Like many area residents these days, Howard County Health Officer Penny Borenstein has been preoccupied with finding scarce flu vaccine. Bit by bit, Borenstein has gathered enough to make more shots available to residents in the coming weeks.
Thanks to donations from local sources, such as doctors' offices and private companies, and a redistribution by the state to local health departments, Borenstein has between 2,000 and 3,000 doses. She estimates that an anticipated redistribution of supplies by the federal government could raise her department's doses to about 5,000. Still, that won't meet the demand, which has only been heightened by news of the shortage, she said.
"There's not enough supply to go around," she said. "We have had to make difficult decisions."
It's been an intense search these past two weeks for Borenstein, whose department had 170 doses on hand when news came that Chiron Corp., one of two U.S. vaccine suppliers, had possible contamination problems at its plant in England. As a result, the Howard County Health Department lost 90 percent of its expected supply of 8,200 doses, while six other county health departments in Maryland received no vaccine at all. Nationwide, the supply was reduced by almost half the expected 100 million doses.
Last week, the Health Department canceled its popular flu shot clinic at the 50+ Expo. Nevertheless, one elderly couple showed up at Wilde Lake High School for a shot at 6:30 a.m. Friday, hours before the Expo's start, said Phyllis B. Madachy, administrator of the county's Office on Aging. Some people arrived at the Expo on a shuttle bus, but immediately reboarded when they learned there were no flu shots available, Madachy said. The department, however, did administer pneumonia vaccine to those 65 and older.
A few flu shot clinics are expected to be offered by the Health Department later this month, although no schedule has been set. They likely will operate on a first-come, first-serve basis for residents who are at high risk, such as the elderly, children younger than 2 and residents with a chronic medical condition. Borenstein said the Health Department does not expect to offer shots to nursing home residents, but will encourage employees at those facilities to obtain FluMist, the nasal mist vaccine recommended for ages 5 to 49.
"The ambulatory population spreads the virus," she said. "We are doing the best we can with a limited supply."
Even as she tries to devise a shot schedule, Borenstein is worried that the clinics will draw anxious swarms of people, similar to those that turned out at recent supermarket clinics.
"We will probably have security on hand," she said. "We don't want to have the situation some Giant supermarkets have had." The Health Department will charge $10 a shot to cover its costs, she said.
When news of the shortage broke early this month, Borenstein quickly surveyed private medical providers and large employers, asking if they had a supply of the vaccine and whether they would be willing to donate or sell some at cost. Health officials estimate that more than 90 percent of flu vaccine supplies go to the private sector.
Borenstein got only a few responses to her stream of faxes seeking the vaccine. Many, she decided, were facing their own shortages.
"Our provider pulled the plug at the last minute," said Doug Pindell, the school system's wellness committee chairman. In previous years, the system administered 1,000 to 1,200 flu shots to employees, he said. "There's no other source available to provide vaccine."
Sheila Gamble, vice president for human resources at Micros Systems Inc. in Columbia, said she was about to sign a contract for flu shots for Micros employees when the distributor canceled the clinic.
"Employees definitely ask for it every year," she said. "They understand we can't do anything." Other major businesses in similar straits include W.R. Grace & Co., Arbitron Inc. and Magellan Health Services, all of Columbia.
Pediatric Associates in Ellicott City urged its families to sign up early for flu shots and received its full shipment of 1,300 doses before the news about Chiron broke. The practice plans to give those shots by appointment. Pediatrician Edward H. Cahill said last week there likely won't be any to spare. "It hasn't gotten nasty around here yet," he said. "I don't know what's going to happen next month."
Borenstein's appeal to employers prompted the Johns Hopkins University Applied Physics Laboratory (APL) in Laurel to transfer 850 of the 1,700 doses it had received to the Health Department and Howard County General Hospital, said Dee Reese, head of APL public affairs. Before that, the hospital had no vaccine on hand.
As she hunts for more doses, Borenstein looks for a silver lining to the shortage, hoping that a national system will emerge to ensure adequate supplies and that "people will be tuned in every flu season."
For more information as it becomes available, check the Health Department Web site at www.hchealth.org or call 410-313-6503.