Flu vaccine redirected to targeted providers.

Byline: From Register-Guard and news service reports

The scramble for scarce influenza vaccine continued Tuesday as the federal government announced a plan to ship remaining flu shots directly to pediatricians, nursing homes and others who care for patients who need flu shots most.

In Lane County, public health authorities received a shipment of 3,200 doses Tuesday and will continue holding flu clinics for high-risk groups, including those under 2 and over 65 and those with chronic medical conditions. The next clinic is from 1 p.m. to 4 p.m. today at Lane County Public Health, 135 E. Sixth Ave., Eugene.

Local health officials encouraged families to wait until Oct. 20 to bring in children in high-risk groups for vaccination. That's when the state's Vaccine for Children program clinics will be held at Lane County Public Health, from 8 a.m. to 11:30 a.m.

Under the plan announced Tuesday by the Centers for Disease Control and Prevention, vaccine maker Aventis Pasteur will send shipments of its remaining vaccine directly to providers who care for patients the CDC has deemed at highest risk of death or hospitalization from influenza.

But only a fraction of the 22.4 million doses that Aventis has yet to ship can be diverted to areas with the biggest shortages. And officials acknowledged Tuesday that even if planned rationing goes well, there will be high-risk patients who won't get shots.

"We're sorry for the people who need flu vaccine and may not be able to get it this year,'' said Dr. Julie Gerberding, CDC director. ``But we will take every step that we can take to get an equitable distribution of vaccine as quickly as we can."

The targeted shipments come as the CDC struggles to ensure that the youngest, oldest and sickest Americans - those most vulnerable to influenza - have first access to flu shots now that the nation's supply has been cut in half.

The supply of vaccine in rural Lane County is spotty at best, said Betsy Meredith, nursing supervisor at Lane County Public Health.

Her office has begun surveying all health providers in the county to find who has the vaccine, how much they have, how many high-risk people they serve, whether they would accept referrals, and whether they have surplus vaccine they'd be willing to share or sell.

Other county health departments will be doing the same thing. In the meantime, health facilities are hoping their promised shipments arrive.

"As we're already doing, if we know if some place that has extra flu vaccine, we will put them in touch with groups that actually need it," Meredith said. "It is a very big job."

At Aidan Healthcare in Florence, a long-term care facility, administrators are anxiously waiting to receive their vaccine, administrator Don Wessels said.

"Of course our residents are concerned," he said. "Every year there is some crisis, and usually we get through it, but this year it is heightened more than before."

Gerberding called those healthy adults heeding the CDC's plea to forgo flu shots this year "heroes."

"Shame on the people who are price gouging,'' she said, pledging to help state officials prosecute anyone caught doing so.

There have been scattered reports of price gouging since the shortage was announced, and Kansas filed a lawsuit Tuesday against Meds-Stat, a pharmaceutical distributor. Attorney General Phill Kline said Meds-Stat proposed selling the vaccine to a pharmacy in Kansas City, Kan., on Friday for $900 per vial; a week earlier, the company was selling the vaccine for $85 per vial. Each vial contains about 10 doses.

Also Tuesday, two other companies revealed they had offered the government flu vaccine originally intended for sale abroad. GlaxoSmithKline has 500,000 doses manufactured in Germany; ID Biomedical is offering 1 million to 1.5 million doses made in Canada.

The Food and Drug Administration hasn't approved either vaccine brand for sale in this country.

``It's not easy to get unlicensed vaccine into the country in time to solve any problems this year,'' Gerberding cautioned. ``But we're not ruling anything out.''

British regulators unexpectedly shut down a major U.S. vaccine supplier, Chiron Corp., last week, freezing shipment of up to 48 million expected flu shots.

That left Aventis as this year's sole supplier of injectable flu vaccine, a total of 55.4 million doses. More than half already has been sold and shipped, mostly to private distributors - doses that can't be yanked back, although Aventis is asking customers to share any not reserved for high-risk patients.

In Eugene, the city's biggest medical practice, PeaceHealth Medical Group, hedged its bets by ordering half its flu shots from Aventis and half from Chiron. As a result, it has less than half the number of doses than it ordered, medical director Dr. Tom Ewing said.

"It has a ripple effect," he said. "Now, even though we ordered half our supply from Aventis, we likely will not get all we ordered from Aventis."

Ewing said PeaceHealth Medical Group clinics are not now providing flu shots to Oregon Health Plan patients. That's because the group does not yet have the vaccine that is federally mandated to be given to people who are uninsured, on Medicaid or covered through American Indian insurance plans.

Eugene's other big practice, Oregon Medical Group, used Aventis and received its entire order, medical director Dr. Scott Johnson said.

Johnson said OMG is "trying to make sure everyone who is high risk" can get a flu shot, including Oregon Health Plan patients.

Federal officials said shipment of about 14.2 million doses from Aventis will begin this week, headed for pediatricians' offices, hospitals, care facilities and Veterans Affairs clinics - distribution that will take six to eight weeks.

Also on the list are state health departments that had ordered supplies only from Chiron and thus haven't received any doses.

"Be patient," urged Damian Braga, president of Aventis' U.S. branch. Vaccine shipments normally are paced through late November, when flu season is getting started.

But the vast majority of those doses en route - 11.8 million - already were sold to high-risk providers, Braga acknowledged.

That leaves 8.2 million doses - half headed for an already planned federal stockpile - that the CDC will target even more tightly.

The agency is tracking vaccine shipments, the number of high-risk residents and number of flu cases county-by-county, to direct those final doses to areas most in need.

Still, 42 million to 50 million high-risk patients probably will seek flu shots this year - roughly half the number who need them - and it's unlikely all will find one, Gerberding and Braga acknowledged.

High-risk patients who don't get vaccinated should contact a doctor as soon as they feel flu symptoms, Gerberding said. Other drugs can treat influenza if taken promptly and even can prevent it when taken before infection.

The healthy do have another option: the nasal spray vaccine FluMist, made of live but weakened virus. Maker MedImmune Inc. said last week it would double supplies to 2 million doses. It is to be used only by healthy 5- to 49-year-olds.

Flu shots are made of killed virus, and thus are recommended for high-risk patients.

Reporter Tim Christie contributed to this report.

HIGH RISK FOR FLU

State public health officials say flu shots shall be given only to people at high risk for flu complications. According to the U.S. Centers for Disease Control and Prevention, that includes:

Children ages 6 months to 23 months

Adults ages 65 and older

Anyone ages 2 to 64 with underlying chronic medical conditions

Women who will be pregnant during flu season

Residents of nursing homes and other long-term care facilities

Children age 6 months to 18 years on chronic aspirin therapy

Health care workers who deliver direct patient care

Out-of-home caregivers and household contacts of children under 6 months

More information: Call the Lane County "Flu Line" at 682-4181, or on the Web, go to: www.lanecounty.org/hhs_pubhlth/default.htmorwww.cdc.gov/flu