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By Maggie Fox, Health and Science Editor
WASHINGTON, July 23 (Reuters) - Essential health care workers would be immunized first if a flu pandemic broke out in the United States, the government said on Wednesday.
The Department of Health and Human Services released long-awaited details on who would get vaccinated if and when a pandemic -- serious global influenza epidemic -- emerged.
The plan puts a million health care workers, such as emergency room staff and nurses, at the top. Next are military and "mission critical" personnel, public health workers and hospital and nursing home staff.
All of these play a "critical role in providing care for the sickest persons; highest risk of exposure and occupational infection," the plan reads.
"This guidance is the result of a deliberative democratic process," HHS Secretary Mike Leavitt said in a statement. "This document represents the best of shared responsibility and decision-making."
Mike Osterholm, an infectious disease expert at the University of Minnesota's Centers for Infectious Disease Research and Policy, said the plan did not do enough to protect critical workers.
While it designates people involved in making vaccines and drugs for flu, it does not account for other drugs such as insulin and antibiotics, he said.
"It does nothing to help support the manufacturing and transportation system for moving these drugs from offshore to the United States," Osterholm, who advised the government on the guidelines, said in a telephone interview.
Many public health experts agree some sort of influenza pandemic is inevitable, although no one can predict when it might come and how severe it may be.
It is also impossible to predict what strain of flu might cause it, although H5N1 avian influenza is the main suspect now. It has become entrenched in birds in Asia, Europe, the Middle East and possibly Africa.
While just 385 people have been infected since 2003 and 243 have died, experts fear H5N1 could acquire the ability to spread easily from human to human, setting off a pandemic that could kill hundreds of millions of people.
Making enough vaccine to protect everyone would take months and so experts agree a plan is needed to determine who gets the first doses to come out of the factory.
The HHS plan designates 700,000 "deployed and mission critical personnel" to follow the key health care workers. After that, 300,000 public health workers, 5.7 million inpatient and outpatient health care providers, and 1.6 million long-term care workers would be next to get the vaccine.
"It should be noted that during the 1918 pandemic, more American soldiers died of illness than in combat during the First World War," the plan reads.
Emergency services, law enforcement, makers of pandemic vaccines and drugs, pregnant women and babies and toddlers are also in the first designated groups.
HHs said the plan, available here , can be modified to meet the characteristics of any real pandemic.
Healthy adults not in any other priority group come last.
At least 16 manufacturers in 10 countries are working on vaccines against H5N1. Antiviral drugs can help protect people but they are also in short supply and the U.S. plan also calls for closing schools, limiting public gatherings and other measures to prevent flu transmission.
Editing by Alan Elsner and Will Dunham