In some cases, financial institutions and other recipients got doses before some county health departments and doctors' offices, according to records obtained by The Associated Press through a Freedom of Information Act request.
Also, even though the federal government spent more than $1.6 billion to manufacture and distribute the vaccine, there is no complete record of where it went.
That's "a big deal" — the absence of complete data makes it hard to spot waste and other problems, said James Colgrove, a Columbia University scholar on the history of immunization campaigns.
A partial picture emerges in thousands of pages of information provided to the AP.
To be fair, at least 85 percent of the doses given in the first six weeks went to groups most at risk for flu complications — children and other young people, pregnant women and those with certain health problems, according to an estimate from the Centers for Disease Control and Prevention. Wall Street banks and cruise ship companies accounted for a tiny fraction of the 30,000 or so sites sent vaccine in those desperate early days.
Overall, U.S. health officials and a number of outside experts say the vaccination effort went very well.
"It was a remarkable logistical success," said CDC Director Dr. Thomas Frieden. "As with many things in public health, the things that work really well, nobody notices."
He said that the imperfect database is due to limited money and that the agency's top priority at the height of the epidemic was to get the vaccine out as quickly as possible.
But health officials don't know for sure how vaccinations at some venues played out, said Rep. Frank Pallone, chairman of a House health subcommittee.
"How do we know whether or not somebody like Goldman Sachs wouldn't just be giving it to their executives?" the New Jersey Democrat said. "I think the guidelines need to be stricter."
Swine flu, first identified last April, has sickened about 59 million Americans, hospitalized 265,000 and killed about 12,000. The U.S. death toll from the new H1N1 virus, declared a global epidemic, is about one-third of the estimated deaths from a regular flu season. But it was a fearsome threat because children and teens are much more vulnerable to it than seasonal flu.
The vaccine campaign began slowly in early October, with only 11 million doses shipping in the first three weeks of that month, when swine flu was closing schools and approaching its worst, most widespread levels. Ultimately, 86 million people were vaccinated.
The CDC decided how many doses would go to each state, and state and local health departments decided where the vaccine was sent. Doctors' offices, large employers and even federal offices were among those that applied for vaccine. Health officials told them to give it to at-risk people first, but there was no enforcement of that.
It's clear that at many sites, lower-risk people got precious doses in the first two months:
- When a U.S. Department of Energy office in Idaho Falls, Idaho, got about 200 doses in October, officials there offered it to higher-risk employees for four hours. When hardly anyone came, any worker who wanted it was vaccinated, a facility spokesman said.
- Royal Caribbean got 2,100 doses in October and November, vaccinating low-risk crew members along with staffers who care for children on Florida-based ships. The rationale? Employees aboard ships work with the public and would probably come into contact with people in priority groups.
- NASA's Johnson Space Center in Houston got about 800 doses in October and 1,400 more in November, some of which were sent on to other NASA operations. At Johnson, doses were offered first to employees in priority groups, but NASA also set aside doses for healthy astronauts and their families.