BANGOR, Maine — Vulnerable nursing home residents and schoolchildren are among the Mainers being told they will have to wait for a vaccination against seasonal influenza, despite a vigorous public health campaign this year urging everyone to get vaccinated early.
Fewer than half of the approximately 300,000 doses of seasonal flu vaccine ordered by the Maine Center for Disease Control and Prevention have been delivered to date, and the agency’s director, Dr. Dora Anne Mills, says it probably will be late November before all the ordered vaccine is distributed.
“Unfortunately, we don’t control the supply,” Mills said Thursday. “We were led to believe it would be there.”
The delay has led to the indefinite postponement of many school-based and other public flu vaccine clinics. Also put at risk are homeless shelters, nursing homes and other group settings.
Mills said the delay is being caused by a bottleneck in the vaccine manufacturing process due to the competing demand for H1N1 swine flu vaccine. Public health officials have strongly recommended that virtually everyone get both vaccines this fall, as the combination of seasonal and swine flu could prove especially dangerous.
Whereas seasonal influenza is typically most lethal for the elderly and chronically ill, the illness caused by H1N1 is worse in pregnant women, children and young adults.
At the Bangor Nursing and Rehabilitation Center, Director of Nursing Lucy Higgins said the facility’s 30 long-term residents are at risk of serious illness. Because seasonal influenza is especially hard on frail elderly people, she noted, public health officials have given them high priority status for the annual flu vaccine.
“We’re just praying that no one gets sick before the vaccine arrives,” she said. “Flu can wreak havoc in an environment like this.”
About 40 staff members at Bangor Nursing and Rehab also have yet to get their vaccines, she noted, because supplies ordered by the city’s Department of Health and Community Services have not arrived. Health care workers are advised to get the annual vaccine to protect not only themselves but also the individuals they care for.
At the Maine Health Care Association, which represents nursing homes and other residential facilities, director of communications Nadine Grasso said many of them have not gotten their vaccine supplies.
“Most of our facilities placed their orders months in advance,” she said. “We remain hopeful that they’ll get the supplies they need soon.”
At the Maine CDC, spokeswoman Nancy Birkhimer said demand for the seasonal flu vaccine has been especially brisk this year due to heightened awareness of the H1N1 pandemic and the growing number of cases of flu in Maine communities.
Most of those cases are caused by the emerging H1N1 virus and not the seasonal influenza, she said.
Although public health experts urged Americans to get the seasonal flu vaccine in September and the H1N1 vaccine as soon afterward as it became available, Birkhimer said the delay of the seasonal vaccine has so far only slowed things down to the normal seasonal schedule.
“There’s more demand than there has been in the past,” she said, “but we’re actually at a fairly normal place” in terms of the number of vaccines delivered for the time of year.
Birkhimer said the U.S. Centers for Disease Control and Prevention are predicting that states will have all their ordered doses of seasonal flu vaccine by the end of November. Supplies will be distributed promptly to schools and other public sites, she said.
“We expect that school clinics will continue to happen throughout the fall,” she said. Many schools also will be providing H1N1 vaccines for children as supplies become available, she said.
As of the end of last week, approximately 14,800 doses of the H1N1 vaccine had arrived in Maine, with another 18,900 anticipated by the end of this week. The H1N1 vaccine will be distributed rapidly for priority administration to pregnant women, children, adults with underlying health problems and health care workers.
The state has ordered a total of 800,000 doses of H1N1 vaccine. The state has ordered 500,000 more doses of H1N1 than seasonal vaccines anticipating higher demand for the new vaccine. Also, many doses of the seasonal vaccine are purchased by private medical practices.
Mills said periodic shortages of seasonal flu vaccine, including this year’s shortage, seem to fall most heavily on purchasers for schools, nursing homes, homeless shelters and other public health environments.
“There doesn’t seem to be any shortage for those who buy it privately,” she said.
But at Miller Drug in Bangor, pharmacist Bill Miller said that even he has been unable to purchase all the seasonal flu vaccine he wants to administer at his well-attended in-store clinics. Miller Drug, like most private drugstores and supermarket chains, does not purchase seasonal flu vaccine from the state or U.S. CDC but from a private distributor.
He said many scheduled store clinics have been postponed or canceled due to the shortage.
“It’s just too bad the public has to go through this ordeal of trying to figure out how to get a flu shot,” he said.