Flu shot shortfall: Physicians scramble to direct high-risk patients to scarce vaccine

The problems of massive vaccine shortages and the need to move vaccine to those who need it most marked the start of the flu season.

By Susan J. Landers, AMNews staff. Oct. 25, 2004.

Washington -- Physicians are being called upon to help direct a suddenly limited supply of influenza vaccine to patients most in need -- that is, if their practices are lucky enough to have any vaccine to begin with.

This year's best-laid vaccination plans were abandoned Oct. 5 when federal health officials announced that the Chiron Corp. would not provide the 46 million to 48 million influenza vaccine doses expected across the nation. The manufacturer's license was suspended by British health authorities because of contamination problems in its Liverpool plant.

Now, just as the flu season is beginning, physicians and patients are scrambling to make the most of a scarce resource -- only having about half of the total anticipated U.S. vaccine available for fall and winter months. As a result, physicians are facing another frustrating year of flu shot shortages and rations.

They also are confronting the challenges of educating patients about who should be vaccinated in the wake of this changed landscape and are again trying to form ad hoc supply chains to ensure access for their most vulnerable patients.

"Take a deep breath," said Julie Gerberding, MD, MPH, director of the Centers for Disease Control and Prevention, at an Oct. 5 news conference. "We are going to work through this as we have other shortages in the past."

But how to work through not having any vaccine was uppermost in many physicians' minds.

Consider the example of an 11-member practice in Shreveport, La. About 10,000 doses were ordered, but these physicians now find themselves empty-handed. Vanderbilt University Medical Center in Tennessee is also out of luck. Both of these facilities decided to try to purchase some from local supermarkets and pharmacies that had received their shipments.