With flu season little more than a month away, public health authorities say they expect the nation's vaccine supply to be large enough to avoid the shortages and chaos of last season.
The U.S. Centers for Disease Control and Prevention estimates that 71 million doses from three manufacturers are in the pipeline - about 10 million more than were available in the past flu season.
The supply could range as high as 100 million doses if Chiron Corp. gains federal approval to produce injectable vaccine, which is considered likely. The company stopped making flu vaccine last year after contamination was found in its production facility in England.
Companies already supplying flu vaccine are Sanofi Pasteur, GlaxoSmithKlein and MedImmune Vaccines.
"Based on anticipated demand, we should have enough," said Lola Russell, a CDC spokeswoman, but she added that there's no good way to predict how serious this flu season - which is November to March - will be.
The CDC is asking doctors and patients to cooperate in a system in which people at high risk for flu's complications would be vaccinated first. Under the voluntary plan, the most vulnerable would receive their shots through Oct. 23. Then, vaccine would be given to all other takers.
The priority group includes people 65 and older, nursing home residents, people with chronic illnesses, children 6 to 23 months and pregnant women. Also included are health care workers and household contacts of infants younger than 6 months of age.
"The only way to protect kids under 6 months is to get family members protected," said Dr. Daniel Levy, an Owings Mills pediatrician who is president-elect of the Maryland chapter of the American Academy of Pediatrics.
Immunizing parents and siblings reduces the chance they will transmit the virus to babies, for whom vaccination is not recommended.
In the aftermath of last year's shortage, vaccine was diverted to the state health department, which sought to direct it to the most vulnerable people at public health clinics.
That shouldn't be necessary this year, said Greg Reed, director of the department's immunization program. Local health departments have ordered 144,000 vaccine doses and the state an additional 91,000 for public clinics, he said. Private doctors are ordering vaccine, too, with no indication of shortages.
"The health departments serve as backups for people, either for their convenience, or because they have no doctor or cannot afford to pay," Reed said.
Last year, federal authorities urged the most vulnerable to get vaccinated first after they recognized the shortage. Public reaction was swift and exaggerated, with many in high-risk categories passing up vaccination because they figured supplies were exhausted. As the season progressed, authorities realized there was excess supply and offered vaccine to all comers.
Michael Williams, director of the communicable disease division of the St. Louis County Health Department in Missouri, said the planned allocation should prevent that from happening again.