The nation is on the verge of running out of influenza vaccine just as the flu season is off to one of its earliest starts, distributors of the vaccine say.
Experts attribute the shortage to an unexpectedly heavy demand for flu shots that developed after federal health officials warned in October that the predominant flu virus this year would be unusually widespread and deadly.
Although some health officials in New York said they still had adequate stocks of flu vaccine, officials in several other cities said that they had run out or were scrambling to get an additional supply.
Some officials said they were rationing their stock, offering flu shots only to the elderly and people with heart and lung conditions and other chronic ailments who are most likely to suffer severe complications from the viral infection.
In Maryland, a spokesman for the state Department of Health and Mental Hygiene said that a few counties reported that they had begun to run out of the flu vaccine.
"But that's because of the success of their programs," said Michael Golden, the spokesman. "There's not enough vaccine to vaccinate everybody in the state or the county," and therefore local health departments target the elderly or those with chronic diseases.
Joan S. Schnipper, a spokeswoman for University Hospital, said there is no shortage of flu vaccine at the hospital, which is offering the shots free to employees.
"We're not having any shortages, to my knowledge," she said. A spokeswoman for Johns Hopkins Hospital said last night that she also knew of no shortages there.
But the nation's two largest distributors say they have run out of flu vaccine after the heaviest demand they have seen in many years.
Joseph R. Gregory of General Injectibles and Vaccines Inc. of Bastian, Va., which describes itself as the largest distributor of flu vaccine in the country, said the company will run out of supplies today.
"Everyone is wiped out," said Bob Bessie of Bessie Medical in Cincinnati, which calls itself the second-largest distributor of the vaccine. "Dealers I have never heard of are calling me."
The shortage has arisen even though the four vaccine manufacturers had anticipated that this would be a bad flu season and had made extra vaccine. But the nature of the demand for flu vaccine is as notoriously unpredictable as the behavior of the virus itself.
The federal Centers for Disease Control in Atlanta estimates that production was sufficient for 30 million people this season; although manufacturers refused to say how much vaccine they had made, one company said it had raised its production by 40 percent.
But the companies say they have sold all of this year's supply. Because the vaccine is prepared in eggs, it takes a month to produce a new batch. As a result, even if the companies resumed production, it might be too late in the winter flu season for it to do much good.
Wyeth-Ayerst Laboratories of Philadelphia, a division of American Home Products Corp., which sold more than 10 million doses, said late Wednesday that it would make an additional 500,000 doses that would become available sometime in January.Federal officials had no data on how many people have been vaccinated this year because no agency monitors use of influenza vaccine. In fact, officials of both the Food and Drug Administration and the Pharmaceutical Manufacturers' Association said they were not aware of a shortage.
"We have no way of checking on the extent of the shortage and exactly where the shortages are," said Dr. Walter Gunn, an influenza expert at the Centers for Disease Control. In spot checks around the country, health officials from Massachusetts, Georgia and the District of Columbia said they were fac
ing shortages of vaccine. Doctors and health officials in Minnesota, Tennessee and Colorado said they still had enough on hand, but only because they had scrambled to maintain their stocks.
In some areas, doctors said they could not get flu vaccine for themselves.
Because of the shortage, doctors and clinics are paying about $1 more for each dose of vaccine, normally about $2.50, Mr. Bessie said. Some doctors, he said, have been charging patients more for flu shots, which normally cost $10 to $20. He said he had heard that some doctors in Ohio were charging $50.