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States to decide flu-shot priority

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The Centers for Disease Control and Prevention said Tuesday it is shifting responsibility to distribute most of the country's remaining doses of flu vaccine to state health departments, which will decide who in the high-risk groups will get the injections.

State health directors sought the change, believing they --- better than federal authorities --- know best where to ration the highly sought vaccine, said Dr. Mary Selecky, secretary of health for Washington state and former head of the Association of State and Territorial Health Officials. Selecky announced the change at a news conference with CDC Director Dr. Julie Gerberding.

"We are where the rubber meets the road," Selecky said in an interview. "We know where our high-priority residents are."

More than 10 million doses of influenza vaccine --- 90 percent of the United States' remaining 11.6 million shots for this year --- will be sent to the state health departments. The CDC could not on Tuesday give the numbers of doses states will receive, but Gerberding said each will get its "fair share."

The United States lost nearly half of this year's expected injectable flu vaccine Oct. 5, when Chiron Corp.'s production of 46 million doses was disallowed by British health officials for bacterial contamination. That left 58 million doses from Aventis Pasteur, the nation's only other flu vaccine supplier.

CDC announced several weeks ago that it would redirect the remaining vaccine to ensure that only high-risk individuals get it. The agency acknowledged there would not be enough vaccine to meet even high-risk demand.

The new redistribution plan could prove problematic. State health departments have heard they may have to buy the vaccine before they can allocate it, said Richard Quartarone, spokesman for the Georgia Division of Public Health. Under the previous arrangement, public and private providers paid directly for vaccine redirected by the CDC and Aventis.

If that report is correct, states might end up as middlemen, buying and reselling vaccine --- an arrangement that could force them to find unbudgeted funding, and cost them if they are left with unused vaccine.

The plan announced Tuesday is a collaboration among the CDC, the ASTHO membership and Aventis.

Under the plan, 7.2 million doses of vaccine will be sent directly to states under a formula that considers the number of high-risk individuals in each state, based on census data; the number of doses a state has already received; and the number of high-risk unvaccinated residents.

An additional 3.1 million doses of vaccine will be sent to state health departments for their public health clinics. Those doses will guarantee that the clinics, which serve mostly low-income patients, get 100 percent of what they ordered from either Chiron or Aventis, the CDC said.

The CDC will hold in reserve a final 1.3 million doses until the redistribution is complete in case problems arise once flu season intensifies, Gerberding said.

The officials acknowledged Tuesday that those who most need flu shots will not get them, even with states taking over responsibility for identifying those most at risk of death or complications from flu.

Under the plan, doses will be sent first to the 29 states, including Georgia, that have reported flu cases, Gerberding said.

Copyright 2004 The Atlanta Journal-Constitution


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