State collects
10,000 flu shots
for chronically ill

HMSA's donation of its
7,000 remaining doses
boosts supplies

State health officials have pulled together 10,000 doses of the flu vaccine to be administered to the chronically ill who are unable to get the shot from other health providers.

Vaccination orders available Dr. Sarah Park of the state Health Department said chronically ill people who have not been able to get a flu shot from their health-care provider can see their doctor and obtain a vaccination order form for a state shot. They will be given an appointment date at a clinic and must show up on time with the form and identification or they can be denied a vaccine, said Park.

It is unclear how big of a dent the doses will make in the state's flu-shot shortage. Health officials say there are potentially hundreds of thousands of people in Hawaii who want the shot, but about 230,000 doses went to isle clinics and private physicians before the shortage was made public last month.

Yesterday, the state Department of Health announced that the Hawaii Medical Service Association has donated its remaining inventory of 7,000 shots, which had been intended for its clinics, so that the chronically ill in the state may be immunized beginning Nov. 15. The state also had about 3,000 from other sources.

Dr. Sarah Park, deputy chief of the Health Department's Disease Outbreak and Control Division, said the department has additionally directed another 2,700 shots to immunize patients in long-term care facilities who are considered the most at-risk population in the state because of their frailty and high exposure in such facilities.

There are an estimated 4,000 patients in long-term care facilities statewide, but some of them receive shots from private doctors.

The Health Department has had difficulty estimating the number of chronically ill and at-risk individuals in need of vaccinations in part because there is overlap among these groups. For example, someone could be both elderly and afflicted with diabetes.

Previously, Park has said an estimated 100,000 people, based on the census, would be considered at-risk and that "we are grossly undersupplied."

The Health Department has been scrambling to assess how many doses were already stockpiled in private physicians' offices and clinics so that they could be redirected to the most at-risk people.

The department has urged private physicians and health plans such as HMSA, Kaiser Permanente and Straub Clinic to inoculate only high-risk patients as defined by the U.S. Centers of Disease Control. Many clinics have posted signs in their waiting rooms advising patients of this policy.

In addition to frail seniors, the CDC identifies those with immune-system deficiencies, pregnant women and very young children as high-risk groups.

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

Cliff Cisco, a spokesman for HMSA, the largest health insurer and provider in the state, confirmed it donated 7,000 doses to the Health Department's effort.

HMSA had received about 12,000 doses and inoculated about 5,000 patients just before the shortage became public.

Concern about a critical flu shot shortage started in mid-October 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 who face hospitalization or even death if hit by the flu.

Waimanalo Health Center, one of 11 public clinics in the state which use state and federal funding to treat patients who are underinsured or not insured, has had rushes of people to its clinics in recent weeks.

Waimanalo executive director Charles Braden said the clinic, which serves about 3,700 patients annually, has administered about 500 vaccines. He said the clinic's remaining supply will be administered strictly following CDC guidelines and that those who are not eligible will be turned away.

"We need everyone to work together," said Park. "We need doctors to screen patients and for patients to understand."