Tuesday, October 24, 2000, 09:19 a.m. Pacific

Flu shots going to businesses before doctors

by Lauran Neergaard The Associated Press People at highest risk for flu complications Anyone over 64. People of any age who have chronic heart or lung disorders, including asthma, or who have diabetes, kidney disease or a weakened immune system. Women who will be in the second or third trimester of pregnancy during flu season. It is also important for health-care workers and family members who are in contact with high-risk patients to receive vaccinations.

WASHINGTON - Dr. Raymond Scalettar is angry: He has to send elderly lung-disease patients to nearby supermarkets for a flu shot. Why? Some huge grocery chains received thousands of vaccine doses before manufacturers shipped them to many private doctors whose patients are so frail that influenza could kill them.

The sick standing in store lines aren't doctors' only frustration. Manufacturers acknowledge shipping shots to large corporations for employee-vaccination programs ahead of many doctors - even though this year's vaccine delay means high-risk Americans, not healthy young workers, are supposed to be first in line.

"We have patients on cancer chemotherapy, who have chronic bronchitis and obstructive lung disorder and immunodeficiency - people who really need the protection as soon as possible," said Scalettar, a prominent Washington, D.C., physician who eventually will get the vaccines but doesn't want his sickest patients to wait.

"It doesn't make sense for corporations to give it to healthy people and we can't give it to sick people."

Washington state health departments and providers are also receiving their shipments later than usual.

"It's definitely late," said Filiz Satir, public-information officer for the Washington State Department of Health, which provides vaccine for high-risk children between 6 months and 19 years of age. One-third of the state's supply has arrived and the rest is due by December, Satir said.

Influenza isn't threatening just yet, and plenty of vaccine is coming, says the Centers for Disease Control and Prevention (CDC): It's just taking longer to arrive this year because of manufacturing problems, which have been resolved.

So state and federal health officials are urging healthy people to wait until late November for vaccination - letting the elderly, pregnant women and people with chronic illnesses such as asthma, heart disease or weak immune systems get the first shots now being shipped.

The flu typically kills 20,000 Americans annually, mostly the elderly and chronically ill. Thus, they need the earliest protection.

However, some corporations that placed high-volume orders with vaccine makers are getting their orders before many private doctors.

The CDC, receiving complaints from physicians like Scalettar, is asking corporations to offer the first shots only to employees and their family members who are high-risk, and vaccinate healthy workers later - but it can't enforce its recommendations.

"We want to make sure that high-risk people get vaccinated first," said Dr. Keiji Fukuda of the CDC. Other people "are anxious, and we recognize that. But know that more vaccine is on the way and it's pretty quiet right now on the influenza front."

"There's always a concern," said Terri Campbell, Group Health spokeswoman, "but we think we'll still get people immunized in plenty of time to avoid the flu."

Group Health is scheduled to begin giving shots in mid-November. Seattle-King County Public Health is scheduled to start Nov. 6.

Among the Seattle area's large corporations, Boeing's flu-shot program began Oct. 18 and will run through Nov. 3. The company said it administers 30,000 vaccinations a year. Microsoft will offer flu shots on its campus beginning Nov. 15.

Contrary to earlier fears, and some erroneous media reports, the CDC insists there's no impending shortage. About 75 million flu shots ultimately will be distributed.

Typically, doctors finish vaccinating most high-risk patients, and lots of healthy people, by late October.

November or December is not too late to vaccinate healthy people, the CDC says. Although some flu strains typically start circulating by then, in 14 of the past 18 winters large outbreaks didn't begin until January or later. It takes two weeks after vaccination to reap full protection.

Companies with early vaccine shipments could lend them to needier nursing homes or high-risk clinics, which would repay the loan when their own shots arrived, CDC suggests. The Atlanta-based agency plans to lend doses to needier neighbors after vaccinating its own high-risk employees in November.

And if the flu strikes earlier than expected, manufacturer Aventis is setting aside some shots for priority shipment.

Plus, the CDC has ordered 9 million vaccine doses set aside in December just for high-risk patients as a "safety cushion" in case healthier people squeeze out the neediest.

Also, once the flu hits, doctors in outbreak areas can check a new CDC vaccine-sharing Web site to hunt other regions with leftover doses.

Seattle Times staff writers Eric Sorensen and Tom Lee contributed to this report.

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-- Martin Thompson (mthom1927@aol.com), October 24, 2000

Answers

Flu vaccine supply inconsistent

24 October 2000

By Lydia Carrico Messenger-Inquirer

People rushing to get their flu vaccinations have depleted the stock of one local health-care facility and will soon zap the supply of another.

Convenient Care has run out of the vaccination and won't be getting any more. An employee at MultiCare said it is expected to run out in a couple of weeks. Other facilities have yet to receive their shipment of vaccines.

"We've contacted three suppliers, and all three said they won't make any more," said Marilyn Rice, a registered nurse with Convenient Care. "There's no ordering any more."

The Centers for Disease Control and Prevention issued warnings that it would be as late as December before flu vaccinations reached doctors' offices and clinics. The delay was due to the CDC's difficulty in cultivating a strain of influenza expected to strike this year, resulting in a low initial supply. Despite the delay, the same amount of the vaccine that was distributed nationwide last year, about 75 million doses, will be eventually available this year, the CDC said.

A couple of facilities distributing flu shots are reserving their supply for company employees or for people in high-risk groups, such as the elderly or those with chronic illnesses. Convenient Care has about 500 doses, but those are for companies that have contracts for the shots with the center. The Perry County Health Department will be reserving their short supply for high-risk groups, said Jan Meyer, registrar. It received only 200 doses, she said.

Ohio Valley Medical Center in Perry County will be doing the same, said Marilyn Ayer, nurse practitioner.

Minor EmergiCenter in Owensboro hasn't received any of the vaccine, said Dorothy Erickson, office manager, but they will soon.

And the Green River District Health Department has about 9,000 doses coming in November, said Lamone Mayfield, executive director. So far, the center has received 500 doses. Waiting until November or December to get a flu shot is fine, she said, because the flu season doesn't kick in until late December or early January. It takes only about two weeks before the shot becomes effective.

Sandy Perrin, purchasing coordinator for MultiCare in Madisonville, said costs may be a factor for some facilities that are not restocking their supplies. Prices already have tripled due to the delay, she said. However, there will be enough vaccine to go around, she said.

"We will be able to get more if we want to," Perrin said.

Even if there were a shortage, Dr. Khaled Jouja, infectious disease specialist with Owensboro Mercy Health System, said there would be no reason to panic. Extra precautions will help protect people from getting the flu. People should see their doctor if they have symptoms and cover their mouth with a napkin when they sneeze or cough.

"If they can get the vaccine that's fine," Jouja said. "If they can't, it's not the end of the world."

http://www.messenger-inquirer.com/daviess/2287161.htm

-- Martin Thompson (mthom1927@aol.com), October 24, 2000.