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After Flu Shot Crisis, Demand Dwindles

High-Risk Groups Do Without Vaccine

By Rob Stein
Washington Post Staff Writer
Friday, December 17, 2004; Page A03

With the peak of the flu season approaching, many Americans who should have received vaccine shots have not yet been inoculated, federal officials reported yesterday.

Only about 34 percent of those who are eligible to receive vaccine have gotten shots, and about half have not even tried, according to two new surveys.

Customers leave a grocery story hosting a recent flu shot clinic in Seattle. (Elaine Thompson -- AP)

Forgoing Flu Shots

_____Flu News_____
No Evidence Flu Vaccine Works in Kids, Study Finds (Reuters, Feb 25, 2005)
Flu Season Arrives, Late but Potent (The Washington Post, Feb 11, 2005)
Health Groups Now Worry About Flu Shot Surplus (The Washington Post, Jan 28, 2005)
Flu Special Report

The low numbers prompted federal health officials to urge everyone at high risk from the flu -- the elderly, people who have chronic illnesses, health care workers and children 6 months to 23 months -- to get vaccinated, saying that despite a shortage, vaccine is available across the nation.

"It's not too late to get flu vaccine, and we want people to be stepping up to the plate to get vaccinated if they are in a high-risk group," said Julie L. Gerberding, director of the federal Centers for Disease Control and Prevention. "Many people believe that no vaccine is available, and that is simply not the case."

Although this year's flu season has gotten off to a slow start, with only one state, New York, reporting widespread cases, the season's usual peak is still ahead, she said.

"Compared to last year, this year is getting off to a slow start, but we always know that flu is unpredictable, and the most common time for flu to peak is February. So we are certainly not out of the woods yet," Gerberding said.

She acknowledged there is a possibility that some vaccine could end up unused this year if too few high-risk people seek the shots. But she said it is worth erring on the side of too much vaccine to avoid having to turn people away.

This year's flu vaccination effort was thrown into turmoil in the fall when British officials discovered manufacturing problems at the Chiron Corp.'s Liverpool, England, factory that was supposed to provide half of the U.S. supply.

In response, the federal government recommended that only those at high risk from the flu get vaccinated.

To try to assess the situation, the CDC added questions about flu vaccination to an ongoing national survey of health issues. The survey of 16,713 Americans conducted Dec. 1-11 found that 34.8 percent of those at high risk had gotten shots, according to a report in CDC's weekly journal, Morbidity and Mortality Weekly Report.

Slightly more than 23 percent of high-risk people who had not been vaccinated reported they had tried but failed to get shots, 10 percent said they were saving vaccine for others, and 6.5 percent did not realize they were eligible.

"That is not what we want them to be doing," Gerberding said. "We want people in high-risk groups to seek vaccine, because we still have doses and there's still time to be vaccinated."

A second survey conducted by the Harvard School of Public Health in Boston found that 51 percent of the elderly and 63 percent of chronically ill adults had not tried to get vaccinated, while 37 percent of seniors and 54 percent of those with chronic illnesses who tried were unable to get the vaccine.

But Gerberding said the long lines that many people found early in the season have disappeared, and vaccine is available for those who qualify.

"It's not too late to be vaccinated. There still is flu vaccine. So if you're in a priority group and haven't gotten your shots, please don't give up," Gerberding said.

In fact, several states have relaxed their guidelines for who can receive vaccine because they have plenty of shots available.

"A few states have indicated they have surplus, and they are broadening their recommendations," Gerberding said.

Health officials in Virginia, Maryland the District are recommending only those at high risk receive vaccine.

Because of continued availability of vaccine despite the shortage, a committee of experts that advises the agency will meet today to discuss whether to relax recommendations nationally for who can receive the vaccine.

To supplement vaccine from a second manufacturer, federal officials have been buying surplus vaccine from other countries. That decision has drawn criticism from some health officials because the CDC is using money budgeted to provide poor children with other childhood vaccines.

Nineteen public health groups, including the American Medical Association, American Academy of Family Physicians and American Academy of Pediatrics, yesterday protested the move in a letter to Health and Human Services Secretary Tommy G. Thompson.

"We urge you to identify other sources of federal funding that are available . . . for the purchase of influenza vaccine," the groups wrote. "Please do everything you can to ensure that both those Americans in need of influenza vaccine and all of our nation's children in need of childhood vaccines are fully immunized."

But Gerberding attacked the criticism, saying the childhood vaccine funds were tapped as an expediency to provide as much flu vaccine as possible. In addition, much of the money will be repaid by Medicare, and plenty of funds remain for other childhood vaccines.

"The allegation that we would somehow subtract from childhood immunization to support adult immunization is ridiculous," Gerberding said. "We would never do anything to jeopardize a program to vaccinate children."

© 2004 The Washington Post Company


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