Officials scramble




WASHINGTON — One flu shot maker will squeeze out an additional million doses this year, but it is unlikely that any more can be made, federal health officials said Wednesday.

A day after the nation’s flu vaccine supply was cut in half, officials scrambled to determine which cities and states will have the most dire shortages.

Despite early, scattered reports of price gouging, the government is appealing to people’s sense of good citizenship to ensure the fair distribution of scarce supplies of flu vaccine this year.

Most vaccinations are done at health departments, private doctor’s offices, malls, grocery stores or work places.

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Communities have begun canceling long-planned flu-shot clinics. Hospitals suddenly stripped of planned supplies began searching for luckier neighbors that might share.

Aventis Pasteur this year will produce 55.4 million flu shots, 1 million more than originally estimated, Health and Human Services Secretary Tommy Thompson said Wednesday.

But Aventis said it is unlikely that it can produce any more than that before February or March, when flu season usually is waning.

Aventis has shipped 30 million of its doses and sold all but about 2 million.

Tracking down doses
Most of the doses are in the hands of private distributors, not state health departments. The Centers for Disease Control and Prevention has began trying to track down exactly where those doses are, in an effort to help direct vaccine to the youngest, oldest and sickest people — those who need it the most.

The CDC could not even estimate on Wednesday which regions would have the greatest shortages. The search probably will take weeks and will be voluntary.

The CDC cannot override private contracts that, for instance, allow for healthy office workers to get the shot instead of people in nursing homes. The agency hopes to soon open a hot line for patients and doctors to use to help find scarce supplies.

“People do need to be patient,” CDC Director Julie Gerberding said.

Told of scattered reports of healthy adults lining up for shots, Gerberding said health officials will urge mass-vaccinators to comply with the voluntary rationing.

The United States had expected a record 100 million doses of flu vaccine. But on Tuesday, British regulators unexpectedly shut down a second supplier, Chiron Corp. That held up the 46 million doses, destined for the United States, at the factory in England where the vaccine had been made. Manufacturing problems apparently led to the contamination of a portion of those doses.

U.S. health officials were stunned. The Food and Drug Administration’s monitoring had suggested that most of Chiron’s vaccine would be fine.

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FDA scientists are going for Britain to discuss “where the disputes are and how we might be able to reconcile them,” Thompson said.

He was not optimistic that any of the shots ultimately would be usable. “It does not look promising,” Thompson said.

The extra Aventis vaccine is the result of the company’s production line proving more efficient than anticipated, Gerberding said.

“It’s very doubtful” that manufacturers will be able to make any more, Thompson said.

“This catastrophe is going to be the impetus for Congress and manufacturers to start transforming the development of vaccine,” he said.

Redistribution scramble
Flu vaccine now takes months to brew, using chicken eggs, an old-fashioned method that the government hopes to modernize.

The CDC is optimistic it will find more vaccine because doctors and hospitals placed orders anticipating they would give shots to many more people this year than the roughly 50 million classified as high-risk. Those providers, Gerberding predicted, “will do the right thing and not hoard doses.”

Hospitals scrambled to find alternatives.

New York bought most of the area’s flu shots from Chiron, said Dr. Pascal James Imperato, a former New York City health commissioner who is now at SUNY Downstate Medical Center in Brooklyn.

“I don’t think there’s ever been the kind of redistribution in the past that may now be required,” he said.

Baylor University Medical Center in Dallas has received half of its planned Aventis shipment, infectious disease chief Dr. William Stuker said.

“We’re in limbo until Aventis decides what to do — we’re hoping that perhaps information will be coming down from the CDC or the National Institutes of Health or Aventis itself as to what strategy we’re going to take,” Stuker said.

In suburban Washington, the Inova Health System that gave over 70,000 flu shots in Northern Virginia last year canceled dozens of flu clinics planned to start this weekend, until it can assess how many doses it ultimately will receive.

High-risk patients depend on flu shots because the injections are made of killed influenza virus.

Other people have a different option: About 1 million doses of an inhaled flu vaccine, MedImmune Inc.’s FluMist, will be available for healthy 5- to 49-year-olds. This vaccine is made from live but weakened influenza virus.

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