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Health Groups Now Worry About Flu Shot Surplus

CDC Takes Unusual Steps to Dispense Vaccine

By Susan Levine
Washington Post Staff Writer
Friday, January 28, 2005; Page B01

Alice Hegner used a day's work leave to save a place in a line hundreds of people long so her 93-year-old mother could get a flu shot. Leamon Lee endured his own vigil, perched on an overturned plastic basket that he scooched forward for five hours in a grocery store crowd. Evan Leepson took more assertive action, sidetracking a business trip to Buffalo to drive across the Canadian border and roll up his shirt sleeve.

"Everybody was panicking," Leepson recalled yesterday.

Despite the public's initial interest, GW Medical Faculty Associates couldn't give away all 2,000 flu shot doses at a recent vaccination site at the Foggy Bottom Metro station. (Susan Biddle -- The Washington Post)

Three months later, it's not the public worrying. To the increasing consternation of government officials, the demand for flu vaccine has fallen so sharply that millions of doses remain available across the country. What last fall seemed an imminent national shortage yesterday was deemed "unprecedented supply-and-demand mismatches" by the director of the federal Centers for Disease Control and Prevention.

The CDC announced that it would offer more than 3 million vaccine doses, which are still in the federal emergency reserve, back to the manufacturer for marketing and resale to public and private providers. As enticement to providers, any additional orders will be covered by a guaranteed return policy so that no physician will be stuck for a dollar loss with leftover vaccine.

The government also is expanding its Vaccines for Children Program to allow inventories within it to be used for adult patients, irrespective of financial need.

"These are extraordinary measures being taken," CDC Director Julie L. Gerberding said.

The situation in the area mirrors the national dilemma. At least a couple of thousand doses of flu vaccine are on hand in public health departments, and numerous agencies are soliciting residents to get vaccinated. Private clinics that were canceled hastily last fall are being rescheduled. The District and Maryland have completely dropped the guidelines that prioritized who should get a shot based on medical conditions or age; Virginia is maintaining them, but loosely.

Everyone's goal is to move remaining supplies fast, before the influenza season peaks late next month and before unused doses must be thrown out. Given that most Americans were first asked to step out of line and now are being encouraged to step forward, the challenge is not insubstantial.

"When January comes around, people feel if they haven't gotten the flu, they're not going to get it," said Alan G. Wasserman, chairman of the department of medicine at George Washington University Hospital and president of the GW Medical Faculty Associates.

The mixed signals of the past several months might have exacerbated public skepticism. "Year after year, we tell them to get [a shot] in October, and now we say it's okay to get in February," he said. "You can't keep changing messages."

Two weeks ago, GW Medical Faculty Associates stationed physicians and nurses at the Foggy Bottom Metro station, armed with 2,000 shots to give free to passersby. Business was initially steady, but then interest started dropping off. The workers stayed until midafternoon -- even extending their street clinic an extra hour -- and couldn't give away all the doses.

"People weren't going out of their way to get a flu shot," Wasserman said.

For many, the mild flu season has diminished any sense of urgency. Virginia has experienced only localized levels of flu activity and the District even less, according to the CDC. Influenza in Maryland is classified as widespread, though the term can be deceptive. Although four of the state's five health regions have seen increasing cases in recent weeks, the state has fewer than 400 confirmed cases to date, compared with nearly 1,300 at this time last year. There have been no deaths.

"Technically, the season doesn't end until the end of April," said Greg Reed, of the Maryland state immunization center. He stayed on message: There are people at high risk of the flu who have yet to be vaccinated. It's not too late for them -- or others -- to get a shot. "The possibility does exist that vaccine will go unused, but I don't think we should consider that a failure," he said.

Prince George's County, which has about 1,000 adult doses remaining, is pushing to distribute those free through hospitals and medical centers. "Are we going to have some left over?" Health Officer Frederick J. Corder asked. "We're trying very hard not to."

The District reports a similar inventory, which it would like to exhaust during a health expo this weekend at the Washington Convention Center. Several jurisdictions in Virginia are gearing up to move their supplies. Loudoun Hospital Center's van will hit the streets in Lucketts tomorrow and continue visiting communities until the last shot is given.

Flu shots even might return to the grocery stores, which is where the panic was most visible after the government revealed that half the nation's vaccine supply had been discarded because of possible contamination.

Maxim Health Systems plans to buy more vaccine from the national stockpile and is considering rescheduling supermarket clinics. "Giving flu shots at public events in February is almost unprecedented," national director Steve Wright said. "It really is a crapshoot because we've never done it before."

The veterans of last fall's long lines will be watching.

"I hope that people who still need a shot go get it," said Alice Hegner, who spent that workday on her mother's behalf last October at a Giant Food in Ellicott City. "It would be a tragedy to waste anything."

Leamon Lee, whose afternoon-in-waiting was at a Safeway in Greenbelt, hopes never to see a repeat. "They shouldn't have come and announced such a great shortage until they had done some research on what was out there," he concluded. "It was just mishandled."

© 2005 The Washington Post Company


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