Doctors and patients across the country are reporting shortages of influenza vaccine as the outbreak spreads and fatalities mount.
“Thirty states in New York City are now reporting high levels of influenza-like illness activity. Last week it was 24 states. Forty-eight states report widespread geographic flu activity,” said Dr. Thomas Frieden, director of the Centers for Disease Control during a telephone briefing with reporters Friday.
Hospitalization rates for individuals 65 and older increased sharply, rising to a rate of 82 per 100,000, “which is really quite a high rate,” Frieden said.
Thirty children have died of the flu so far this season.
“Some people haven't been able to find vaccine and I understand that they're frustrated. Some providers haven't been able to get vaccine for their patients and they're also frustrated and that's understandable,” Frieden said.
One Staten Island resident called her pediatrician for the vaccine for her two children and was told vaccines were only available for those on Medicaid. One user on the government site also reported their pediatrician only had vaccines for uninsured patients.
A similar story circulated in Dallas County. According to a local report, its health department received 2,000 additional doses, but they were only for those on Medicaid or the uninsured. Many pediatricians and local pharmacies in Dallas County have run out of the vaccine.
“The seriousness is when you’ve got two pediatric deaths and you’ve got families looking around for the flu vaccine. It should be made available,” Dallas County Medical Director Zachary Thompson told a local CBS affiliate.
The federal entitlement program Vaccines for Children (VFC) offers the immunizations and the influenza vaccine, but it is limited only to those who are uninsured, on Medicaid, underinsured, or those who are American Indian or Alaska Native, according to the CDC website.
“CDC buys vaccines at a discount and distributes them to grantees—i.e., state health departments and certain local and territorial public health agencies—which in turn distribute them at no charge to those private physicians' offices and public health clinics registered as VFC providers,” the website says.
Another federal-state program is the 317 program which also offers flu vaccines for the underinsured and uninsured. Vaccines from this supply can be purchased but must be replaced.
Maryland Department of Health and Mental Hygiene director Dori Henry said some health care providers in Maryland are reporting they do not have the vaccine, but there are vaccines still available in the state. The department recommends that if someone’s provider does not have the vaccine to check with other providers.
Temporary shortages of the antiviral, Tamiflu, are also occurring. Food and Drug Administration commissioner Margaret Hamburg in the press briefing said the FDA is “working hard to make sure medicine to treat the flu and its symptoms are available for all who need it. Some locations may experience intermittent, temporary shortages of the oral suspension form of the antiviral, Tamiflu, which is the liquid version often prescribed for children for the remainder of the flu season.”
Hamburg said people should use the government’s website, flu.gov, to find the flu vaccine.
The CDC website also allows people to report shortages in their area. A review of the site shows hundreds of people across the country have reported difficulty in finding the vaccine.
“My son who is six years old has been on the waiting list for over a month. Please help,” wrote one mother from Oregon. She indicated the West Side Pediatric Clinic in two locations in Oregon did not have the vaccine.
A call to the clinic confirmed they do not have the vaccine. As of Friday afternoon, the clinic had 99 children on its waiting list, and a receptionist said they didn’t know when they would be receiving more doses of the vaccine.
Reports of vaccine shortages may be out of date.
One user wrote that all CVS and Walgreens in Reno, Nev., are out of the vaccine. The Free Beacon called one CVS location in Reno on Saturday and was told while they were out of the flu vaccine for a few days, but now they have received additional doses.
One person reported that the University of North Texas Health Pediatrics in Fort Worth, Texas, was out of the vaccine. While that also proved accurate at the time, the clinic said on Friday they now have received additional doses of the vaccine.
Two states, Minnesota and Connecticut, have now opened up their state supply to include those who are insured. Connecticut Gov. Dannel Malloy announced he is temporarily expanding the availability of state-supplied season flu vaccine to all children, ages 5 through 18, “regardless of their insurance status.”
“We must be proactive in protecting our children from the flu and continue to vaccinate as many children as we can, which is why we are making the state’s vaccine supply available to all of Connecticut’s children," said Malloy.
Minnesota, which had one pediatric death, is also allowing providers to borrow from its state supply, according to Doug Schultz, spokesman for the Minnesota Department of Health (MDH).
“MDH is allowing providers to borrow public vaccine purchased with 317 funds (not VFC funds) when they are expecting future shipments of privately purchased vaccine to replace the doses used. In other words, we are distributing vaccine paid for with discretionary funds and the rules surrounding those doses differ from VFC-funded vaccine. Even with the different rules we still want to see the doses replaced,” he said in an email.
The high demand for flu shots this year has left some health care providers without additional doses. “Some providers may have run out and may not order more,” Schultz said.
But with the demand high for flu vaccines this year and the supply in some locations being depleted, providers can order additional doses as the CDC pointed out.
CDC spokesman Curtis Allen said that vaccines start reaching providers in late August and September and vaccinations typically occur from September through December. So, he said, by February, it is not unusual for some providers to run out of vaccine. Since this flu season started a month earlier, and is a more severe year, sporadic shortages are typical.
“We do believe there is enough vaccines out there, people just have to be more diligent in searching for it,” Allen said. He said that flutracker.com is pretty accurate and people can search for vaccines in their area. “We understand there are vaccines in all areas, it’s just a matter of searching it out,” he said.
He said the VFC program, paid for by the federal government, allows children below the age of 18 who are uninsured or on Medicaid to have access to the influenza vaccine. Allen said by legislation, it must be “used for those children.” When asked if there was a need to open up the supply of flu vaccines to other children, he said he couldn’t speak to changing legislation.
According to CDC guidelines, “one-directional borrowing” in the VFC program is allowed with the influenza vaccine. That borrowing could only occur for VFC eligible children from private stock doses.