Anxiety Contagious in Flu Shot Delays

With county public health agencies across much of Southern California exhausting their rations of flu vaccine, social workers warned Thursday that the virus could run rampant among the poor, the elderly, the homeless and others more susceptible to illness.

Social service agencies that serve low-income families and senior citizens across Orange County say they have been besieged with calls from worried, would-be flu shot recipients who have learned that free clinics were being canceled.

Orange, San Diego and Imperial counties all reported Thursday that they have run out of doses and are waiting--and hoping--that the state can deliver on its promise to provide vaccines by December, when flu season begins.

“Basically, today will be it for our clinics,” Orange County Health Care Agency spokesman Howard Sutter said.

Federal and state health officials say there is no need for panic. They assured local agencies that more vaccine will be available in plenty of time to protect the high-risk population against a virus that contributes to the deaths of an estimated 2,000 Californians each year.

“We can say that we don’t think this flu season is going to be any worse than any other flu season,” said Chuck Fallis, spokesman for the Centers for Disease Control and Prevention.

But Mickey Stultz is worried. She showed up early to get her flu shot at a senior center in Mission Viejo last week and was turned away for the first time in 14 years.

“Those over 80 years old should be able to get their flu shots; it’s getting to be our time to meet the maker,” said Stultz, 85, of Mission Viejo.

“It’s discouraging, especially when you think that a flu shot is going to do you some good,” Stultz said. “I just have to keep making phone calls and checking around and see when clinics will be getting the vaccine. What else can you do? I’m just a number.”

Seniors aren’t the only ones concerned.

“Imagine the flu in a shelter. Many of them are group sleeping arrangements,” said Mary Ellen Hadley, executive director of Infolink, an Orange County government operation that links callers with social and health agencies. “The ability for the virus to pass around is enormous. We would ideally isolate patients, but when you live in that population, it is near impossible.”

California, like states across the country, received only one-third of its normal vaccine supply because some manufacturers had trouble growing one of the most common strains of the virus. Others got a late start after addressing quality control issues.

Orange County, which ordered 100,000 doses for the year, announced this week that 100 clinics scheduled for November would be canceled but that its four public health centers would remain open until its share of 30,000 doses ran out. Officials had hoped to keep serving people through next week, but they ran out of vaccine Thursday.

Dr. Natalie Smith, immunization branch chief for the California Department of Health Services, said the state is working with its Pennsylvania distributor every day to determine when the next deliveries will be made.

“We’re just going to have to go on a day-to-day basis,” Smith said.

Extra Pressure on Public Sector

The CDC has spent $18 million to buy 9 million additional doses from one of the leading manufacturers, bringing the national supply up to 75 million doses, about the same amount rationed last year, Fallis said.

“By the end of this month, 70% of the flu vaccines will have gone out,” he said.

Until this week, complaints about delays have come from physicians, hospitals and pharmacists in the private sector. Now shortages in the private sector are increasing demand for vaccinations in the public arena--making already short supplies dry up faster.

“The people who normally get it in the private sector are coming to us,” said Dr. James Haughton, Los Angeles County’s medical director of public health. “At one site where we were scheduled [to give] 500 doses, 2,000 people showed up. At another, we were scheduled for 300 doses and 800 people showed up.”

Private sector health providers say they face the choice of waiting for their already ordered vaccine or buying it at exorbitant prices on the open market.

Ron Sato, director of pharmacy services at Los Alamitos Medical Center, said his hospital hadn’t received its April order, so it was forced to pay six times the booked price for an emergency ration to cover staff members in critical areas.

“I think it’s really, really a shame that the flu shot vaccine was not distributed better to hospitals and nursing homes,” Sato said.

One San Francisco internist argued Thursday that the delays and uneven distribution amount to a “huge scandal.”

“You can buy heroin in San Francisco easier than you can get a flu shot,” said Dr. William Andereck, a member of council on ethical affairs for the California Medical Assn.

A California congressman announced Thursday that he is calling for hearings.

“It is unacceptable for anyone in this country who wants a flu vaccination not to get one,” Gary A. Condit (D-Ceres) said in an interview. “We are questioning how [the production and distribution] has been handled.”

Social workers remain concerned about the effect that waiting for the vaccine will have on high-risk people.

“The flu can easily be a fatal problem for a senior and can lead to pneumonia,” said Marilyn McLaughlin, recreation director at the Tustin Area Senior Center. “We want to protect our seniors and make sure a flu doesn’t turn into something worse.”

At the San Clemente Senior Center, as many as 100 seniors had lined up by the time doors opened early Thursday, even though that day’s clinic was canceled.

“It’s been crazy,” center director Cathy Lee said. “Seniors are concerned. And they’re getting more nervous as the flu season gets closer.”

Betty Johnston, a 76-year-old receptionist at the Orange Senior Center, has asthma and can’t get her shot at work or from her doctor. But she has faith that the vaccine is coming.

“I don’t think there’s any sense in panicking at this point,” Johnston said. “It’s just that they’ve run out of the first supply. The flu season isn’t until after the holidays. And there’s going to be more batches.”

Staff writers Jennifer Mena, Elaine Gale, Jane Allen and Tina Dirmann contributed to this report.