Patience wearing thin over flu shot distribution woes

Public health officials say more vaccine doses are coming, but doctors wonder about the window of opportunity to use them.

By Victoria Stagg Elliott, AMNews staff. Dec. 5, 2005.

When it became clear to Brian Bachelder, MD, a family physician in Mt. Gilead, Ohio, that none of the 250 doses of influenza vaccine he had ordered were going to get to his office through the usual channels, he hatched a plan. He made a deal with the pharmacist from the local grocery store, which had an ample supply, to hold two clinics at his office.

"It's not ideal, but we're getting some service for the patients," he said.

Dr. Bachelder is one of many physicians across the country dealing with a flu vaccination season characterized by maldistribution.

High on the list of physician complaints: Many retail outlets appear to have plenty, while some medical practices seem to have none.

According to the Centers for Disease Control and Prevention, more than 80 million doses are expected to be delivered before this season is done. Several surveys suggest, however, that so far the vaccine may not be reaching physicians. One conducted by the Medical Society of the State of New York found that as of the beginning of November about 60% of physicians had received less than 25% of what they ordered and many had received none. Another by the California Medical Assn. found that 46% had not received a single shot.

"We should have vaccine in the hands of doctors," said Jack Lewin, MD, CMA chief executive officer. "This is a terrible mess. All of the big box stores have vaccine. Something stinks in the way vaccine is distributed."

But experts say these rapidly carried out surveys may not offer a completely accurate picture because physicians who are having difficulties may be more likely to respond, thereby skewing results. The CDC and the AMA are currently conducting their own randomized, scientific survey to gain a better understanding. The data are expected to be presented at the National Influenza Vaccine Summit in January 2006.