Shots Across the Bow In a week when the federal government announced plans for dealing with a global bird flu pandemic, supply-chain glitches raised questions about the local health care system's ability to cope with even routine vaccine distribution. In-store clinics -- the most prominent source of shots in the Washington area, with vaccine supplied through Maxim Health Systems -- have been discontinued, and officials at Giant -- whose stores and pharmacies hosted many of the events -- said they weren't sure the clinics would resume.

Meanwhile, as some local doctors continue to report difficulties getting vaccine, public health officials say they have plenty on hand. Lucy Caldwell, a spokeswoman for the Virginia Department of Health, says jurisdictions throughout Northern Virginia are planning to proceed with scheduled vaccine clinics. Officials in Montgomery and Prince George's counties say they are doing the same.

Cindy Edwards, the nurse administrator who oversees Montgomery's vaccination program, said vaccine is coming slowly but surely from manufacturers and distributors. And officials say consumers should check with their normal providers, because public health clinics aren't equipped to handle all the demand.

"In order to do . . . really big clinics we basically have to suspend our other program services, because it takes a lot of people," Edwards said. "We saw 650 people" at a clinic in Silver Spring last week, she said. "Three years ago when we did these clinics, we'd see maybe 100 to 150."

Reduced Fear Formulation To encourage vaccination of children, particularly those between 6 and 23 months of age and those with chronic health conditions, "thimerosal-free" flu shots have become more widely available.

Robert S. Baltimore, a professor of pediatrics at Yale University and a member of the American Academy of Pediatrics Committee on Infectious Diseases, says the shift aims to allay parents' fears about the preservative, which some say causes autism in children. (Most doctors believe the preservative causes no harm.)

Baltimore also notes that children receiving flu shots for the first time need to get a booster shot a month later, "because they don't respond to the vaccine quite as well as older people do. So they need the second shot to assure that they develop sufficient antibodies."

-- Gregory Mott


The Wakmah, one of many anti-flu products being touted, is a plastic suction cup used to open germy bathroom doors or hold grubby subway grab bars.