Thread: Flu Vaccine Shortage In North Carolina

I think we discussed this on another thread but I can't find it. This article can be found at www.the-dispatch.com

AP State News

November 04. 2005 11:34AM

Flu shot availability crimped by delays

By The Associated Press

Public health officials say there will be plenty of flu vaccine this year, but shipping delays and increased demand have created the appearance of a shortage because vaccination clinics across North Carolina have been canceled.

"It shouldn't be such a hassle to do something like this," said Gordon Rauschenberger, who arrived two hours early at a drug store's clinic in Charlotte but left without an injection.

The store ran out of vaccine, as did two grocery stores contacted by the retired sales executive. Retailers such as Eckerd, Harris-Teeter and Lowes Foods have said they canceled clinics because suppliers had no vaccine.

Maxim Health Systems, the company that provides flu shots in 35,000 locations across the country, said it scheduled clinics in grocery and drug stores before it knew supplies would arrive late.

"We're in the same boat as everyone," said spokesman Chris Hayes in Durham. "It's really a day-to-day process right now."

Doctors' offices also are running short of vaccine, if they got any at all.

Naomi Slifkin, nursing supervisor at The Family Doctor office in Chapel Hill, said she usually gets about 900 doses, but hasn't received any this year.

"We have no flu shots and no idea when or if they'll arrive," Slifkin said. "We have no idea what's going on. People are calling, anxious for flu shots."

Vaccine is being manufactured by Sanofi Pasteur Inc., MedImmune Vaccines Inc., GlaxoSmithKline Biologicals and Chiron Corp. Chiron has a backlog and its Web site said the company is producing less than expected.

FDA officials say they are working with the companies to be sure there is a sufficient vaccine supply.

Brian Letourneau, director of Durham County's Health Department, urged patience.

"It's still very early in the (flu) season," Letourneau said. "I don't see any reason for people to become overly concerned about access to flu vaccine. Our information from federal and state sources is that the supply is adequate, and it's coming intermittently, as expected."

Dave Nowakowski of Durham said the clinic he attended ran out of vaccine before he got a shot.

"I made it through last year" without a shot, Nowakowski said. "(The homeopathic treatment) Airborne and Nyquil will get me through again this year."

Found another article about the shortages. Looks as if California is also having problems distributing vaccines. Some places are getting it while others are not.

http://www.sacbee.com/content/news/stor ... 8029c.html

Flu-shot supplies lagging for U.S.
Vaccine orders unfilled as the season kicks off.
By Dorsey Griffith -- Bee Medical Writer
Published 2:15 am PST Saturday, November 5, 2005
Despite assurances of plentiful supplies of flu vaccine, manufacturing delays combined with high demand have left many local health care providers without the shots.

The first three weeks of November marks the peak season for flu-shot awareness, but many doctors who ordered vaccine last spring still have not received their supplies, and some larger public providers are curtailing or canceling flu shot clinics.

The problems can be traced, in large part, to Chiron Corp. of Emeryville, the company that was unable to ship about 50 million doses of flu vaccine to the U.S. market last year because of manufacturing problems at its plant in Liverpool, England.

Chiron had hoped to produce between 18 million and 26 million doses of vaccine this year, or about a quarter of the nation's supply. The company has since cut its estimated production, though it wouldn't give a specific figure. As of a week ago, the company had shipped 5 million doses.

"We are very aware that everyone has been skeptical, impatient and frustrated with us," Chiron spokeswoman Alison Marquiss said Friday. "We will continue to ship (vaccine) through November. There is definitely more to come."

Chiron's delays and reduced output this year were caused by the time-consuming process of fixing the problems that led to last year's production line crisis. That crisis halved the U.S. supply of vaccine, leading to nationwide rationing and redistribution.

"Certainly we are behind from where we would be in a normal year," Marquiss said. "The past year has been a rebuilding year for us."

Chiron's delays have left Mercy pharmacist Neal Cardosa with just 150 of the 2,000 doses he ordered for doctors throughout Sacramento.

"I get probably six calls a day from physicians' offices: 'When will you get it? Do you have it yet? Why does someone else have it and we don't?' " he said.

The situation has left many older patients, who under federal health guidelines should have already received the vaccine, have been unable to get the shot from their doctor.

"I'm 72 with diabetes, and I am one of the ones who is supposed to get it first," complained June Hansen of Carmichael.

The delays and related shortages have angered many in the medical field, including the California Medical Association, which wants an overhaul of how vaccine is distributed so physicians are not at the end of the line when problems occur.

"Something is totally wrong in the distribution system," said Dr. Jack Lewin, who heads the CMA. "It's going to drug stores and Costcos and Wal-Marts but not to the doctors who actually care for people at risk. We are going to make sure this doesn't happen again."

Dr. William Dugdale, a Sacramento general practitioner, has not received a single dose of flu vaccine this year, said his medical assistant, Mary Baumgartner.

For the past 14 years, Baumgartner has made it her mission to get every elderly patient immunized. She ordered 2,500 doses in April, then made follow-up calls at least once a month to make sure the shots were en route. This year, her daily calls have yielded nothing but assurances that she's on a waiting list.

The problem has been exacerbated by high vaccine demand. Sanofi Pasteur, which will supply the United States with 60 million doses, booked orders for its entire output in just two days.

"Demand has been extraordinary," Sanofi spokesman John Abrams said. "In a normal year, on the first day of booking, it can be as low as a few hundred to a maximum of a few thousand requests. The first day this year we had over 10,000 orders."

Abrams said Sanofi has delivered about 45 million doses of vaccine and expects to ship the rest this month.

Customers who were turned away have had to rely on manufacturers with much less output, including Chiron, GlaxoSmithKline and MedImmune, which makes an intranasal vaccine for healthy people ages 5 to 49.

Maxim Health Systems, which holds shot clinics at supermarkets, pharmacies and other retail outlets, had planned to provide between 2.2 million and 3 million doses, but after receiving 70 percent of its order - all from Sanofi - it doesn't expect to get the remaining 30 percent.

On Friday, Maxim canceled all flu shot clinics scheduled after Sunday. The Maxim clinics - held at several local Safeway, Albertsons, Costco, Priceless and Longs stores - typically run through Thanksgiving.

"We know the demand for vaccination is higher this year and currently there is simply not enough vaccine available to continue our retail programs," said Steve Wright, Maxim's national director of wellness services, in a statement. "We understand the frustration that some have experienced in trying to get vaccinated against the flu this year."

Sutter VNA & Hospice Association, which conducts more than 1,200 flu clinics in 12 Northern California counties, will have to curtail clinics the next several weeks because its early shipments are being depleted and it has still not received a large shipment from Chiron, said Gerri Ginsberg, program spokeswoman.

"We are on a waiting list for over 10,000 doses, which would carry us through and help us fulfill our existing commitments," Ginsberg said. "But now, we're in the process of limiting and postponing and canceling clinics."

While acknowledging that many people haven't been able to get vaccinated by their own doctor, federal and state health officials said everyone who wants to be immunized should be able to get a shot before the end of the year.

"I hope they will persevere over the next weeks and keep checking in with their physicians because there will be more vaccine," said Dr. Robert Schechter, a medical officer with the state Department of Health Services.

The state agency, which ordered 650,000 doses to distribute to county health departments, is still waiting for more than 200,000 doses from Chiron.

CDC spokesman Curtis Allen said, however, that the agency has not ruled out redistributing available doses.

I was sure I didn't DREAM that. I also mentioned it to my friend in Richmond, Va. earlier this week and she said there was plenty there. But, when I sent her this article, she started calling around and found the same problem there.

WHAT is wrong with our bureacracy that they can't even get the FLU VACCINE out?? They needn't be worrying about coming up with something for the Avian flu if they can't get out the vaccine for the flu we have NOW.

Everywhere you look within our government, you see failure. Just every aspect of our government seems FROZEN.

Something else about Chiron--my son gets their supply for his office from Chiron and, as of three weeks ago, he had only gotten 100 doses. I'm not sure whether he even got those from Chiron or not BUT he had called Chiron the week before to see where their order was and they told him that they had JUST gone through the INSPECTION PROCESS by CDC and that was why it was so late. Now, it looks to me like the CDC should have been over there MONTHS ago looking into whether the problems from last year had been resolved--not wait until right before flu season started.

It appears the supply in California is going to eventually get depleted soon. All the vaccines either went to drug stores, Walmarts, and Costcos, but doctor offices were shut out from the supply. Fortunately my parents who are elderly, and in a high risk group got their shots early with no problems. If Chiron is the culprit of the shortages every year someone should look into finding another source for the vaccines.

That's the problem we have here. The doctors' offices aren't getting any and even OUR HEALTH DEPARTMENT hasn't gotten any.

This article was on the front page of the Winston-Salem, NC Journal this morning--November 7th--www.journalnow.com


Flu shots sometimes hard to find in Forsyth
Stores have shortages, but health department says it will hold second clinic
By Brian Louis
JOURNAL REPORTER
Monday, November 7, 2005


Ray Miller has been spending a lot of time lately calling local retailers and health groups to find a flu shot for him and his wife, Elsie.

"As of now, I haven't been able to find any place where I can go to get a flu shot," Miller, 86, a western Forsyth County resident, said last week. "It is a frustrating experience."

Miller and his wife are not alone. Demand for shots is high, but the supply of flu vaccine has been spotty. In some instances, the lack of supply has forced retailers to cancel clinics in the area.

Costco Wholesale Corp. held a flu-shot clinic in Winston-Salem on Friday, but the company that offers the clinics in Costco stores only had 75 shots to administer, said Terry Pace, a pharmacist at Costco.

Demand far outstripped the number of shots it had available, Pace said.

"It was a zoo," he said.

The store will not be offering flu-shot clinics again until next fall, he said.

Maxim Health Systems, the company that provides the flu shots to Costco and other retailers, said Friday that it will cancel all flu clinics after Nov. 6.

Maxim is a division of Maxim Healthcare Services Inc., based in Maryland.

Steve Wright of Maxim Health, said that part of the problem is that Chiron Corp. in Emeryville, Calif., was late in supplying the market with its flu vaccine.

Chiron is one of the biggest producers of flu-vaccine.

In mid-October, it said that it had started shipping its Fluvirin flu vaccine and that it would make shipments through October, November and into December. But about a week after that announcement, the company said that it would produce fewer doses than it thought, partly because of production delays.

Lowes Foods, also a client of Maxim Health, was forced to cancel scheduled flu-shot clinics, said Diane Blancato, a spokeswoman for Lowes Foods.

The Harris Teeter supermarket chain said that because of a limited supply of flu-shot vaccine, Virginia Health Screenings could not get enough supply to offer clinics in its stores after Oct. 28.

Officials said that there is no reason to panic and there is expected to be enough vaccine this year.

The federal Centers for Disease Control and Prevention said on Oct. 24 that the supply of vaccine for the flu season was good.

The Forsyth County Department of Public Health held a flu-vaccination clinic Oct. 31, at which it administered more than 2,000 doses, said Barbara Carter, the manager of the public-health clinic.

It is expecting 2,000 more doses soon, and the department will hold another clinic then, she said. The date for the clinic has not been scheduled.

Wake Forest University Baptist Medical Center has an adequate supply for patients at its hospital and clinics, said Shannon Koontz, a medical-center spokeswoman.

• Brian Louis can be reached at 727-7378 or at blouis@wsjournal.com

http://www.boston.com/news/local/articl ... commodity/

Flu shot is hot commodity
Demand exceeds supply of vaccine
By Stephen Smith, Globe Staff | November 11, 2005

Patients left jittery by last year's shortage of flu shots and the specter of a global influenza epidemic have fueled a run on vaccine with few parallels in health history, creating demand for a service that clinics once had to beg to give away.

When the Visiting Nurse Association of Boston shows up these days expecting to vaccinate 150 people, twice as many clamor for protection.

When a major national provider of vaccine started giving shots at supermarkets and pharmacies in October, business boomed at places such as CVS and Stop & Shop, surging as much as 40 percent higher than previous years.

And when the phone rings at the Maine state health bureau headquarters, the public health chief can pretty much guess the caller's lament.

''My office is getting inundated -- I mean inundated -- with calls from healthcare providers and the public who say, 'I can't find a flu shot. Help!' " said Dr. Dora Mills, director of public health in Maine.

This year's flu season is proving to be an extreme example of healthcare supply and demand: The director of the US Centers for Disease Control and Prevention yesterday predicted that by the end of this month, as many as 83 million doses of vaccine will have been shipped nationally. And there's more on the way.

That means the nation would have a record amount of vaccine that, in most years, has so outpaced demand that millions of doses have been dumped at the end of the flu season.

This year is different.

Even the mother of the nation's top disease tracker has had a tough time tracking down a shot. Dr. Julie Gerberding, the CDC chief, said her mother called complaining that her physician said there was no vaccine in the medicine cabinet. Gerberding's message to her mother about vaccine mirrored her directive to the American public, delivered yesterday: ''If you can't get it right now, be persistent and patient if you can -- you may be able to get your shot a little bit later this month or next."

Kirsten Resnick got her vaccination yesterday in Cambridge. So did two of her children, Paul, 12, and Lex, 9.

Like about 20 other people, old and young, they found themselves in a Massachusetts Avenue senior center a few minutes before the official 9 a.m. opening time of an immunization clinic run by the Cambridge Public Health Department.

By the time the clinic ended at noon, about 300 people had been vaccinated.

For six weeks, Resnick had called her sons' pediatrician inquiring about the availability of shots.

''We were even in Arizona, and I called from there to ask if they had shots," Resnick, 39, said. ''We're concerned about keeping them healthy, and we remembered the shortage from last year. Then there's the avian flu, of course."

That was Wai Liu's concern, too. He, like Resnick, acknowledged what public health authorities have cautioned: The shot against the seasonal flu provides little or no protection against the bird flu strain that has decimated fowl stocks in Asia while infecting 125 humans, killing 64.

Disease specialists fear that avian flu, which has spread to humans mainly through direct contact with diseased birds, could ignite a global pandemic if it mutates in such a way that it is easily transmissible between people.

After his vaccination, Liu, 38, said this was the first time he'd bothered to get a flu shot.

''I'm not sure this vaccine will work against avian flu," said Liu, a mail carrier in Cambridge. ''But usually I pick up the flu each year much more than my wife, and she gets a shot. This year, I decided I should have one."

So did a lot of other people.

Maxim Health Systems, a company that provides shots at large grocery and pharmacy chains, recorded a 30 percent to 40 percent increase in demand in October, compared with the same period in 2003. Last year, because of an unexpected dearth of shots, little vaccine was available until much later in the fall.

Each week in October, said company executive Steve Wright, demand burgeoned at shops such as CVS, Stop & Shop, and Costco. Because of the robust demand, the company last week announced it was canceling any further appointments at retail locations. The company will still provide vaccine to the nursing homes, physicians, and public health departments with which it has contracts.

In past years, the Visiting Nurse Association of Boston conducted 300 flu-shot sessions over an entire flu season. This year, it has already done that many, or has them scheduled, by now.

The heightened interest, though, has collided with the hard realities of vaccine production. A few decades ago, more than half-a-dozen drug companies made shots for US patients.

But since then, the number of shot producers has dwindled. Drug companies turned their interests, and their investments, to blockbuster drugs that patients need to take for a lifetime to control blood pressure or cholesterol rather than making flu shots.

Last year, there were just two drug firms producing shots for the United States, and when British regulators closed one of their factories upon discovering contamination, a pitched shortage ensued.

This year, that company is making vaccine again, but it began delivering shots behind schedule, which delayed getting vaccine to some clinics.

That's what happened at the Bowdoin Medical Group in Brunswick, Maine, where Daniel Morgenstern is an internist. The physicians there ordered 6,000 doses and have received about half that many so far, with no promises about how many more are en route.

Doctors, though, are reminding patients that if reserves of vaccine can be located in December or even later, it's still worthwhile to get a shot: Flu season in New England doesn't peak most years until February, and it only takes two weeks after inoculation for a flu shot to provide protection.

''Patients just nod when I tell them I can't give it to them now, " Morgenstern said. ''They're not happy, but so far, nobody's beating us up."

Patients seeking vaccine in Massachusetts can find a list of clinics offering shots at flu.masspro.org/search.htm.