Stuck without a shot Visits to Maxim Health Systems's for the week ending Oct. 16, were up 3,800 percent from three weeks earlier, with Washington area residents contributing heavily to the increase. What most people found: No flu shots here.

Shots of hooey The flu vaccine scarcity has inspired sales pitches for nostrums from echinacea to "systemic enzyme therapy" as stand-ins for the shot. All bunk, according to Adriane Fugh-Berman, an alternative medicine expert and associate professor at Georgetown University's School of Medicine. "There's no evidence that any alternative medicine prevents flu, and no reliable evidence that alternative therapies are effective treatments," Fugh-Berman wrote in response to an e-mail query.

Out of line Fugh-Berman, in a column for the National Women's Health Network, notes that people in robust health ought to skip standing in line for flu shots if only because they're not especially effective in healthy populations. Citing a meta-analysis performed by the Cochrane Collaboration, she said three-quarters of those vaccinated end up getting flulike symptoms anyway.

What works Public health experts generally agree that the vaccine is only one part of what ought to be a comprehensive effort to stay well during flu season. Elaine Larson, associate dean for research at the Columbia University School of Nursing, advocates using alcohol-based hand sanitizers sold at pharmacies and grocery stores. "You can carry them in your pocket. You don't have to have a sink, you don't have to have a towel. And they actually are faster-acting and kill more viruses" than traditional soap-and-water washing.

-- Gregory Mott