Dec. 5, 2000 -- Snow may be on the ground in some places across the U.S., and Christmas lights up, but don't count on getting a flu shot yet unless you fall into a high-risk category. That is essentially the message from state health departments contacted by WebMD -- some of them still waiting for more flu vaccine.
While all health agencies were expecting a delay due to reported manufacturing problems, there was a general hope it wouldn't be this long. But according to the CDC, the national delay will still be resolved. CDC press officer Chuck Fallif tells WebMD, "What we're hearing from the manufacturers is that all the [vaccine delays] will be dealt with by the end of the year." That would mean delivery of the final third of orders, he says.
But at present, some places, like Arizona, are in particularly dire straits. Shipments of vaccine there are being used up as fast as they come in, and calls to a vaccination information line have tripled:
"We're still in a real tight situation down here," says Anne Lutz, MPH, adult immunization coordinator for the Arizona Department of Health Services. "We have flu-shot clinics and they're overwhelmed. Lines wrapped around the building. It's not a very good situation. Very bad, actually."
Especially for those near the end of those lines. At some clinics they're running out of vaccine and turning people away. "It's lucky for us we don't have any flu reported yet," Lutz says.
On the other hand, Massachusetts is in relatively good shape. The state supplies half the needed vaccine for the season and its order has been filled. "We received our last shipment the week of Thanksgiving, approximately 248,000 doses," says Roseanne Pawelec, spokesperson for the Massachusetts Department of Public Health. It came about three weeks late, she says, and was quickly soaked up around the state. "There's a great demand. Certainly state-supplied vaccine isn't going to be sufficient. But it will cover the high-risk patients."
That category includes people older than 65 and anyone who suffers from a chronic disease, such as emphysema or heart problems. Those are the only ones being invited right now for vaccination in Vermont, too, but it's possible some of them may still be waiting.
"There certainly is a big demand and people have been extremely angry. I don't know if they are going elsewhere [to get a shot] or giving up," says Carolyn Greene, MPH, immunization program chief for the Vermont Department of Health. "There's a little bit of good news. The shipments are picking up, and we don't have flu [cases] confirmed ... We have to hang on to what little good news we have."
As for when those delays may be over, Greene says, "I have heard so many dates, so many promises that we just sit and wait. I've been told the 15th of December. If that is so, I would love it."
They're talking more like the end of this month for delay resolution in Maryland. "It's about what we expected," says Greg Reed, program manager for the Maryland Center for Immunization, Baltimore. "I was hoping it would've been resolved sooner but it's far from my worst-case scenario." Reed says 99% of the state's long-term care facilities (primarily nursing homes) have at least partial supplies of vaccines -- enough to cover patients at highest risk. "However, there's not enough vaccine floating around at this moment," he adds.
That goes for Kentucky, too.
Health officials there report small quantities coming in to counties across the state at a time when flu vaccination programs are usually finishing up. "Nobody has gotten their complete order yet," says state epidemiologist Glyn Caldwell, MD. "It leaves you concerned because you don't know what's going to happen, and you really don't have much you can do about it. We're just hoping we don't have a major outbreak."
And so far, that pattern seems to be holding nationwide. Less vaccine -- but very little flu.
"We monitor a number of different things," says Michael Hendry, DSc, chief of the respiratory virus section of the California Department of Health Services. "In-patient admissions for influenza and pneumonia, a number of sentinel physicians. We also monitor pharmacy data for use of antiviral [medications]."
The verdict in the nation's most populous state: 10 confirmed cases as of the end of November -- what health officials would characterize as "low-level, sporadic activity."