Flu shots will be prohibited for anyone not in a high-risk priority group under an emergency rule the District's acting health director plans to issue today for physicians, hospitals and other health care providers.
Gregg A. Pane said the measure will help ensure adequate inventory for those who need it most, from babies, toddlers and the elderly to pregnant women, people with chronic diseases and front-line health workers. It makes mandatory what the federal government has only urged as the country grapples with the loss of half its vaccine supply and increasing public anxiety.
Pane announced his intended action yesterday after meeting with Del. Eleanor Holmes Norton (D-D.C.) and representatives of the city's hospital, nursing home, clinic and medical organizations, all of which lent their support.
Though they do not expect the situation to remain so dire into the winter, several hospitals and the vast majority of nursing homes reported extremely limited vaccine as the flu season approaches.
"We're doing what we have to do," Pane said in a late afternoon telephone interview. "There's not enough vaccine right now, not in D.C. or a lot of states."
Of 12 District hospitals, only one has received all the vaccine it ordered, and most have gotten less than half. At eight nursing homes, seven have absolutely nothing because their doses were coming from the plant that British authorities suspended last week for contamination problems.
The city Health Department is in the same position, having ordered all its adult doses from Chiron Corp. It got less than half of the 29,000 vaccines anticipated for its immunization program involving children 6 to 23 months of age.
"It's important for the Department of Health to look at this as a potential public health crisis," said Veronica Damesyn, executive director of the D.C. Health Care Association, which represents nursing homes.
The federal government announced Tuesday that it will oversee the disbursement of vaccine that has not been shipped, diverting some orders to areas and facilities with the greatest shortfalls.
Neither Virginia nor Maryland has called for anything but voluntary compliance in targeting high-risk patients. But at least two states have put edicts in place since federal officials announced the catastrophe involving 48 million doses from Chiron, one of the country's two suppliers. In New Mexico, the state health secretary's directive warns that failure to comply will result in enforcement "including court proceedings." Oregon's law requires providers to report vaccine supply and demand to authorities when requested.
Anyone in the District administering a flu shot to a child or adult not in the risk categories could be cited for a misdemeanor and fined $1,000 per violation, though Pane said he's not keen on emphasizing the punitive consequences. "The penalty part I'm trying to minimize because this has to be a cooperative effort," he said.
The rule, which can remain in effect for up to 120 days, does not address any forced reallocation of vaccine between providers.
Robert A. Molson, executive director of the D.C. Hospital Association, said Pane's move will assist, not constrain physicians. "Many of them have very powerful or wealthy patients who might put pressure on them" for vaccine.
But to hear that the law allows a doctor to dispense flu shots only to certain individuals is "a more understandable explanation," agreed K. Edward Shanbacker, executive director of the Medical Society of the District of Columbia.
"It is a rapidly evolving situation," Shanbacker said.
Staff writers Michael D. Shear and Ovetta Wiggins contributed to this report.