What's taking so long with the flu vaccine?

Jeffrey Weiss

Nov. 4, 2009 (McClatchy-Tribune Regional News delivered by Newstex) -- Scarcity and fear are driving a nationwide hunger for the H1N1 flu vaccine. In much of the country, long lines have formed at clinics where the vaccine is available.

In Dallas County, two vaccination clinics are planned for today: one run by the Dallas County health department, the other by the Garland health department. Both are intended for people who have no health insurance.

Officials at both locations say they hope that the demand doesn't outstrip their supplies.

Dr. Thomas R. Frieden, head of the federal Centers for Disease Control and Prevention, offered basically the same message Tuesday that he had last week: The flu is widespread and the vaccine is not.

"We know it's frustrating, inconvenient and disruptive for people to try to get the vaccine and not to be able to," he said.

Why isn't there enough vaccine for everybody who wants it?

Federal officials say the answer is simple: It doesn't exist yet. During a normal year, vaccine manufacturers decide in February which strains to put in the seasonal vaccine that is distributed about nine months later.

The 2009 H1N1 flu was only identified in March. Health officials didn't decide until May that the new flu was dangerous enough to require a special mass-produced vaccine. And then the strain of virus used to grow the vaccine turned out to grow much more slowly than other strains of flu. That means the vaccine is being produced more slowly than manufacturers and federal officials had predicted.

As of Tuesday, the CDC said that 31.8 million doses have been shipped or are available for shipping. But the original order was for 225 million doses.

Why are the local health departments treating the uninsured better than people with insurance?

Actually, there's a lot more vaccine in Dallas County for people with insurance. According to Texas health officials, private medical providers in Dallas County have been shipped about 20 times more vaccine than the county health department. That vaccine is mostly going to patients who have insurance. But those practitioners are generally not advertising that they have the vaccine because it is intended for their patients. That leaves the public health departments as unusually high-visibility suppliers.

If the vaccine is out there, how do I find it?

The bad news is that there still isn't very much available yet -- about 100,000 doses at this point in a county of about 2.4 million people. Many doctors haven't ordered any. And there's no way for you to know whether your doctor has some without contacting the office. Texas health officials had promised to provide county-by-county statistics about vaccine availability and even a list of providers. But the information page on the state Web site still reads "coming soon."

State health department spokeswoman Carrie Williams said the county-by-county data may indeed be available soon but that there are no plans to identify specific providers.

"Providers receiving vaccine at this point are getting amounts to serve their own patients," she said.

When will I be able to find H1N1 vaccine at my neighborhood pharmacy?

Probably not until the end of the month, state officials say.

Why does the county want to target the uninsured with its vaccine, anyway?

The original plan for distribution assumed that the vaccine would be quickly and widely available at doctors' offices and pharmacies, county health officials say. The county requested only enough to serve what it estimated the needs were for its traditional clients: people with no insurance. If the county uses up its supply of vaccine now on people who can afford to pay for it, there may not be any for its clients once the vaccine is more widely available in a few weeks.

Government officials say that only members of "risk groups" should seek vaccination now. Why?

People of all ages and types have caught the H1N1 flu, and most people recover after a few days. But members of some groups are more likely to get severely ill.

Frieden of the CDC said Friday that a third of the people hospitalized with the H1N1 flu also had asthma. But only 10 percent of Americans ever have asthma, according to the American Academy of Allergy Asthma and Immunology.

People under 25 years old -- about a third of the population -- account for a majority of the hospitalizations. The CDC has said that pregnant women are six times more likely to get severely ill with this flu.

On the other hand, few people older than 65 are even catching this flu, much less developing a severe case.

That's why government officials are asking people who aren't in the risk groups to wait until the supply grows large enough to cover more than those at highest risk of severe illness.

Newstex ID: KRTB-0046-39480647