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Flu shots given sparingly

Those who want vaccine must identify risk factor

Safeguards are being implemented to ensure only those at highest risk of complications from influenza get access to a very limited number of flu shots, local health officials say.

The list of "high-risk" categories has been tightly drawn this year after half the expected vaccine became unavailable due to the forced closure of one of only two manufacturers, Chiron.

People waited in long lines over the weekend at flu-shot clinics in area pharmacies and stores, where many healthy adults were turned away. Tuesday, those who wanted a shot had to identify their high-risk category to get one at several public health clinics run by the Salt Lake Valley Health Department.

Health-care providers like the health department, which ordered from the other manufacturer, Aventis Pasteur, have already received some or all of their expected flu-shot doses. But such agencies — which traditionally order a conservative number of the injections with plans to order more later, depending on the flu season and demand — may find that "later" won't exist this year, said health department spokeswoman Pam Davenport.

That's a big deal, said Sue Nicodemus, immunization coordinator at the health department, because her agency ordered about 13,000 doses, planning to order more later. That's a typical order for them, although last year's early and ugly flu season had more people rolling up their sleeves. The Salt Lake Valley Health Department used about 25,000 flu vaccine doses last year.

When rumors of a shortage first surfaced, the department called in a waiting-list order to be sure it could get more. But a recording at Aventis on Tuesday said it is doubtful waiting-list orders will be filled.

Also Tuesday, the Centers for Disease Control and Prevention, along with Aventis, said they were working together to reallocate the 22.4 million doses of vaccine that have not already been shipped. In the first of two phases, about 14.2 million doses will be sent to priority providers that serve the most at-risk populations, such as nursing homes, hospitals and health-care providers that treat young children, said Steve McDonald, spokesman for the Utah Department of Health.

Aventis said it would track the orders nationwide to see that those in most danger of complications from flu receive it.

Those at risk and eligible for the available vaccine include those 65 and older, children 6- to 23-months-old, pregnant women (they are four times more likely to become hospitalized with complications), residents of long-term care facilities, children 6 months to 18 years who are on chronic aspirin therapy, those who care for children under age 6 months (those babies can't be vaccinated), those who provide direct patient care and people with certain, but not all, chronic conditions.

The CDC said it also will provide at least half the vaccine ordered from Chiron for its children's vaccination program.

Local health departments are wrestling with how to help the most vulnerable people, even reallocating some of the doses they have received from Aventis, said Davenport. Salt Lake Valley Health Department, for instance, is providing some of its doses to Salt Lake County Aging Services for its home-bound elderly clients. Aging Services ordered its vaccine from Chiron. And several local health departments, including Utah County and Davis, ordered part or all of their supply from Chiron.

Some health-care providers hedged their bets after previous supply problems and split their order between the two companies, so they will get some but not all of their orders.

The state Department of Health issued guidelines asking that the existing supply be reserved for those at most risk for at least the next month. After that, restrictions may be loosened.

Health officials say those at high risk should first try their own physicians, then expand their search. The state's immunization hotline can help, at 1-800-275-0659. Information also is available on the Web at

A number of agencies that traditionally run many employer-sponsored and public clinics said they will follow the state's guidelines. At clinics scheduled for the public, "we will make sure (recipients) fall under the guidelines," said Kim Olsen of Community Nursing Services, which has its own information hotline, 801-233-6170.

Nicodemus said her department is even being selective this year about which health-care workers receive the vaccine. "We're trying to prioritize and are only going to do our staff who do direct patient care in the pediatric and prenatal clinic," she said.

Those caring for children under 6 months should get a shot, she added.

"Infants have nothing to protect them," she said.

Intermountain Health Care ordered from Aventis and is vaccinating all staff members who provide direct patient care, said Jess Gomez, spokesman at LDS Hospital.

University Hospital split its order between the two drug manufacturers. As a result, it is providing the vaccine to inpatients and those in its clinic who are at high risk, but not others. It has arranged for its own staffers who provide direct patient care to get their flu shots from Salt Lake Valley Health Department, said University Hospital spokesman Jason Burgess.

The main recommendation for others is to use good hygiene, like washing hands often and telling anyone who gets the flu to stay home and avoid exposing anyone else — and hope for a mild flu season.

Besides injections, there is a nasal spray vaccine called FluMist that prevents someone from contracting influenza. But health officials told the Deseret Morning News it doesn't seem to be readily available yet, either.