Complaints Build Across Nation

[David Farber <dave () farber net>]

Just to put a context. I called my Doctor in Pittsburgh -- part of the  
UPITT Medical facilities and was told they had no vaccine and would not  
get any.

Dave


Complaints Build Across Nation
on Flu Vaccine Supplies

October 19, 2004
 By GARDINER HARRIS





WASHINGTON, Oct. 18 - As the flu crisis stretched into its
third week, complaints are building across the country that
health officials are failing to distribute the remaining
vaccine supply quickly or equitably.

At Louisiana State University in Baton Rouge on Monday, any
student who wanted to be vaccinated could obtain a shot, no
questions asked. The university Web site, <a
href=http://www.lsu.edu>www.lsu.edu, did not mention any
restrictions, and a staff member at the clinic, when asked
whether anyone could receive a shot, said, "Yeah, you can
just walk in."

Dr. Timothy Honigman, medical chief of staff at the student
health center, said students who wanted injections were
given a fact sheet saying only students at the highest risk
should receive the shots. But no one asks students who
request vaccine whether they qualify.

"We're trying to do the best we can following the
guidelines of the C.D.C., yet not totally turning our back
on our students, for whom we are here," Dr. Honigman said,
referring to the Centers for Disease Control and
Prevention.

A spokesman for the Louisiana Health and Hospitals
Department, Bob Johannessen, said several state health
officials had called the university to complain about the
distribution policy. Mr. Johannessen said health care
providers had a moral obligation to ensure - through direct
questions and, if necessary, medical records - that people
who asked for flu shots were at high risk.

"To vaccinate others,'' he said, "is not responsible and is
the wrong thing to do."

Influenza cases have started to appear. Through Oct. 9,
scattered cases of influenza were reported in seven states,
California, Florida, New York, Pennsylvania, Michigan,
Texas and Utah, according to a report posted this weekend
on the disease center's Web site, <a
href=http://www.cdc.gov/flu/>www.cdc.gov/flu/.

On Monday, Minnesota reported its first case, a 44-year-old
from Hennepin County. The illness was caused by the A
Fujian virus, a strain included in the new vaccine.

Flu causes about 36,000 deaths and 200,000 hospitalizations
a year in the United States.

Dr. Anthony S. Fauci, director of the National Institute of
Allergy and Infectious Diseases, said that nearly 90
million Americans had a high risk of catching flu, with
half of that number usually seeking vaccinations.

The nation has just enough vaccine to provide for this
high-risk half, Dr. Fauci said.

Healthy people who are vaccinated, he added, take vaccines
from people who need them. The C.D.C. says healthy people
from 2 to 64 should "postpone or skip" shots this year.

Hospital officials in New York said the federal
government's plan to distribute the remaining supply was
too slow. In a letter to Health and Human Services
Secretary Tommy G. Thompson, the president of the Greater
New York Hospital Association, Kenneth E. Raske, wrote that
"there are very large providers in our membership that care
for vast numbers of high-risk populations and that have
absolutely no adult doses of influenza vaccine."

Hospitals, Mr. Raske added, are starting to share supplies,
but remain far short of what they need.

Such sharing is now government policy, Dr. Mitchell Cohen,
director of the Coordinating Center for Infectious Diseases
at the C.D.C., said.

The vaccine shortage resulted because Chiron, expected to
produce 50 million doses, was found to have doses infected
by bacteria. Its entire supply was condemned. Aventis
Pasteur is now the sole approved supplier in the United
States. It expects to produce nearly 55 million doses for
this season.

Aventis has delivered 35 million doses to customers, though
some may not need all their doses. Health officials are
combing through the Aventis customer list, calling clinics
and asking whether they have remaining doses that can be
redistributed.

Other than redirecting some early shipments, health
officials will not be able to satisfy demands for quicker
deliveries of more vaccine.

"It's a 'loaves and fishes' problem," a top health official
said. "It would take a miracle to get supply to everyone
who needs it."

Aventis is shipping two million to three million new doses
a week. It plans to deliver its final 20 million doses over
the next seven weeks. The company will send the remaining
doses mostly to hospitals and nursing homes that the
disease centers has identified as particularly needy.

An Aventis executive, Len Lavenda, said that could not be
accelerated.

Most of the remaining supply has to be tested for potency.
The company performs the time-consuming tests in animals,
and the Food and Drug Administration repeats them, Mr.
Lavenda said. Bottling the vaccine in vials and hypodermics
also takes time, he added.

In most years, the gradual delivery matches vaccination
campaigns. But Chiron's closing has caused huge gaps. The
New Jersey health commissioner, Dr. Clifton R. Lacey, said
his state was nearly out of vaccine. Nursing homes, with
60,000 residents, had no shipments, he said.

In San Antonio, health officials began their campaign on
Monday. Nearly 800 people went to two clinics, said Dr.
Fernando A. Guerra, health director of the San Antonio
Metropolitan Health District.

Dr. Guerra said the district had in placed billboard and
public service advertisements encouraging everyone to be
vaccinated.

"We suddenly have to change our message," he said.

The
district usually distributes 47,000 flu vaccines a year,
Dr. Guerra said. It has received 30,000 doses, usually
enough to vaccinate all high-risk patients who ask for
them, he added, but some hospitals do not have any
vaccines.

"So I have to figure out how to allocate some of our
vaccines to some other groups," he said.

An editorial in The New England Journal of Medicine this
week suggests that officials explore whether diluted
vaccine would protect healthy adults and be considered as a
strategy to stretch supplies. The disease centers
recommends against partial doses.

Marc Santora contributed reporting for this article from
New York, and Gretchen Ruethling from Chicago.

http://www.nytimes.com/2004/10/19/health/19flu.html? 
ex=1099198183&ei=1&en=5b9359cd1f47ee7c


---------------------------------

Get Home Delivery of The New York Times Newspaper. Imagine
reading The New York Times any time & anywhere you like!
Leisurely catch up on events & expand your horizons. Enjoy
now for 50% off Home Delivery! Click here:

http://homedelivery.nytimes.com/HDS/SubscriptionT1.do? 
mode=SubscriptionT1&ExternalMediaCode=W24AF



HOW TO ADVERTISE
---------------------------------
For information on advertising in e-mail newsletters
or other creative advertising opportunities with The
New York Times on the Web, please contact
onlinesales () nytimes com or visit our online media
kit at http://www.nytimes.com/adinfo

For general information about NYTimes.com, write to
help () nytimes com.

Copyright 2004 The New York Times Company

-------------------------------------
You are subscribed as interesting-people () lists elistx com
To manage your subscription, go to
 http://v2.listbox.com/member/?listname=ip

Archives at: http://www.interesting-people.org/archives/interesting-people/