Mary E. Frank, a primary care doctor in Rohnert Park, Calif., says her practice usually places an advance order about now for the flu shots she will give her patients in the fall.
Not this year.

Chiron Corp. had to discard 48 million does of flu vaccine when contamination problems were discovered at a British plant in October.
(Chiron Corp. Photo Via AP)
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The Business of Vaccine Production It takes up to 10 months to produce the flu vaccine, and any delay in the complex process can affect the timing of the vaccine's availability for the following season.
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Many vaccine makers and large distributors aren't accepting pre-orders as they did the past. In an advisory on its Web site, for example, vaccine distributor ASD Healthcare said it didn't know when it would take orders or whether customers would ultimately receive their full orders.
"It's January. Doctors need to order soon. And we just don't have a clue about what will happen," said Frank, who is president of the American Academy of Family Physicians. "A lot of us are very nervous."
The flu vaccine shortage that turned into a surplus this season has created uncertainty and confusion among doctors and hospitals, vaccine manufacturers and federal health officials who are trying to plan for next season. Nobody knows which manufacturers will produce the vaccine, how much will be available -- or what the demand will be from patients.
The uncertainty comes at a key time. Companies usually begin plotting strategy now for a complicated and time-consuming production process.
"Things are really still up in the air," said Anthony S. Fauci, director of the National Institute of Allergy and Infectious Diseases in Bethesda. "We just don't really know what's going to happen yet."
The current flu season began with a vaccine shortage in October, when contamination problems at a plant in England forced Chiron Corp. of Emeryville, Calif., to scrap 48 million doses of flu vaccine, about half of the U.S. supply. Public health officials urged that shots from other manufacturers be saved for high-risk patients. Now there's a surplus of more than 5 million shots nationally, and federal authorities said they may soon urge anyone who wants a shot to get one.
The chain of events has left confusion about both supply and demand for next season.
On the supply side, the government had hoped to have about 110 million shots available next season. But Chiron's plant remains shut, and the company says it doesn't know when it can resume production.