Influenza Vaccine Shortage Information-

 By Sam Stebbins, M.D., Deputy Health officer San Mateo County

Almost half of the flu vaccine will not be available this year because of manufacturing problems at the Chiron plant in England. The CDC now anticipates that only 55 million doses will be available. Approximately 87 million doses of flu vaccine were administered last year in the United States. California in general and San Mateo County in particular had many orders through Chiron; and as a result, the available supply of flu vaccine for this county is very low at this time.

Important Topics

1. San Mateo County Public Health has set up three ways to obtain up-to-date

     information about the current status of the influenza vaccine supply:

•   San Mateo County’s Web site www.smhealth.org

•   Flu hotline at 650-573-3927 (this is a frequently updated recording in English 

     and Spanish)

•   A live person at 650-372-8572 (during regular working hours)

2.  Public Health has sent out a survey to medical offices asking for information on how

     many doses of vaccine you have ordered, how many you have received, and how

     many you think you will need for your high-risk patients. If you have not filled one

     out, please go to our Web site (www.smhealth.org) and fill out the survey.

3. Remember that influenza is preventable through good infection control and proper

    hygiene. See details below.

Major Developments

On October 8, state and local Health Officers issued orders requiring that ONLY high-risk individuals be vaccinated against influenza at this time. High-risk  persons in San Mateo County include:

-   All children 6 – 23 months

-   Adults aged 65 years and older

-   Persons aged 2 – 64 years with chronic medical conditions (heart, lung, kidney and

     liver disease; immunosuppression; metabolic disorders; blood disorders; and 

     others)

-   Pregnant women (any trimester during flu season)

-   Residents of nursing homes and long-term care facilities

-    Children aged 6 months – 18 years on chronic aspirin therapy

In general, protection of the health care workforce is a very high priority during flu season. However, because the shortage is so severe the county Health Officer has ordered that only a limited number of health care workers receive flu vaccination at this time. This order may change if sufficient vaccine becomes available. These groups, in order of priority, are health care workers with direct patient contact who

a.  primarily serve the severely immunocompromised,

b.  primarily work in nursing homes, long-term care facilities, and assisted-living

     facilities that house residents in high-risk groups,

c.  provide home care to patients in high-risk groups.

On October 12, the CDC and Aventis Pasteur (the company that makes the vast majority of vaccine available this year) announced a plan to reallocate 22.4 million doses of unshipped flu vaccine. Although the details of this plan are incomplete at the time of this article, two effects are likely: Immunization sites that were completely dependent on Chiron vaccine may be able to obtain some flu vaccine this year; and 2. Sites that ordered through Aventis Pasteur will likely receive only part of their order. More details on this will be posted on the Public Health Web site as they become available. (www.smhealth.org)..

We currently are developing educational materials for health care providers, daycares, schools, senior centers, and other appropriate places regarding precautions that can be taken to avoid getting the flu. These materials will be made available on the above Web site.

The CDC has an excellent Web site with references on infection control in medical settings at: www.cdc.gov/flu/professionals/infectioncontrol/index.ht

Please be mindful that, even if you or your patient cannot get a flu vaccine this season, there are ways to protect your-self from respiratory illnesses in this upcoming flu season. Good hygiene and proper hand washing are very effective at preventing influenza and cold virus spread.

•   Wash your hands frequently!

•   Respiratory protection—wear a mask in crowded settings such as hospital

     waiting rooms,

•   Stay home and rest if you become ill—don’t go to work or social functions!

•   Wash hands, cover mouth when coughing or sneezing,

•   Drinks lots of fluids, get plenty of sleep, avoid smoking,

•   Consult with your regular health care provider about flu antiviral medications if

     you become ill.