By David Brown and Rob Stein
Washington Post Staff Writer
Friday, November 6, 2009
As the public clamors for the still-scarce H1N1 pandemic flu vaccine, a top federal health official on Thursday urged state and local health departments to be on the lookout for the possible diversion of the vaccine to people who don't yet qualify for it.
"Any vaccine distribution decisions that appear to direct vaccine to people outside the identified priority groups have the potential to undermine the credibility of the program," Thomas R. Frieden, head of the Centers for Disease Control and Prevention, wrote in an e-mail message.
The dispatch followed media reports that employees of Wall Street banks and other well-connected firms were jumping the line and getting pandemic flu shots, even as many of the 159 million people in the priority groups await their turn.
Wall Street firms said they had received limited doses of the vaccine, but added that they had provided them only to qualified employees, as have other corporations, universities and other large employers. Nonetheless, the reports about Wall Street firms, which have received billions in taxpayer dollars over the past year, appeared to drive a public frenzy. The New York City Health Department was besieged with complaints.
Health officials said there was no evidence that the vaccine had been given out to ineligible employees.
"Our system is designed to make the vaccine available to the priority groups established by CDC," said Thomas Farley, New York City's health commissioner.
About 150,000 "providers" -- everything from hospitals, clinics and doctors' offices to pharmacies and the medical departments of schools and corporations -- are qualified to get shipments of the H1N1 vaccine. The federal government owns the entire supply but is distributing it as directed by 63 state, city and territorial health departments.
Anne Schuchat, another CDC official, said she believes the rumors may have arisen in part because a few private companies are starting to get vaccine, even though many public agencies still don't have enough.
"It is important to separate the venue where the vaccine is being offered from who is getting it," she said. "Even when vaccine is shipped to an employer-based clinic, we expect it is being given to the target population."
She added that workplace medical departments are, in fact, good ways to reach pregnant women and adults with chronic illnesses such as asthma and diabetes -- two of the five groups now being targeted. Independent observers agreed.
"Whether it's an anthrax attack or a pandemic, the question is: How do you get to people?" said Paul Jarris of the Association of State and Territorial Health Officials.
"If an employer was able to step forward and identify they had a number of high-risk people, it would be legitimate to consider that employer as one dispensing center for the vaccine," he said. "Just because it's Goldman Sachs doesn't mean it's wrong."
Vaccine providers must assert in writing that they will follow the CDC's guidelines. However, there is no formal monitoring or enforcement by the federal government of the pledge.
New York City's health department has ordered 858,000 doses. Only 6 percent are for providers targeting adults, with company medical offices just a subset of that, a spokeswoman said.
A spokesman for the California Department of Public Health, Ken August, said his agency has "intentionally delayed supplying vaccine to occupational immunizers. None have received any that we're aware of."