"It was the right message, but a really difficult one to convey," said Orenstein, now associate director of the Emory Vaccine Center in Atlanta. "With the discouragement of healthy people from getting the vaccine, it appears many took that as the basis for not getting any vaccine."
CDC officials said yesterday that the percentage of healthy people vaccinated this flu season had fallen to 4.4 percent from 23.9 percent a year ago.
Bill Pierce, a Department of Health and Human Services spokesman, said yesterday, "We acted to make sure we were prepared." He said the flu season typically peaks between December and March so there is still plenty of opportunity for people to seek flu vaccines.
To come up with its estimate, Lazard Freres contacted 121 physicians and pharmacies in 60 major metropolitan areas that MedImmune had listed as ordering FluMist last year or this year. A majority said they had either not ordered FluMist this season or were left with unused doses.
Joel Sendek, a Lazard analyst who downgraded MedImmune stock yesterday from "hold" to "sell," said that only 4,031 doses of FluMist were ordered by those surveyed. Sendek calculated total sales using methods from his survey last flu season, which accurately predicted FluMist sales. His new calculation is supported, he said, by federal health statistics showing that only 1.6 percent of all vaccinated adults surveyed have received FluMist.
"I was surprised," Sendek said. "I really thought MedImmune was in a good position this year."
Regardless of the final sales this season, MedImmune executives have made it clear that they do not expect FluMist to be a significant part of the company's business until they get a new version on the market, not likely until 2007.
The new version would be refrigerated, rather than frozen, eliminating storage problems. And MedImmune is conducting several studies to show that FluMist works better than a flu shot, particularly in children under 5, which could persuade the FDA to permit its use for that age group.
Shares of MedImmune closed yesterday at $25.25, down $1.12, or 4 percent.