Wednesday, Oct. 6, 2004 | 10:58 a.m.
Flu shots
The Centers for Disease Control put out guidelines to limit flu vaccinations. Those not in the priority groups are asked not to seek vaccination, the CDC said. Complying with the guidelines is voluntary. Those who should get the shots include:
Steven Hansen, the nonprofit private clinic's CEO, put calls in to the federal Centers for Disease Control and the two manufacturers of the vaccine.
"Nobody's answering the phone anywhere," he said. "I assume they've all turned the phones off until they figure out what they're doing."
Confusion and a sense of dread prevailed as the news spread that half the nation's flu shot supply -- and all of the Clark County Health District's 35,000 doses -- would not be distributed because of problems with a factory in England.
"We heard a couple of weeks ago that part of the lots Chiron (maker of the flu shots) was manufacturing was in jeopardy, but in no way did anybody realize that the entire shipment was in jeopardy," said Dr. Donald Kwalick, Clark County's chief health officer.
Because there won't be enough shots to go around, the Centers for Disease Control on Tuesday rushed to put out guidelines as to who should get the limited supply, targeting those most at-risk for flu -- children, people over 65 years old and those with medical conditions.
Clark County ordered all of its shots from Chiron because the company's price was dramatically lower than that of its only competitor, French manufacturer Aventis Pasteur, said Bonnie Sorenson, the health district's public health nurse manager.
"When you're using public money, you always go for the best deal," Sorenson said.
Chiron Corp. announced on Tuesday that it would not supply vaccine during the coming flu season because British authorities had suspended the company's license.
Chiron was supposed to supply 46 million to 48 million doses to the U.S. market out of a total of 100 million, according to the federal Department of Health and Human Services.
Health officials warned of a global shortage that could exaggerate the effects of a disease that regularly claims the lives of 36,000 Americans per year, most of them elderly.
Chiron's supply was delayed about a month ago amid concerns that a small part of the massive vaccine shipment might be tainted.
In yanking the company's license on Tuesday, the health authorities in England cited broader concerns about standards at Chiron's factory in Liverpool.
The announcement was totally unexpected; the news from Washington spread among local health officials by cell phone as they traveled to work Tuesday morning.
Clark County county, which provides low-price vaccines at its offices and in rural areas, has 2,500 doses on hand from Aventis, Kwalick said.
Those shots were for use in an emergency drill next week, but now they are too precious to waste -- they may be the only doses the county gets. The drill has been canceled, Kwalick said.
Flu vaccine must be grown in a laboratory, a process that takes five or six months, so Aventis can't just make more to meet demand. The flu season normally lasts from late October through May.
But health officials have little grasp of the scope of the shortage in Nevada thus far because the government's supply makes up only a small portion of the total vaccine availability.
Private health providers are thought to have ordered many more doses than the health district, perhaps several times as many, Kwalick said.
Nevada Health Centers had ordered about 5,000 shots from a vendor supplied by Chiron, Hansen said. The vendor notified him this morning that the vaccines, scheduled to be delivered in the coming weeks, would not come as planned and might not arrive at all.
Others were luckier. The Department of Veterans Affairs ordered from Aventis, and the VA Southern Nevada Healthcare System got the first quarter of its 18,000 shots last week.
The agency began vaccinations on Monday, said Heidi Pool, the system's nurse manager of medicine and primary care.
The mean age of the 41,000 Southern Nevada veterans served by the agency is about 65, Pool said. The agency routinely offers the flu vaccine to those 50 and over and those with chronic diseases, she said.
"We are continuing right now to vaccinate as planned, and we will make a contingency plan based on those recommendations," she said of the CDC guidelines.
"In the past when we have had shortages, we have limited further" the groups that are eligible for shots, she said.
The state Health Division also ordered from Aventis, purchasing about 26,000 shots for provision to the state's rural counties. So far, 11,700 doses have arrived, State Epidemiologist Randall Todd said.
The state is looking at how to mete out those doses considering Clark County's situation, Todd said, but he noted that the county's order of vaccine was bigger than the state's.
"Our ability to really make Clark County whole is very limited," he said.
The message the state wants to convey to the public, Todd said, is that people in the high-risk group should try to get vaccinated, while those not in it should not.
"It's a difficult message -- I haven't really come up with a catchy slogan for that yet," he said.
After an emergency conference call of state health agencies Tuesday afternoon, the state is preparing to send out technical bulletins detailing recommendations for nursing homes and emergency rooms, Todd said.
There is no cure for the flu, though antivirals administered within the first 24 hours can cut short the disease, which usually lingers for seven to 10 days. Officials advise flu sufferers not to go to the doctor unless they have a very high fever or abnormal symptoms.
Health authorities' prevention tips are not glamorous, Todd noted, but they work: wash your hands, cover your mouth when you cough or sneeze, stay home from school or work if you're sick.
Many compared the coming flu season to the hurricanes that have recently ravaged the East Coast, especially now that prevention is difficult -- better to focus on dealing with the inevitable fallout.
Experts say it's only a matter of time until a mutant flu strain hits the population, causing a pandemic that could kill 200,000 people. They point to the avian flu currently brewing in Asia.
Between October 2003 and May 2004, 233 cases of flu were reported in Clark County, and three people died, according to county statistics.
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