If you're looking for a flu shot this season, you shouldn't have much trouble finding one.
As Washington area residents begin lining up in grocery stores, pharmacies and workplaces, federal officials and others monitoring the situation say they don't foresee a repetition of last year's vaccine shortfall, which resulted from the shutdown of an English factory manufacturing drugs for California-based Chiron Corp.
"We don't anticipate a shortage, although there might be a delay" in getting vaccine to doctors who have ordered it, said Norman H. Edelman, chief medical officer for the American Lung Association, which offers a flu shot locator on the Web at http://www.flucliniclocator.org. (Maxim Health Systems offers similar information at www.findaflushot.com.)
Shot providers like Giant, CVS and others whose clinics turn up on the shot finder Web sites tend to get their supplies earlier than individual medical practices and public health clinics because they purchase vaccine in large quantities and often have contracts that require early delivery.
The reassurance came after Chiron's announcement last week that its vaccine production for the 2005-06 flu season will fall short of its previously projected 18 million to 26 million doses. The company did not reveal how much of the drug it will be able to make.
Chiron is one of four companies -- up from three -- producing flu vaccine for the U.S. market, the Food and Drug Administration (FDA) said in a news release after the company's announcement, adding that the government has been working with producers to ensure "an adequate, safe and effective supply of vaccine" for this year.
A new injectable vaccine, GlaxoSmithKline's Fluarix, has been approved by the FDA for use in people age 18 and older, joining Chiron's Fluvirin, Sanofi Pasteur's Fluzone (the U.S. market leader) and the nasal vaccine FluMist from Gaithersburg-based MedImmune. The Centers for Disease Control and Prevention (CDC) had indicated before Chiron's announcement that 80 to 100 million doses of flu vaccine might be available nationwide this season; 61 million doses were available last season.
Edelman said matching supply to demand is an annual problem for those distributing the vaccine, "because you don't know what the demand will be."
Another issue, he said, is the growing acknowledgement among public health experts that elderly people -- who make up a large portion of the high-risk population given priority for flu shots -- in many cases get little or no benefit from the vaccine. "Some of them have immune systems that are just not responsive enough and vaccine just doesn't elicit an appropriate antibody response," Edelman said.
New attention is being focused lately on how the illness is spread. "Everyone agrees that the vectors -- the Typhoid Marys of the system -- are school-age children," said Edelman. "The American Lung Association has said in its public statements that the CDC has to really rethink its strategy, and I think an optimal strategy would be one that encourages all kids to get vaccinated."
The CDC's definition of high-risk is those groups considered to be most likely to develop flu-related complications -- people 65 years of age and older, residents of long-term-care facilities, people with chronic cardiovascular or metabolic diseases, children 6 to 23 months of age, pregnant women, health care workers involved in direct patient care and those in regular contact with children under 6 months of age.
Edelman and other health experts say everyone who wants flu protection should get vaccinated and that the government should play a larger role in making vaccine available and getting people to use it. But evidence suggests that even universal availability and access would have limited impact on immunization rates. In the Canadian province of Ontario, which offers free flu shots to every person who lives, works or attends school there, less than half the population got vaccinated last year, according to Dan Strasbourg, a spokesman for the Ontario Ministry of Health and Long-Term Care.
While there is general agreement that vaccination is the cheapest, best and most effective means of preventing the flu, there are plenty of things people can do to lessen their likelihood of contracting the illness this season. The CDC offers this advice:
* Avoid close contact with those who are sick, and stay away from others when you are sick, which means staying away from work, school and errands to avoid spreading illness; and
* Cover your mouth and nose with a tissue while coughing or sneezing, wash your hands often and avoid touching your eyes, nose or mouth.
Tamiflu (oseltamivir), which has drawn attention as a possible weapon against avian flu, is one of four prescription antiviral drugs -- Symmetrel (amantadine), Flumadine (rimantadine) and Relenza (zanamavir) are the others -- that have been approved as treatments for those who do get the flu. If taken within two days of contracting the illness, these drugs can shorten the duration of illness by a day or two and make a person with the flu less contagious.
Three of the antiviral drugs -- all except Relenza -- have also been approved for use in preventing the flu in healthy adults. But Edelman said they are generally not regarded as alternatives to the vaccine, which "is simple, totally safe and much less expensive, especially than Tamiflu."
The antiviral drugs might be useful alternatives for people who cannot receive flu vaccine because they are allergic to eggs, Edelman said. The Lung Association strongly encourages people with asthma to get flu shots, but Edelman points out that those people should not use FluMist, which he said has been shown to trigger asthma attacks in some cases.
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