Shopper's special on flu shots
Wondering what to get your dear ones for Valentine's Day? How about a flu shot? Although four months ago grandmas were standing in line for hours to get immunized against the infectious disease, now in most parts of the country anyone who wants a flu shot can get one, no questions asked.
"We have vaccine to offer to anybody," Gregg Pane, director of the District of Columbia's health department, said last week. "We're trying to do everything we can to get it to people who might need it." That includes handing out about 400 free shots at various health clinics and working with pharmacies and groceries to help distribute the approximately 5,300 doses of adult vaccine the District has left. Nationwide, 4.5 million doses are available. This is not just cupboard cleaning: Flu cases are on the rise in D.C. and elsewhere, and February is traditionally one of the worst months for outbreaks. Pane says: "It's not too late."
State and federal officials are hustling to get vaccine out to patients while it can still do some good. They say that the priority distribution system hastily cobbled together by the Centers for Disease Control and Prevention last October--after the nation's flu vaccine supply was summarily cut in half by contamination problems at a supplier--did by and large manage to steer vaccine to the people who needed it most. Those include the elderly, small children, pregnant women, healthcare workers, and people with chronic illnesses. "It worked. It really did work," says Donald Poretz, an infectious-disease specialist in Fairfax, Va., and president of the National Foundation for Infectious Diseases. A milder than usual flu season helped, too. But many people who tried early in the fall to get a flu shot and weren't able to may not have tried again. A Harvard School of Public Health survey found that 37 percent of adults over 65 who tried to get a flu shot in the first three months of the season weren't able to; 54 percent of adults with a chronic illness found their efforts thwarted. The year before, 87 million doses of flu vaccine were manufactured, and 83.1 million distributed. This year, about 61 million doses were produced. At the end of January, the CDC rescinded guidelines restricting flu shots to priority groups and also made available excess vaccine. A late-season excess is not unusual. In years past, tens of thousands of flu shots have been trashed because of small demand, despite the fact that in an average year the viral infection kills 36,000 people in the United States.
Federal officials are already gearing up for next fall. By April 5, they should know if Chiron Corp. will pass the safety inspection it failed last year. Others have applied for licenses, but it's too soon to know how things will turn out.
Homebound. The District was among the first areas in the country to declare an emergency last October and was also one of the cities most aggressive in seeking out people to vaccinate, reaching 85 percent of the people it had vaccinated the year before within the first three months. But it wasn't easy. The Washington Home Center for Palliative Care Studies worked with the health department, a hospice, and two home-care agencies to vaccinate 2,250 frail and homebound elderly, tracking them down at day-care centers, at places that serve free meals, and at their homes. Organizers of the effort were astonished at how hard it was to pull off such a seemingly simple task. Federal patient-privacy regulations kept groups from sharing client information. Volunteer doctors and nurses weren't covered by malpractice insurance. And there was no central listing of people too ill to come in. Joanne Lynn, director of the center, says, "It's easier to find the dogs and cats in this city than it is to find the homebound elderly."
The difficulty in reaching these most vulnerable citizens reveals one of the weaknesses in the nation's public-health system, weaknesses that could prove deadly not only in a long-expected major flu epidemic but in a bioterrorist attack as well. It also suggests solutions. "The infrastructure is the same for getting a smallpox shot quickly," Lynn says. "You're not going to do a smallpox shot every year, but you could do the flu."
This story appears in the February 14, 2005 print edition of U.S. News & World Report.
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