Early end to flu shot clinics

Delays prevent provider from supplying retailers


One of the nation's largest providers of seasonal flu shots said yesterday that it will end flu clinics at retailers such as Giant Food about two weeks sooner than planned as a result of shipment delays and greater-than-expected turnouts.

The move by Maxim Health Systems to stop giving shots after tomorrow comes as the nation wrestles with flu vaccine supply problems for the second year in a row. It also comes as public interest in immunization appears to be growing, thanks to publicity about whether an unrelated avian flu pandemic will materialize.

Public health officials have repeatedly said they expect to have plenty of seasonal vaccine in time for the peak flu season in January and early February. The shot takes two to three weeks to give its protective effects, and Maryland has yet to record any cases of influenza.

FOR THE RECORD - An article on flu shots in yesterday's edition incorrectly stated that Maryland has yet to record any cases of influenza this season. The state Department of Health and Mental Hygiene reported Thursday that a woman had come down with a confirmed case of the "B" strain. The Sun regrets the error.

This fall, vaccine is arriving incrementally and later than expected - and also later than healthy adults at lowest risk for illness generally want to get shots.

Meanwhile, senior citizens and others considered at high risk have in some cases been unable to get the shots at their physicians' offices because of shipment delays. They have gone instead to clinics like Maxim's, and ended up in line with people at low risk, quickly depleting the amount of vaccine the company wants to devote to retail locations.

"We're getting what we ordered, but timeliness is an issue," said Steve Wright, Maxim's national director for wellness services, adding that the Columbia-based company has gotten about 70 percent of the 2.3 million doses it ordered.

The company, which had planned about 35,000 clinics nationwide, has held all but about 10 percent.

The demand shift is exemplified by Sol Fisher, 80, of Baltimore. He called his physician to schedule a flu shot but was told the doctor had no vaccine. So he went to a clinic at a Giant supermarket in Owings Mills and ended up in line.

"The whole system is at fault, the way it's handled," said Fisher, who got his shot but was distressed by the circumstances. "It used to be so good. I used to get it in my doctor's office; it was calm and quiet."

Now, he said, "The way [to get it] is to run from one supermarket to another to get a flu shot. They tell you [the clinic will be] from 9 to 11, but by 11 it's gone."

Shipment delays

Hospitals have had to reschedule clinics, and some for-profit providers are canceling them.

St. Joseph Medical Center in Towson, for example, had to postpone flu clinics scheduled for last Sunday and tomorrow, and has rescheduled them for a series of dates beginning Nov. 19.

"It's because our shipments hadn't arrived," said Vivienne Stearns-Elliott, a hospital spokeswoman.

Fran Lessans, CEO of a nationwide chain of for-profit immunization clinics called Passport Health, said that nursing homes keep calling to ask her to hold flu clinics at their facilities but that she has been forced to turn some away.

"We pre-ordered 40,000 doses and we've gotten in 12,000," Lessans said. "It's just trickling in."

Lessans said the problem is much wider than a distributor or two that cannot put their hands on vaccine. She said she orders from at least five distributors.

The problems early this flu season appear to result from a mix of factors that include the federal government's flu vaccination strategy, a free-market system for distributing vaccine and a public conditioned to get the shot early, just when this season's supply is a trickle.

`Window of demand'

Contributing to the problems have been manufacturing delays at Chiron Corp., which has begun to ship vaccine but at a lower volume than anticipated. The same company last year was unable to ship any vaccine because of contamination problems in its Liverpool, England, manufacturing plant.

That left the U.S. market without about half the doses it was expecting last year, prompting the Centers for Disease Control and Prevention to ask that vaccine be rationed. Early on, only the elderly, the chronically sick and other people at high risk for the flu were to get it.

The plan worked so well that there was a surplus of vaccine late in the season, when healthy adults didn't want the shots anymore. Maxim and others were stuck with extra doses.

"There is a small window of demand for flu shots," Wright said, explaining that most people want them in October, November and perhaps early December. So if someone says to a flu-shot provider, " `I can get you flu doses; you'll get them Dec. 15,' all providers, including physicians, say they won't take them anymore."

This year, when the CDC - faced this time with the Chiron manufacturing delays - asked flu-shot purveyors to give the vaccine to only at-risk people until Oct. 24. Companies such as Maxim, burned last year by offering healthy adults flu shots too late in the year, are shifting their remaining doses to assisted-living centers and corporate clinics, where Webster said experience shows doses are more likely to be sold.


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