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Plan B for flu shots

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Oct 11, 2004 (United Press International via COMTEX) -- A shortage of vaccine has canceled flu-shot clinics at several hundred workplaces in southern Wisconsin as state officials go to Plan B: redistributing available vaccine to those at highest risk.

State officials were asking local health departments to coordinate supplies and share available vaccine in reaction to last week's announcement the Chiron Corp., which was expected to provide 46 million to 48 million doses of vaccine, would not be able to ship any this fall.

British government regulators found vaccine produced at Chiron's plant in Liverpool, England, was contaminated with a bacteria commonly found in hospitals.

None of it likely is salvageable, acting FDA Commissioner Lester Crawford told the House Government Reform Committee Friday, leaving the United States with 54 million doses of influenza vaccine made by Aventis Pasture rather than an expected 100 million doses.

"If you have a county where all the vaccine was ordered from Chiron, clearly they are going to have to go out of the jurisdiction," Wisconsin's chief medical officer Jeff Davis told the Milwaukee Journal Sentinel.

Flu vaccinations scheduled for employees at their workplaces were canceled at hundreds of companies.

Under federal guidelines, people in high-risk groups -- children ages 6 months to 23 months, caregivers who come in contract with infants 6 months and under, adults 65 and older, chronically ill patients between 2 and 64, pregnant women, residents of nursing homes and long-term care facilities, children on aspirin therapy and healthcare workers -- are supposed to get first crack at the available flu vaccine.

Wisconsin's Visiting Nurse Association did not get 60 percent of the vaccine it ordered and Monday restricted shots mainly to the elderly, chronically ill and people with compromised immune systems.

The VNA gave about 94,000 flu shots at 350 clinics in 13 eastern Wisconsin counties last year. This year substantially fewer will be vaccinated. Miller Brewing Co. in Milwaukee canceled company-provided flu shots.

Fortunately, many healthy people will do just fine without the vaccination, which is about 80-percent to 90-percent effective in preventing the flu in healthy people.

City of Milwaukee chief virologist Gerald Sedmak predicts the cold weather will bring a moderate flu season with 5 percent to 10 percent of adults affected by the A-Fujian (H3N2) virus, the same flu virus many people were exposed to last year. Immunity either by vaccination or exposure typically lasts about one year. The flu season runs from November until April.

Gaithersburg, Md.-based Medimmune, maker of a relatively new live virus inhaled flu vaccine, is doubling production to 2 million doses for healthy people ages 5 to 49. FluMist is a nasal vaccine.

Sen. Charles Schumer, D-N.Y., blames the federal government for the shortage of flu vaccine and recommends health officials decrease reliance on two private drug manufacturers to provide all of the doses ordered for the nation.

He estimates it would cost around $200 million a year to get U.S. drug companies to provide enough vaccine. His plan would have companies make a uniform order of vaccine each year. The government would pay whether it was all used or not, decreasing the manufacturer's economic risk.

"If the federal government guaranteed they would buy an adequate supply of flu vaccine every year, we'd have more than enough," Schumer said. "Because then companies would know that in the years where they didn't sell all their vaccines, because it was thankfully a mild year, the federal government would buy it up.

"Unless the federal government gets involved, we're going to have shortages and crises like this year after year," he said.

The situation is not dire everywhere. The Visiting Nurse Service of Indianapolis obtained additional vaccine from Aventis for public clinics sponsored by the Marion County Health Department through Tuesday and ordered 2,000 doses of FluMist. The shots are limited to people considering high-risk.

The Indiana State Department of Health has ordered 10,000 doses of FluMist.

Last Thursday, Anthony Fauci of the National Institutes of Health warned people not to count on extra supplies of vaccine before flu season begins because it takes about six months to make the vaccine.

Shortages, though widespread, are scattered.

USA Today said Ohio received 260,000 of the 270,000 doses it expected but neighboring Indiana only got 18,000 of the 85,000 doses it ordered. A drugstore might offer flu shots while a medical group or hospital might not have any vaccine.

The Pentagon ordered more than half of its 2.5 million doses from Aventis and is trying to get FluMist for troops being deployed. The Wall Street Journal said Aventis had not yet shipped about 25 million doses and is developing a plan to redistribute supplies this week.

Federal officials are investigating reports of price gouging by distributors and pharmacists.

A pharmacist at Children's Hospital of Orange County in California reportedly said a vendor offered to sell him a 10-dose vial of flu vaccine for $700, The New York Times said. The vial normally costs $67.

Sen. Pat Roberts, R-Kan., sent U.S. Health and Human Services Secretary Tommy Thompson a letter Friday warning the price of flu vaccine for a Kansas nursing home tripled "in the matter of a few hours."

"To find a solution to this egregious price gouging problem, I have reported complaints to the Centers for Disease Control and Prevention," Roberts said. CDC plans to set up a toll-free number to allow individuals to report price gouging by distributors and others.

The Iowa attorney general's office said flu shots cost about the same as last year -- $10 to $28 -- and that the state had received no reports of price gouging.


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Copyright 2004 by United Press International.

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