Vaccine Supply? It Flu

Unprecedented demand for flu shots in Orange County has nearly exhausted supplies for clinics offering free vaccinations, and with prospects dim for getting more vaccine, some of those most vulnerable to the disease won’t be inoculated.

“The thing I’m banking on is that now that we’re into November, demand slows up.” said Mary Wright, the Orange County Health Care Agency’s immunization project coordinator.

At Placentia Linda Community Hospital, the free vaccination clinic used 1,000 doses in less than two hours Tuesday before running out of the vaccine. Two weeks ago, Chapman Medical Center in Orange gave 2,000 doses in three hours. Inundated with about twice the usual number of flu shot requests, both hospitals turned away hundreds of people.

“It’s a very, very sick feeling to have to say to a fragile senior who’s on limited benefits, ‘You’re out of it,’ ” said Sonoma Van Brunt, a vice president at both hospitals. “That’s a scary thing.”

Several people who came to Placentia Linda had been to other clinics and private doctors’ offices that had run out of the vaccine, she said.

Public health officials aren’t sure when Orange County will run out of the vaccine and hold out the possibility that they will receive small amounts from other counties.

The number of people getting flu shots nationwide each year has grown from 20 million a decade ago to an expected 90 million this year, according to the Centers for Disease Control and Prevention.

Health officials said increased public awareness of flu shots has prompted more people who may face complications from the disease to get vaccinated. It also has led younger and healthier people to get shots in an effort to avoid the muscle aches, high fever and respiratory problems that come with the disease.

In addition, some physicians’ groups this year have lowered to 50 the age at which they recommend that their patients receive flu shots.

Demand also has increased since federal rules were changed a few years ago to provide Medicare coverage for free flu vaccinations for anyone 65 or older.

There is no system to check if private physicians are running short of the vaccine. But Wright said past shortages have hit private physicians as well.

So far, Kaiser Permanente, St. Jude Medical Center in Fullerton and UCI Medical Center in Orange are not short of supplies.

Orange County is not alone. Tulare and Fresno counties in the Central Valley also have suffered shortages.

The obvious solution of buying more vaccine is not so easy.

The state purchased 730,000 doses and distributed them to county health departments statewide. Orange County received nearly 100,000 doses, the same as last year. Typically, the county receives 10% to 15% more each year.

The county gives the vaccines to hospitals, volunteer groups and board-and-care facilities that provide free inoculations. The county also provides hypodermics at no cost.

The state notified the counties in June that because the cost of the vaccine had risen, they wouldn’t receive any more than they did last year.

Figuring out how much flu vaccine to produce is something of an art.

The same vaccine cannot be used year after year because the virus changes each year. Health and pharmaceutical experts gather each January to figure out which flu strains will hit in the fall, and the drug companies make the vaccine to target the three most likely.

The companies also must calculate the number of doses they expect to sell, and they take a loss on those that sit on the shelf.

“Some years, for assorted reasons, the demand wasn’t there,” Wright said. “We’ve had years when we were swimming in it. This happens to be a tight year.”

The whole process is “a private-public enterprise without a real national coordination,” said Dr. Ray Strikas, a medical epidemiologist at the CDC’s National Immunization Program.

He has doubts whether drug companies now could make more of the vaccine in time to make a difference.

Influenza has the potential to cause more debilitating illnesses, such as pneumonia, in people with a high risk of complications. Among them are people older than 60, those with lowered immune systems, people suffering chronic diseases and pregnant women in their second or third trimester.

Experts say it’s impossible to predict how widespread or severe this year’s flu will be. So far, few flu cases have been reported in California.

The vaccine causes few side effects. Because the vaccine is cultured in eggs, people allergic to eggs should not be vaccinated.

The odds of a serious problem from the flu vaccine are about a million to one, said Dr. Alexandra Duke, a family physician at UCI Medical Center. “It’s more likely you’ll get into a car accident,” she said.

(BEGIN TEXT OF INFOBOX / INFOGRAPHIC)

High Demand for Flu Vaccine

The supply of influenza vaccine used by Orange County clinics providing free flu shots is nearly gone. Private doctors, however, may have supplies, and those covered by Medicare can receive vaccinations free.

*

FLU SHOTS

The Orange County Health Care Agency is offering free flu shots to some county residents, while supplies last.

Those eligible for free flu shots must be one of the following:

* 60 or older

* Residents of long-term care facilities

* Anyone with a chronic health condition such as heart or lung disease, diabetes, asthma or a compromised immune system, such as those suffering from AIDS

* Pregnant in the second or third trimester

* Health care workers who come in close contact with people at risk of serious influenza

For more information, call the Orange County Health Care Agency at

(714) 834-7700, or try the Web site: https://www.oc.ca.gov.hca

Agency clinics currently offering flu shots to those eligible:

*

*--*

City Address Day Hours Buena Park 7342 Orangethorpe Ave. Tues., Thurs. 8 a.m.-4 p.m. Costa Mesa 2845 Mesa Verde Drive East Wednesday 11 a.m.-7 p.m. San Juan Capo 27512 Calle Arroyo Thursday 11 a.m.-7p.m. Santa Ana 1725 W. 17th St. Mon.-Fri. 8 a.m.-4p.m. Tuesday 8 a.m.-7 p.m.

*--*

Source: Orange County Health Care Agency

Researched by JANICE JONES DODDS/Los Angeles Times