up.

A clinic at Mater Dei High School on Monday attracted about 800 people, while a similar clinic at Central High School last week drew about 1,800.

"We could have vaccinated three times more people (at Mater Dei) than what we did," Nicholson told the council. "They just didn't show up."

Health Department officials say they and more than 75 area health care providers who formally have agreed to accept and administer vaccine will continue to focus exclusively on individuals in the Tier 1 target group.

That group includes pregnant women, people who live with or care for children younger than 6, health care and emergency services personnel, people between the ages of 6 months and 24 and people from ages 25 to 64 who are at a higher risk for H1N1 because of health disorders or compromised immune systems.

"We've got strict orders from (the Centers for Disease Control and Prevention) that we are not to give any Tier 2 (vaccinations) until we've exhausted Tier 1," Nicholson said last week. "That depends on how long the lines are at the clinics. We'll keep (giving shots to Tier 1 individuals) until the lines go down."

While an estimated 25,000 to 27,000 doses of vaccine have been administered or distributed to health care providers in Vanderburgh County, Health Department officials say more than 90,000 local residents are in the Tier 1 group.

Gary Heck, the department's chief operating finance officer, told County Council members that a shipment received that day would bring Vanderburgh County's total to 29,000 vaccination doses received.

"When you have received about 29,000 doses and you've got 90,000 (Tier 1) people that's potentially eligible before you could get to the whole (county population of) 174,000, it's just a matter of trying to make sure that the right folks who are in line are in that Tier 1 group," Heck said. "... We feel that we've done as good a job as possible, holding really efficient clinics."

Extrapolating from CDC figures on the number of people who annually seek vaccinations for seasonal flu, Heck said the Health Department estimates that about 45,000 local Tier 1-eligible people can be expected to seek H1N1 vaccination.

There is time to get to them, Heck said, as Vanderburgh County likely will continue to receive increasingly large allocations of vaccine from the Centers for Disease Control and Prevention on an unpredictable schedule.

"We've been advised we'll probably continue receiving through next April or early May," he said.

All eight of the confirmed flu-related deaths in Indiana last week were confirmed H1N1 deaths, said the state Department of Health, raising the number of H1N1 deaths in the state since June to 33 of the 35 total flu-related deaths.

For Aug. 30 through Nov. 14, there have been 1,049 deaths and 26,315 hospitalizations nationally, including both H1N1 and seasonal flu, according to the CDC.

The Indiana Communicable Diseases Reporting Rule specifies that the exact number of the deaths cannot be released while that number remains at five or below, said Jennifer Dunlap, a spokeswoman for the Indiana State Department of Health.

Dunlap said the rule is designed to prevent the release of information that can lead to the identity of an individual with a communicable disease - whether it is HIV, H1N1 or other diseases. The chances of that decrease as the number of deaths grows.

Staff writer Mark Wilson contributed to this report.

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