Public clinics see flu
shot shortage

State health officials said yesterday that public health clinics are "grossly undersupplied" in flu vaccine doses but that many private physicians here have already received their supplies.

"The vaccine supply is extremely limited and is unlikely to be relieved any time soon," said Dr. Sarah Park, of the Health Department's Disease Outbreak and Control Division.

Park said the stockpiles in public health clinics are "not exactly a great boon. It's more like a Band-Aid. We need to face tough decisions. We are grossly undersupplied, and we need to use the vaccine that is available to the highest good" for at-risk groups that face hospitalization and even death if hit with the flu.

As expected, health officials announced yesterday that "frail elderly" in long-term care facilities will have the highest priority for flu shots.

Health Department officials met this week with representatives of HMSA, Kaiser Permanente, the Medical Corner, Longs Drug and others to determine what the available inventory of vaccine is in the state, who is at the highest risk and how to reallocate vaccine to high-risk groups.

The Health Department expects to form a "collaborative plan" to reallocate existing vaccine in a few days.

Park stressed that the state is not wresting vaccine from the hands of private physicians and clinics for redirection.

However, the department is urging major private providers who already have vaccine doses to immunize only their high-risk patients and to follow the Centers for Disease Control criteria in making that call. In addition to frail seniors, those with immune-system deficiencies, pregnant women and very young children are also among high-risk groups.

Park declined to say exactly how severe the shortage of vaccines is for this flu season, which typically begins in December.

However, she said the estimates of at-risk patients among seniors and young children based on U.S. Census figures is more than 100,000 in Hawaii, and our "supply is grossly under that."

Concern about a critical flu shot shortage started last week when British regulators, citing contamination, shut down the Liverpool plant of Chiron Corp., a major vaccine supplier. They also froze the shipment of about 48 million vaccine doses, about half the United States' supply.

The Chiron shutdown left Aventis Pasteur as this year's sole supplier of injectable flu vaccine. Aventis, which manufactured about 55.4 million doses, has shipped more than half, which cannot be recalled for redistribution to higher-risk groups.

A flu vaccine typically begins development a year or more before distribution, according to experts. Scientists select several strains of flu for a vaccine which then takes months to grow and manufacture, making it impossible to replace this year's botched batch with new ones in time for flu season.

A "flu mist" carried by Longs and others might serve as a backup solution to the more effective injectable version.

The Health Department said yesterday that many physicians in Hawaii receive their vaccine from Aventis and that Hawaii is in a better position compared with states such as California and New Mexico that rely primarily on Chiron.

Bob Ogawa, president of the Hawaii Long-term Care Association, said there are about 4,000 seniors in licensed nursing care facilities in the state. He said those facilities, which mostly purchase vaccine from Chiron, have a "substantial shortage" of the vaccine.

Ogawa acknowledged frail seniors in long-term care homes are at greater risk than frail seniors living independently because their chances for exposure are far greater.



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