"The quantity received will dictate what we do with it," said Brian Schleter, spokesman for the Baltimore city health department. But he added that however much vaccine the department gets, it will be offered promptly to "those who need the protection the most" at two standing immunization clinics open Monday through Thursday. Though the clinics are open to anyone, the spokesmen said top priorities would be vaccinating children and pregnant women.
There are plans to vaccinate children in city schools who don't get it from their doctors or at free health department clinics, Schleter added in an e-mail. He said school staff will be notifying parents about those vaccination clinics as soon as the vaccine is in hand.
Monique Lyle, a Baltimore County health department spokeswoman, said that the county is considering two regional clinics to administer the vaccine, but hasn't confirmed their locations yet.
Howard County's health officer, Dr. Peter Beilenson, said that the county does not plan to vaccinate schoolchildren there until the first week in November, when both injections and nasal spray should be readily available.
Healthy people asked to wait
Beilenson said that the county will strongly discourage healthy individuals from getting the vaccinations initially, to allow the priority population to be served first, but he added, "If someone who is 45 years old and healthy comes in, we will still administer the shot. Waiting is not a requirement, but we're encouraging people to do the right thing for their community and allow the priority population to be served first."
Colmers said there are no plans to take action against any health care provider who deviates from federal guidelines to vaccinate children and vulnerable adults before the rest of the population.
"If vaccine is available and someone presents themselves, we're not going to be doctrinaire about it," the state health secretary said. Health care providers have discretion, he added, "but we're asking them to follow CDC guidelines."
Dr. Melvin Stern, a pediatrician from Highland, said he has signed up to administer the vaccine and expected to place his order for vaccines Thursday evening. He has a waiting list of patients who've asked to have their children immunized, and expects to receive his shipment sometime after Oct. 15.
Stern said he wouldn't deviate from that plan just because a healthy adult walked into his office and asked for the vaccine.
"If that individual was a first responder and needed it, or if there were extenuating circumstances - like they had a youngster with cystic fibrosis - then it would be important to immunize the parent and the child," Stern said. "But as a rule, we have a priorities list and we adhere to it."
Baltimore Sun reporters Joe Burris and Meredith Cohn contributed to this article.
Swine flu vaccine by the numbers
* Number of doses ordered: 55,000 in Maryland, 600,000 nationwide.
* First delivery expected : Tuesday
* Priority population: 2.9 million in Maryland
* People targeted for first vaccinations: pregnant women, people who live with or care for children younger than 6 months old, health care and emergency medical staff; children ages 6 months and up to young adults through 24 years old; adults 25 through 64 years old who have chronic health disorders or compromised immune systems.
