Responding to growing fears of a severe flu strain and a shortage of vaccine, Gov. Robert L. Ehrlich Jr. said yesterday that the state will purchase 100,000 doses of FluMist, a recently developed, Maryland-made nasal spray. The vaccine is to be distributed by local health departments in the next two weeks.
Maryland officials said they also expect to receive 1,690 doses of injectable vaccine from the federal Centers for Disease Control and Prevention, and 810 pediatric doses for children under 35 months old.
And the U.S. Department of Health and Human Services said yesterday that it had negotiated for the possible purchase of 3 million doses of FluMist, which is produced by MedImmune Inc. of Gaithersburg.
The federal agency said it will purchase 375,000 additional doses of injectable vaccine from California-based Chiron Corp., which manufactures Fluvirin vaccine in England, Germany and Italy.
As officials scrambled to fill unprecedented demand for vaccine, two more health insurance companies said yesterday that they would expand coverage to include FluMist.
CareFirst BlueCross BlueShield and Kaiser Permanente Mid-Atlantic said they would cover FluMist treatment until the flu season is over or the vaccine shortage ends.
FluMist reimbursement under CareFirst would increase to $47 and Kaiser said it would provide the nasal spray at no additional charge starting this weekend.
"We do still have some limited flu shot vaccines, which are being reserved for high-risk members," said Kaiser spokeswoman Susan Whyte Simon. "FluMist has only been approved by the Food and Drug Administration this year for healthy people between the age of 5 and 49, because you're actually taking a live, weakened virus into your body. We're urging members who are high risk to come in and get the flu shots while we have supplies left."
Last week, Aetna Inc. and Cigna Corp., the second- and third-largest health insurers, said they would cover FluMist. UnitedHealth Group Inc., the No. 1 U.S. health insurer, already covers FluMist.
Sales of the nasal vaccine are on the rise because it is more widely available than the injectable type. Manufacturers produced less injectable vaccine this year after limited demand last year forced them to throw away 12 million doses, which represents millions of dollars in lost revenue.
The CDC said last week that 24 states had widespread influenza and that 15 states, including Maryland, were reporting outbreaks. Twenty flu-related deaths among children have been reported.
So far, Maryland's health department has confirmed 398 flu cases compared with a total of 147 cases during last year's flu season. Flu case numbers generally peak in late January and early February, and the CDC said the epidemic has not yet peaked this year.
Wyeth Pharmaceuticals in Pennsylvania, a marketing partner for MedImmune, confirmed yesterday that the CDC has the option to purchase 3 million doses of FluMist, but spokesman Doug Petkus said, "The CDC has not executed on that option yet."
CDC spokesman Curtis Allen said the Wyeth-MedImmune contract was signed Friday, giving states a first-come, first-serve right to purchase FluMist for $20 a dose until February.
"We negotiated with Wyeth a contract of convenience so that they wouldn't have to make individual negotiations with each state," Allen said.
Maryland and other states negotiated their own deals. Last week, Indiana said it was buying 5,000 doses of FluMist.
"Our goal in obtaining both types of vaccine is to ensure the best management of available resources," Ehrlich said. "By obtaining the FluMist vaccine, which is recommended for use by healthy people between 5 and 49 years of age, the state can effectively use all available injectable vaccine for those at greatest risk."
Maryland officials declined to say how much the FluMist will cost, but J.B. Hanson, deputy director of public relations for the state Department of Health and Mental Hygiene said the state would not pay the retail price.
MedImmune had said last month that it would miss sales and profit targets because of FluMist's disappointing sales - the premium wholesale price, $46 vs. about $8 for an injection, was blamed - but the rush on flu vaccine could turn things around.
Shares of MedImmune were down 35 cents on the Nasdaq yesterday, closing at $27.66.