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Dose of Trouble for Flu-Shot Season

Posted on: Tuesday, 17 October 2006, 15:01 CDT

By Susan Levine, Washington Post Staff Writer

Barely two weeks into the flu-shot season, the promise of a record supply of vaccine already is being tarnished by shipment delays that are causing sporadic shortages and forcing some doctors to postpone clinics or serve only high-risk patients.

Some 26 million doses were distributed across the country in September, and federal officials expected that three times that many would be on their way by the end of this month. Yet having vaccine in the pipeline doesn't mean getting it to thousands of destinations on time.

Immunizations at grocery and drug store chains are proceeding with few apparent difficulties, but physicians who can't meet demand are questioning the stability and fairness of the distribution.

"It is a real mess," Northern Virginia pediatrician Gary Bergman said last week after being notified that his offices in Alexandria and Fairfax County would receive only 600 of 7,000 doses scheduled by Nov. 1 and "no commitment thereafter." His staff has spent hours rescheduling hundreds of children who had been signed up for flu shots.

"We have a lot of angry and panicking parents now," Bergman said.

Julie Gerberding, director of the federal Centers for Disease Control and Prevention, acknowledged the kinks in the system in an address several days ago to the American Academy of Pediatrics. It's not that some customers were given preferential treatment in deliveries, she indicated; manufacturers and distributors said they would try to ensure that all orders were at least partially filled early on.

"But we all know that this is easier said than done," Gerberding said. "We still have providers who do not have vaccine when a large shopping chain does."

Given the CDC's limited ability to direct distribution, the agency is warning that many orders will not be fully filled until late November and that "significant effort" should be made to continue immunizations into January.

The concerns echo the disruptions of the past several years and again threaten the public health message that urges flu vaccination for nearly three-quarters of all Americans -- 36,000 of whom die annually from the virus.

In 2004, contamination fears at one manufacturing plant cut the nation's expected supply in half, causing acute shortages and anxiety. In 2005, distribution problems initially forced providers to target higher-risk individuals for the vaccine. In the end, only 81 million people were immunized and a glut of vaccine developed. Several million doses were thrown away.

The good news of this influenza season, as Gerberding noted, is that five companies are producing as many as 115 million vaccine doses. Federal policy now recommends regular flu immunization for children 6 months to almost 5 years -- a change from 2005 -- as well as for parents and older siblings, children and adults with chronic illnesses, health-care workers, pregnant women and everyone older than 50.

Because flu cases usually peak in February, even doses administered as late as December provide protection.

Some jurisdictions are making a major push to protect schoolchildren. In Maryland, where a pilot program in two counties resulted in decreased student and staff absenteeism, the state and local education and health departments have teamed up to offer more than a quarter-million doses of the nasal spray FluMist for free.

In Prince George's County, consent forms were sent home with elementary students last week to be returned by tomorrow. Deputy health officer Donald Shell said officials want "to triple or quadruple" the number of children immunized this winter.

Not all providers are worried about pending vaccine inventory. Prince George's expects to begin its public adult and family flu-shot clinics as planned Oct. 28 at the Glendale Community Center. "Everything is still on schedule," Shell said Thursday.

Mary's Center for Maternal and Child Care in Northwest Washington also is on track to start its "big flu push" at the end of the month, spokeswoman Vanessa DeCarbo said. It has received 200 doses, nearly a fifth of the total it administered last year.

Steve Wright, a national director at Maxim Health Systems in Columbia, counsels patience. The company staffs and supplies the flu-shot clinics at such locations as Costco, CVS and Giant stores and last year gave more than 3 million vaccinations nationwide. Wright estimates that one-third of Maxim's supply is in hand from multiple sources. No clinics have been postponed, but the majority take place in November.

"With patience, everyone's going to get a shot this year," he said.

But flu-shot complications are wearing thin in many providers' offices.

"It seems like every year we run into the same situation," said David Anspaugh of Bull Run Family Practice in Manassas, which has only 500 of the 3,500 doses it ordered in January.

With vaccination clinics due to start tomorrow, "we've been scrounging around to see if anyone has any more," said Anspaugh, administrator of the 13-physician office. "Everybody seems to be in the same boat."

Last winter, some of the practice's supply came in so late that few patients still needed or wanted a dose. "We ended up having to eat about $1,200 of vaccine," he said. Should that happen again, the doctors might get out of the flu-shot business.

"It's certainly an option we will be looking at. Because we can't afford to lose that kind of money again."

Reported By TechNews.com, http://www.TechNews.com

(20061015/WIRES /)

Source: Newsbytes

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