Flu season gives two firms a shot in the arm

Doses bulk of income for Passport, Maxim

October 16, 2001

For two area health companies, flu season is nothing to sneeze at.

Passport Health, with national headquarters in Baltimore and nine offices in the area, does travel immunizations all year long. But in fall flu season, flu shots - generally at line-'em-up clinics sponsored by employers - make up 70 percent of Passport's business, according to Fran Lessans, the company's president and founder.

Passport ordered 100,000 doses of flu vaccine in February - 15,000 for the Baltimore area, the rest for its nearly 40 national franchisees - to be ready for the season.

FOR THE RECORD - An article in yesterday's Business section incorrectly reported on immunization services offered by Passport Health of Baltimore. Passport Health offers flu shots and travel immunizations. It does not offer immunization or treatment for anthrax. The Sun regrets the error.

That's a lot of flu shots, except for Columbia-based Maxim Health Systems. Maxim delivered 1.1 million flu shots nationally last year, and is expecting to do 1.6 million this year, said Stephen Wright, national director of wellness services.

The federal Centers for Disease Control and Prevention (CDC) estimates that 70.4 million shots were given in the country last year, and about 9 million more doses are expected in this flu season.

Maxim Health Systems also does a variety of screenings and immunizations, but Wright said those services are fairly new, and flu still represents 90 percent of the company's business. A sister company, Maxim Healthcare Services, is a staffing agency for nurses and other healthcare workers. That makes it easy for Maxim Health Systems to staff shot clinics at workplaces, supermarkets, nursing homes and other locations.

"We have a pool of nurses," Wright said. "That's why we're in the business at all."

In fact, he said, for Maxim, recruiting nurses to staff up for flu season is not a problem but an opportunity. It brings them nurses who can then be tapped for home health care, fill-in hospital staffing and other work. "We're a temp company - everybody we hire is really a temp," he said.

Flu shots are still offered by some individual doctors in their offices and by hospitals. Gregory Reed, program manager for the Maryland Center for Immunization of the state health department, said most county health departments offer "large clinics" which are "well advertised and well attended."

But, Lessans said, companies like Passport and Maxim are doing more and more flu shots, as doctors find that buying the vaccine and keeping the required records doesn't pay to offer the service to a few patients. Overall, according to the CDC, about 90 percent of flu shots are done by the private sector, with the rest from health departments and other government providers.

By offering the shots in volume, Lessans said, Passport can provide "boutique service at public health pricing." Passport charges $20 for individual shots, and as little as $12 a person for large groups, according to Lessans. Average charges from Maxim are about $15 a shot, Wright said.

Vaccine, Wright added, costs $55 to $65 for a 10-dose vial, accounting for about half the cost of the shot. Other costs include nurse staffing, record-keeping and disposal of used needles. Both companies are private, so profit figures are not available.

In some markets, Visiting Nurse Associations are a major provider of flu shot clinics. But June Yingling, executive assistant at the Visiting Nurse Association of Maryland, said the local VNA stopped flu shots several years ago because of a shortage of nurses. The VNA, she said, used to staff the shot clinics at Giant Food supermarkets; Maxim does that now.

The two leading flu shot providers in the area, Passport and Maxim, take somewhat different approaches to the business.

Both do workplace clinics, but Maxim also does retail sites, such as supermarkets and malls. Lessans said Passport finds the retail sites inefficient, because nurses may sit around waiting for people to immunize.

At a workplace shot clinic, where an employer can get people lined up for immunizations, Passport can do 50 shots an hour, according to Carol L. DeRosa, chief of operations.

Passport, on the other hand, will do immunizations for individuals who make appointments at the offices it runs for travel medicine. The work-site clinics, however - Lessans said Passport has contracts with about 150 employers in the Baltimore area - provide most of the business. Maxim doesn't do individual shots at all.

DeRosa said the recent concern about anthrax, which has prompted some calls to Passport centers seeking vaccine or antibiotics, will probably result in more flu shots. She said she explains to callers that Passport does offer anthrax vaccine, but "the first thing out of my mouth is: `Look how many hospitalizations there are for the flu.' Every call, we turn around to an opportunity for public education."

Passport and Maxim have also taken a different approach to a CDC request that, given delays in flu vaccine supply, early shots be targeted at high-risk patients - the elderly, people with chronic respiratory diseases, pregnant women, children on long-term aspirin therapy and health workers.

While the CDC believes enough vaccine will be available this season, it expects only 56 percent of the amount needed to be ready by the end of this month, another 31 percent in November and the final 13 percent in December, according to Curtis Allen, a spokesman for CDC's National Immunization Program.

Wright said Maxim is only giving shots to high-risk patients this month, and deferring its large-scale public clinics until next month.

Because Passport ordered so many doses so early, Lessans said, it has all the supplies it needs. "I wouldn't turn anybody away," she said. "I don't see a need to store 15,000 doses in my refrigerator until November."

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