Flu vaccine is plentiful, experts say

Despite delays, millions more doses likely in U.S. this year


One year after a flu vaccine shortage left some waiting in long lines for rationed shots, health officials say they expect plenty to go around this time.

They're encouraging people at high risk for the flu, including those age 65 and older, and those with immune systems weakened by cancer or other diseases, to get shots as soon as possible.

After Monday, local health departments will begin providing the shots to everyone, not just those at high risk.

The vaccine available this year is designed to protect against the seasonal flu, not the strain of avian flu that has caused at least 60 deaths in Asia since 2003.

That strain has been contracted only through contact with infected birds and has not appeared in humans in the West.

There have been delays in getting the regular flu vaccine out to clinics this fall. Dr. Michael P. Zimring, a Mercy Medical Center internist who vaccinated his first patients yesterday, has had to borrow doses from fellow physicians to tide him over until his supply arrives.

The Anne Arundel County Health Department has pushed its first public flu vaccine clinic back to Monday, about two weeks later than usual.

Professional Flu Clinics, a for-profit provider, had to push back the launch of its shots at Baltimore-area CVS, Bally Total Fitness, and Bed, Bath & Beyond stores to Friday - three weeks later than planned, said spokeswoman Gina Seamans.

"Eventually, we'll get everything we ordered," she said. "But it was delayed."

One reason for the delay was an effort by manufacturers to release vaccine incrementally, as the U.S. Centers for Disease Control and Prevention suggested. The idea was to ensure that the vaccine, which the government approves batch by batch as it is manufactured, was distributed equitably across the country, said CDC spokeswoman Lola Russell.

Another problem was that Chiron Corp., one of four manufacturers that sell flu vaccine in the United States, began shipping it only this week after getting government approvals. Contamination problems at a Chiron plant in England sparked last year's shortage. Yesterday, the company said that because of production delays, it would ship fewer than the 18 million doses previously announced.

Some critics say the CDC recommendations this year were wrong. Producers and distributors should have been encouraged to ship first to those who take care of high-risk people, namely, to health departments, said Patrick M. Libbey, executive director of the National Association of County & City Health Officials.

His organization recently conducted a brief e-mail survey of 120 key health department immunization managers and found that many had been forced to cancel or delay community clinics. Results of the survey indicted that profit-making "mass vaccinators ... are hosting clinics that advertise flu shots available to all, while [health departments] await partial shipments that are coming in haphazardly."

"What I'm concerned about is, how come all these commercial places can get it before us?" said Zimring, who rustled up about 100 doses from friends and the Mercy pharmacy and began vaccinating yesterday. "We have the patients that really need it."

Some commercial sites, such as Giant Food, which contracts with Maxim Healthcare, began offering shots Oct. 1 at selected stores. But it has been following CDC guidelines to limit the shots to those at high risk for flu.

Others, including Professional Flu Clinics, have decided against following the CDC's recommendation that providers wait until Monday to inoculate those not at high risk. Professional will begin offering shots Friday to anyone 18 and older at selected CVS and Bed, Bath & Beyond stores, and Bally Fitness Centers, Seamans said.

Despite the delays, Zimring said he expects to receive his order shortly and doesn't foresee any overall shortages this year.

Unlike last year, there is likely to be more than enough vaccine early in the season, said David Webster, a Bethlehem, Pa., pricing and supply consultant to drug and vaccine makers. Up to 97 million doses are expected to be available, compared with about 55 million last year, said Greg Reed, program manager for the Maryland Center for Immunization.

Reed suggested that patients call their physicians to schedule shots. For healthy people ages 5 to 49, an inhalable mist vaccination may be available. Health officials suggest visiting a doctor and scheduling a checkup at the same time.

Alternatively, the state's 24 local health departments have their own clinics, many of which offer shots that are free or covered by Medicare. Numerous commercial providers offer shots for a fee.

Though the city has received only about two-thirds of the more than 3,000 doses it ordered, "We do have enough," said Dr. Anne Bailowitz, Baltimore's immunization program manager. "We're in good shape."

Officials from Baltimore and Anne Arundel counties also said they are planning public clinics and do not expect shortages.

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