Officials focus on distributing flu shots fairly

Health departments hold lotteries, share vaccine

October 23, 2004|By Jonathan Bor and Frank D. Roylance | Jonathan Bor and Frank D. Roylance,SUN STAFF

After receiving a small windfall of flu vaccines from a neighbor to the south, Montgomery County decided this week to hold a lottery for people still looking for shots.

On Thursday, the first day after the lottery was announced, it had received more than 6,000 phone calls and 4,000 hits on its Web site from people competing for 800 doses.

"We discussed several options," said Mary Anderson, a county Health Department spokeswoman. "This way, we think we're giving everybody a fair shot at calling or e-mailing if they think they fit into one of the risk categories."

Elsewhere in Maryland, public health authorities are finding different ways to distribute scarce doses. The public sector normally supplies just 10 percent of the state's flu shots to residents, but since many people were unable to get shots from their own doctors, the number looking to local health departments is larger than ever.

Many counties plan clinics for people in high-risk groups, while Baltimore has worked with doctors and nursing homes to quietly identify people in need without inviting the long lines and frustration that clinics can bring.

"Clinics tend to attract healthy ambulatory people," said Dr. Peter L. Beilenson, the city health commissioner.

In a further effort to apportion 1,000 doses - a quarter its usual supply - Beilenson narrowed the federal government's definition of risk groups. He limits vaccines to people older than age 2 with serious health conditions that could make them vulnerable to flu's complications. Among those excluded are elderly people who are healthy. (The city had a separate supply of vaccine for children ages 6 to 23 months.)

The national Centers for Disease Control and Prevention recommends vaccines for children ages 6 to 23 months, adults age 65 and older, people age 2 to 64 with chronic medical conditions, pregnant women, health care workers and nursing home residents.

"Clearly, we don't have enough to serve all those people," said Beilenson.

With a dwindling supply to distribute, Harford County invited people in three risk groups - pregnant women, children 6 to 23 months and youths to 18 years old with chronic health problems - to clinics at two Veterans of Foreign Wars halls. Next week, it will open clinics for people in other risk categories.

Chiron Corp.'s inability to supply an expected 48 million doses - its vaccine was contaminated - has left the nation with 55 million doses from Aventis Pasteur, the only other manufacturer. Although many of those doses have already been shipped, federal and state officials have been working on plans to divvy up about 22 million doses still in the pipeline.

In the first phase, which should be completed in six weeks, about 14 million doses are going to nursing homes, veterans hospitals and pediatricians. Next, Aventis and the CDC plan to identify pockets of the country that have been left out.

This week, local health departments carried out a plan to make sure that vaccine supplies destined for the public sector went to people most in need - no matter where they lived.

Under the plan, a few counties that had ordered most of their vaccine from Aventis offered doses to others that had ordered from Chiron.

Calvert and Carroll counties were among the few donor counties, and a long list of other counties - including Arundel, Harford, Howard and Baltimore - were on the receiving end.

Six hundred of Montgomery County's doses came from Calvert County. Lottery participants must be county residents, and they're asked which of the risk categories they're in. If they qualify, their names and phone numbers are logged. Winners will be notified Nov. 1.

Carroll County Health Officer Larry L. Leitch said his office had received all 7,500 doses it ordered. But, as part of the redistribution program, nearly half of that supply has been turned over to public health officials in Allegany, Washington and Howard counties, which received little or none of the drugs they ordered.

Carroll expects to make the rest available to its own residents through health clinics to be held in the coming weeks, Leitch said.

Anne Arundel County, one of the largest providers of flu vaccines in Maryland's public health sector, ordered 37,000 doses for this year's flu season. It won't receive most of that.

The county plans to hold a series of flu shot clinics over the next two weeks, where it will distribute 8,000 doses now in hand and as many as 6,000 more it hopes to receive through the redistribution plan. Participants will be asked to sign a statement attesting that they fall into one of the CDC's high-risk categories.

Howard County ordered most of its supply from Chiron and would have been virtually lost without donations from a variety of sources. These included a private business and medical practice, which had extra doses, and other counties.

Dr. Penny Borenstein, the county health officer, said the county has 3,000 doses and plans to distribute them in public clinics that could open late next week. "I really cannot predict whether our supply will go as far as it needs to," she said.

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