Lining up our defenses

Shortages of flu vaccine are not expected this year, though you may have to time your shot for where and when it is available.

By SUSAN ASCHOFF

© St. Petersburg Times,
published October 23, 2001

CLEARWATER -- Marilyn and Arthur Adler, because of their age and health, are usually first in line every October to get flu shots. And while supplies of the vaccine appear adequate this fall, the Adlers did have some trouble figuring out where to queue up for their doses.

"We always get them at the doctor. This year we were told we have to get them at a supermarket or clinic," says Arthur Adler, an 80-year-old Clearwater resident.

The Adlers' health maintenance organization told them it would no longer pay for flu shots at their doctor's office. After numerous phone calls, the couple found a neighborhood Albertson's giving the shots in mid to late October.

Last year, shortages of the influenza vaccine brought long lines and sent many scrambling, to no avail, for a flu shot as late as January. Almost 10-million more doses are available nationwide this year. No shortages are predicted, although delivery to providers may stretch into December, according to the U.S. Centers for Disease Control in Atlanta.

With deliveries running late, people are being asked to postpone their shots until after October so the elderly and chronically ill may be vaccinated first.

Flu shots are typically given from mid October through early December.

Those with chronic medical conditions or those 65 and older, like the Adlers, are considered at high risk for complications from the flu and should get first priority for flu shots, the CDC advises. Others should plan on a shot in November or early December, as more shipments of the vaccine arrive. Delivery to workplace sites, for example, will be delayed until November.

Complicating the process for some are changes in health care plans. Those insured through Medicare but not in an HMO typically qualify for flu shots at no charge. Others will pay from $3 to $20, an informal survey of Tampa Bay-area providers found.

"I'm 80 and my wife is 71. We have to get the flu shot early," says Mr. Adler. Mrs. Adler has diabetes and congestive pulmonary disease.

About 20,000 Americans die each year from flu and its complications, such as pneumonia. Many sites this year will offer a vaccine for pneumonia as well.

Each year, health officials monitor the strains of flu occurring globally and pick three most likely to be a problem in the upcoming flu season to produce that year's vaccine.

Flu season typically runs from December through March in the United States, peaking most years in February. Since protection from the vaccine begins about two weeks after inoculation, flu shots administered as late as December are still effective, officials say.

"The vaccine is readily available now. We're getting (shipments) in increments, but it is enough to see us through," says Millie Vitale, a nurse at the Pinellas County Health Department.

Slightly more than half of the 79-million doses should arrive at sites by the end of October, the CDC says. Last season, when supplies ran short, about 70-million doses were available.

Delivery is staggered because there are only three U.S. manufacturers of influenza vaccines. A fourth, Parkdale, stopped making the vaccine in 1999. Aventis Pasteur, which produces about half the supply in the United States, raised its prices about 50 percent earlier this year, blaming increased shipping and other costs.

Potential delays in receiving the vaccine prompted the Advisory Committee on Immunization Practices to urge people at greatest risk to get flu shots first.

At high risk are people 65 and older, nursing home and other chronic care residents, adults and children with pulmonary and cardiovascular illnesses, including asthma, and those with diabetes, renal dysfunction and hemoglobin or immune deficiencies. Pregnant women past the first trimester and children and teenagers who are on aspirin therapy should also be vaccinated, officials advise.

Health care workers and those who care for at-risk family members need the shot, too.

Since last year, guidelines also call for people ages 50 through 64 to be vaccinated because one-fourth to one-third of those in this age group have at least one high-risk condition.

"Flu shots are important. There could be a shift in the kind of viruses we get (this flu season)" and many more people could get sick, says nursing program specialist Diana Jordan of the Pinellas County Health Department.

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