Md. counties to share supplies of flu vaccine

Facing severe shortage, officials hope to stem crisis with redistribution

October 08, 2004|By Erika Niedowski | Erika Niedowski,SUN STAFF

State health officials said yesterday they plan to redistribute flu vaccine from local health departments that have some in hand to the seven jurisdictions with none - though even that step will leave Maryland agencies some 60,000 doses short.

About 10 percent of flu vaccinations are provided through state and local health departments, to immunize everyone from healthy soccer moms to senior citizens with chronic health conditions. The state had expected to receive 113,000 doses of the vaccine for the current flu season but will have to make do with less than half that amount.

"Everybody is going to have some need, so everybody has to have some supply," said Dr. Diane L. Matuszak, director of community health administration for the state Department of Health and Mental Hygiene. Local health departments "often work cooperatively on public health issues to make sure that there's fair and equitable coverage throughout the state."

It's not uncommon for county health departments to "share" their vaccine supply with one another - or even sometimes with private health-care providers like doctors and hospitals, which normally administer about 90 percent of immunizations. But this year, with the entire country facing an unexpected, last-minute shortage, the arrangement can work only so well.

"We're all short this time," said Cindy Edwards, nurse administrator for the immunization program in Montgomery County, which has just 200 vaccine doses that are already earmarked for HIV patients.

A team of U.S. Food and Drug Administration officials met yesterday with British regulators - who this week suspended the license of leading vaccine supplier Chiron Corp. because of unspecified manufacturing problems at its Liverpool plant - to determine the scope of the problem.

But it was unclear whether any of the 46 million to 48 million doses the company had planned to ship to the United States could be salvaged. And no one, to be sure, was counting on it.

Focus on high risk

Taking their cue from federal health authorities, state officials have urged Maryland's 24 local health departments to vaccinate only those at high risk for complications from the flu: the very young, the old, people with serious health problems, pregnant women and health-care workers.

But since there won't be enough vaccine to cover even that group, the question remains: How do you prioritize those considered high-priority?

In Baltimore County, where the health department has no vaccine, an estimated 150,000 residents - many of them elderly - are among those in the high-risk category.

"We are really concerned and feel an obligation to make sure those people get that vaccine," said Dr. Michelle A. Gourdine, the health officer there. "Flu is not an insignificant disease for high-risk people. ... We're talking about a real crisis here."

Forgoing a shot

Del. Dan K. Morhaim, an emergency room physician at Sinai Hospital, plans to give up the flu shot he would normally get as a front-line health worker for someone who needs it more. He hopes others will do the same.

"It's going to take the cooperation of patients and providers," he said.

He intends to ask the chairman of the Health and Government Operations Committee to hold a hearing on the vaccine shortage but said the root of the problem lies in deficiencies in the national vaccine supply system - which need to be addressed separately.

"It may be that there isn't much that can be done at the state level except to apportion the vaccine that we have and call on the federal government and the CDC to takes steps to see that there is adequate vaccine [in the future]," Morhaim said, referring to the Centers for Disease Control and Prevention in Atlanta.

"I think this points to a broader issue of vaccine preparedness, which is not just an issue that the state of Maryland can solve. It clearly needs to be a priority at the federal level."

According to the state, seven counties - Allegany, Baltimore, Caroline, Dorchester, Prince George's, St. Mary's and Washington - had ordered their entire vaccine supply from Chiron and are currently without any doses.

But at least one other county, Harford, said it too had none. Howard County, meanwhile, had fewer than 200.

"We have not made any decision as of yet as to how that small supply will be distributed," said Dr. Peggy Borenstein, the health officer in Howard.

The health department in Carroll County - which was the envy of its counterparts for receiving its full order of 7,000 doses several weeks ago - planned to proceed with an immunization clinic at its headquarters today.

Swamped with calls

Debbie Middleton, director of communicable diseases, said the department was inundated yesterday with hundreds of calls from concerned patients. "We're telling people, `Don't panic.' ... We're having several other clinics," she said. Only high-risk patients will be eligible for the shots.

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