Goldstein, EdwardLipsitch, Marc2016-03-082009Goldstein, Edward, and Marc Lipsitch. 2009. “H1N1 Vaccination and Adults with Underlying Health Conditions in the US.” PLoS Currents 1 (December 7): RRN1132. doi:10.1371/currents.rrn1132.2157-3999http://nrs.harvard.edu/urn-3:HUL.InstRepos:2575323365% of fatalities from pH1N1 infections in a large US case series occur in adults with underlying health conditions other than pregnancy, but it appears that only relatively few high-risk adults will get vaccinated during the fall wave of pH1N1 transmission. There are several reasons for this problem; the most important is vaccine shortage. High risk adults (other than pregnant women) were not part of the initial, narrow priority cohort which included pregnant women and children ages 0.5-4; this is despite the fact that some of those high risk groups, such as adults with immunosuppressive conditions and possibly individuals with neurological disorders, have a relative risk for fatality (per capita) higher than pregnant women, and over 28-fold higher than healthy children under the age of 4. With more vaccine becoming available than needed in the initial priority cohort, a broader group which includes high risk adults and individuals under 24 becomes eligible for vaccine in many locations. Nonetheless, due to continuing high demand, high-risk adults face competition for vaccine from healthy individuals under 24; additionally, some locations specifically prioritize school students over high-risk adults. Finally, there is an issue of awareness and a shortage of specific channels that target high risk adults other than pregnant women and facilitate vaccine distribution among them in the US.en-USJournal Article2016-01-08Marc Lipsitch2016-03-0810.1371/currents.RRN1132