Not enough flu vaccine for everyone, CDC says

Central Md. agencies near end of supplies

U.S. looks to Europe for more

December 10, 2003|By Frank D. Roylance | Frank D. Roylance,SUN STAFF

Faced with soaring nationwide demand for flu vaccine and a diminishing supply, federal health officials are searching for surplus doses here and in Europe that could be purchased and sent where shortages are most severe.

But Dr. Julie L. Gerberding, director of the federal Centers for Disease Control and Prevention, said yesterday that there will not be enough for everyone who should be immunized:

"We need to be prepared for the fact that there may be some people who'd like to receive influenza vaccine this year who may not be able to get it."

Maryland health secretary Nelson J. Sabatini said yesterday that Maryland still has vaccine, but several county health departments reported they're near the end of their supplies.

Sabatini called the demand "unprecedented" and said health officials are canvassing private providers and others to locate available supplies.

"Depending on what happens with demand in the very near future," he said, "we will start doing what we can to move supplies around or make sure people know where to go to get the vaccine."

The state also might encourage residents who are eligible for a new nasal mist vaccine, with a weakened but live virus, to take that option. This would save injectable vaccine for higher-risk residents who aren't supposed to receive the mist.

Vaccinations were up almost everywhere this fall - by 38 percent in the clinics sponsored by Anne Arundel County's health department, with 18,000 people immunized. The clinics have ended, but "people are still calling," said health department spokeswoman Elin Jones.

Baltimore City has delivered 3,583 immunizations and expects to dispense its last 700 doses this week. Demand has far outstripped supplies, according to the health commissioner, Dr. Peter L. Beilenson.

"We're asking people to let those 50 and older, particularly those with chronic health conditions, like diabetes, high blood pressure, emphysema, young people with asthma, and a new category - healthy 6- to-23-month-olds ... . get immunized first," he said yesterday.

The 2003-2004 flu season got off to an early start and with the appearance of a particularly severe strain of the virus, called H3N2 Fujian, that has not circulated widely in the United States before. Nor is it perfectly matched to the current vaccine.

Sabatini said Maryland had 126 laboratory-confirmed flu cases as of Monday, compared with about 100 cases in all of the 2002-2003 season. And this year's flu arrived much earlier, in November. But none, so far, has been the H3N2 variety.

News reports on the deaths of young children from flu-related complications, most in Colorado, have heightened demand for vaccination.

Gerberding called such deaths "very sad" and said the CDC is working to determine whether there is anything about this flu strain that causes severe illness among children.

But the flu kills an average of 36,000 Americans every year, she said, some of them children. While not yet an epidemic across the country, Gerberding said, the current influenza outbreak was widespread in at least 13 states by the end of last week.

"A lot more states are just coming in, so I am not going to be surprised to see we have more cases than average this year," she said.

Despite the vaccine shortage, the CDC said more Americans got shots this year than ever before. Although there are 185 million people in groups that should be vaccinated, Gerberding said, about 70 million to 75 million typically seek the shots.

Last year, she said, the vaccine makers produced 95 million doses. But demand was lower and they had to throw away 12 million doses - representing millions of dollars in lost revenues. As a result, this year the target was only 83 million doses.

They include 4 million to 5 million doses of the new vaccine that is squirted into the nose. Unlike injected vaccine, the mist contains an "attenuated," or weakened, version of the live flu virus. It is recommended only for healthy people from 5 to 49.

Gerberding said almost all of the adult, injectable vaccine has been distributed to health care providers. The nasal mist is now more widely available.

"It [the mist] is certainly an option for people who want to reduce their risk and help us retain the [injectable] vaccine for people at high risk for complications," Gerberding said.

It is, however, far more expensive - $46 per dose wholesale vs. $8 for the injectable.

In either case, she said, "we're still encouraging people to get immunized and to be persistent" about calling their doctors and local authorities to find vaccine.

So far, Gerberding said, the CDC has not advised vaccine rationing. That would be up to local officials, she said, but "we are recommending that priority be given to people with the highest risk of complications."

These groups include people ages 65 and older, health care workers, those with chronic health conditions or weakened immune systems, and children 6 months to 23 months of age.

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