Much of flu vaccine to be delayed in fall

Staff and wire services

More than one-third of this year’s flu vaccine is expected to be delayed this year, until November and early December.

That may or may not be a cause for alarm, depending on the severity of the flu season and when it hits.

"If it peaks in December we’re in trouble," Dr. M. Ward Hinds, who heads the Snohomish Health District, said Monday. "It’s unpredictable."

The amount that is coming late is less than last year, when manufacturers had problems growing one strain of the vaccine and one manufacturer dropped out of production rather than upgrade its facilities to meet Food and Drug Administration requirements. Another had to make repairs.

"We were lucky last year," Hinds said. "It was late and mild."

The flu season peaked in late January and early February last year, so a large number of people were immunized by then, even though the vaccine was months late.

Hinds said the vaccine will be used for high-risk people first. Most people are used to that by now and are understanding about having to wait, he added.

Snohomish County health organizations had reported in June that the cost of flu shots would increase dramatically this year, even though the practice is done as a public service, rather than for profit.

Dana Cooper, who orders flu shots for The Everett Clinic, had said that she wouldn’t be surprised to see the price range from $12 to $20. Last year, organizations charged about $10.

But they were hoping to get the vaccinations on time.

"We just hope it comes," said Donna Larsen, director of community health for the Snohomish Health District, adding that the manufacturer had promised that at least one-quarter of the district’s order would arrive in either late September or early October.

The pharmaceutical company has promised to send the remaining shipments by Nov. 30, Hinds had said.

So, this latest development comes somewhat as a surprise.

This year, the three remaining manufacturers, Aventis Pasteur, Wyeth Lederle and Evans Vaccines, predict they will make about 77.1 million doses, about 10 percent more than last year and roughly equal to 1999, a year when 2 percent of total supplies were delayed.

Authorities say it is difficult to tell what this year’s delay will mean, and whether fewer immunizations and more influenza-related deaths could occur. The United States averages 20,000 flu deaths a year.

Last year an unusually mild flu season meant that the delays were not a significant problem, said Martin Myers, director of the National Vaccine Program Office with the Centers for Disease Control and Prevention. Deaths were lower than in the previous three flu seasons, according to the CDC’s Influenza Season Summary. Infections peaked in January, by which time even those inoculated as late as December would have developed immunity, which customarily takes two weeks.

This year, the CDC has issued recommendations for manufacturers, distributors, providers and consumers to ensure that at-risk patients — people with chronic health problems and those over 65 — get the vaccine as soon as it becomes available, which likely will be early next month. Those not at risk are asked to wait until more of the vaccine is released, probably in November.

Last year, reports of a potential vaccine shortage, which failed to materialize, led some distributors to increase their prices. Physicians reported prices of up to $150 for a 10-dose vial, five times the manufacturer’s wholesale price.

The CDC also acknowledged last season’s accounts that physicians were experiencing delays while grocery stores and other sponsors were holding vaccination clinics.

To keep prices stable, Aventis Pasteur, the pharmaceutical company that will produce more than half of this year’s U.S. vaccine supply, has limited the amount it will sell to distributors, and instead it has sold more directly to companies and physicians, company spokesman Len Lavenda said. He added that, legally, there’s not much the company can do to stop distributors from raising prices.

Manufacturers also have said they will try to distribute the vaccine more evenly, filling a portion of every order as soon as the first batch is ready, so that each provider can target the vaccine to their at-risk patients. The practice differs from last year’s, when Aventis Pasteur filled orders one at a time as vaccine was produced.

Regarding prices locally, when the Snohomish Health District placed its order for 5,000 doses, officials discovered the price had doubled, with 10-dose vials costing about $50. Larsen has said that the price per vial her agency was charged went from $23.65 to $50 for 10 doses. But many older adults will be able to bill Medicare for the shots, she said.

Providence Occupational Medicine has ordered 6,000 doses at about double the cost from last year, said Sandy McManus, clinic manager. Valley General Hospital was charged $45 a vial, more than double last year’s $20, spokeswoman Martha Dankers has said.

— Communities Editor Steve Powell contributed to this report.