California might miss swine flu inoculation goal because of vaccine shortage

If H1N1 flu vaccine shortages persist, California may not be able to vaccinate those most at risk by the  end of December, public health officials said today.

Health officials have said that at least 25 city and county health agencies have received less than 45% of the vaccine doses they ordered. The state's goal had been to have all "high-risk" patients vaccinated by Dec. 31 -- but the shortage of vaccine is putting that goal in jeopardy.

“We may not be able to meet the target if the vaccine does not get here," said Dr. Gil Chavez, epidemiologist for the California Department of Public Health.

Chavez said state officials are monitoring the problem and plan to deliver more vaccine within two weeks to the agencies with significant shortfalls. “As we move forward, we are actually able to tell who has received vaccine, who has not, and try to bring people to parity,” he said.

“We believe, by and large, that the vaccine is being given to those who should receive it,” he added.

Vaccinations for the so-called swine flue are supposed to be directed to five priority groups: pregnant women, people ages 2-24, healthcare workers, caregivers of babies under 6 months old, and people ages 25-64 with chronic health conditions that put them at increased risk of complications from the flu.

Nationwide, 32.3 million doses of H1N1 vaccine have been made available, but there are more than 159 million in the priority groups that should get it, according to federal estimates.

In Los Angeles County alone, priority groups include 5.5 million people. Public health officials across the country have said they may have trouble supplying priority groups with the vaccine by December.

The problem, they say, is that the vaccine manufacturing process is taking too long. California was supposed to have received 6.25 million doses of the vaccine by now, but has received about half that, and state officials ordered another 500,000 doses yesterday, Chavez said.

Federal officials bought the vaccine from five manufacturers then contracted with a division of San Francisco-based McKesson Corp. to distribute it nationwide. McKesson is shipping 100-dose pallets of vaccines and supplies such as syringes from six regional distribution centers in northern California, Georgia, Ohio, Tennessee and Texas.

State officials have said distribution delays slowed supplies to some city and county health agencies, but McKesson spokeswoman Anna Buxbaum said today that no delays have been reported and orders are being delivered via overnight courier. She said California and some other states have contracted with other distributors to deliver some vaccine shipments, and they may be to blame for delays.

Chavez would not specify how many people have been vaccinated in each priority group statewide, or whether they received the vaccine from a private provider. He said that before vaccine distribution began last month, state and local officials secretly selected certain private providers, including Kaiser Permanente, to receive vaccine shipments first because they treated more patients in the priority groups.

There are 13,000 providers who ordered vaccines statewide, including 3,000 in L.A. County, officials have said. “Kaiser is a very large provider in the state, has a very good infrastructure for distributing the vaccine, so some of the very first shipments went to Kaiser,” Chavez said.

“It is challenging to sort out who among those 13,000 is most likely to target those priority groups first, but I think we have done a good job of working with local health officials to sort that out,” Chavez said. He did not name which providers were selected to receive early vaccine shipments.

The state has yet to release a list of private providers that received the vaccine. As of this week, more than 4,800 people have been hospitalized with H1N1 flu statewide and 266 have died, including 17 last week alone, Chavez said.

-- Molly Hennessy-Fiske

Comments

[Timmy]

Thank you for telling us that we're all gonna die if we don't vaccine when the vaccine isn't readily available. HURRY UP AND WAIT...WHAT ARE WE GONNA DO!? Fake being a healthcare worker?

[concerned citizen]

An evening news report this week said that 1/3 of all victims of the swine flu are over 50, many over 65 - yet the over-65 age category is totally excluded from the list of those at risk. Clearly the assumption that they're safe because they've likely been exposed to the virus many decades ago is wrong. It only stands to reason that very old and frail people are more susceptible to anything. According to this, they're not even recomended to be vaccinated!

Also we're hearing reports that there's a strong correlation between obesity and who gets this flu - no mention of that either, just some vague "certain medical conditions" for adults under 65. But obesity is also a risk factor for certain cancers, so this shouldn't be surprising - why, we're not sure, if it's because the excess weight strains the heart or blood vessels, exactly what.

Typically lazy and misleading AMA guidelines, lumping everyone together by the sole factor of age, as though obesity and inactivity didn't make at least as much difference in one's health and likely outcomes.

[Jennifer]

Agreed...Obama was a MORON to declare this a national emergency when the vaccines weren't available. What he did caused panic, a media heyday not seen since Octomom, and pushed thousands of people NOT in priority groups to rush out to the free clinics.

Because of the hysteria he caused in the general public, people in the priority groups won't all be able to get vaccinated. Their blood is on his hands.

[ricardo esparza]

dont be fooled by the swine flu hype!! Do you honestly think that the government cares about our health? wake up people!!! scared? you should be, you are on the governments scare tactics new reality tv show!

[Nicole, Los Angeles]

So basically, if you don't have Kaiser insurance your screwed? My family has PacifiCare and we cannot get both the regular flu shot or the H1N1 due to a LACK of the vaccines at our medical group. They have no vaccines available. This means that my 12 year old daughter is unprotected, my pregnant niece is unprotected, my sister and brother in law (who have underlying health problems) are unprotected, blah blah blah. Is it going to have to take many people DYING before anything is done about the vaccine shortage?? Will production suddenly increase once there has been loss of life for many children and adults??

[Rob Fox]

My physician -a specialist dealing with lung disorders such as COPD, does not have a clue as to when they will receive their H1N1 vaccine.

I think think public health officicials and medical suppliers are lying to minimize the severity of vaccine shortages!

[Don R.]

Sure am glad all those folks over at Goldman Sachs were able to get a hold of a stockpile of the Vaccine. Sure wouldn't want to set up a situation where pregnant women, elderly and children would get covered before the very rich stock brokers do....God forbid!!

[John Phillips]

Californians should go to Wall Street. They seem to have plenty of the vaccine and were some of the first to get it. It's too bad WS doesn't get it.

[Jim Coslow]

Where is the outrage??? Is Bush was still President you'd be getting the rope to hang him ready.

[Jim Coslow]

Where is the outrage???? If Bush was still President you'd all be getting the rope to hang him ready.

[concerned citizen]

I saw a news report last week that said that the Downey swine flu inoculation center was giving the vaccine to anyone who wanted it, whether or not they were in a risk category. No wonder they ran out...

[readyornot]

and the government wants us to depend on them to take our money, our rights and our healthcare....something is not right with this picture!

[Ann]

"Chavez would not specify how many people have been vaccinated in each priority group statewide, or whether they received the vaccine from a private provider. He said that before vaccine distribution began last month, state and local officials secretly selected certain private providers, including Kaiser Permanente, to receive vaccine shipments first because they treated more patients in the priority groups."
WHAT? Secret meetings to determine who should receive the vaccine? Are they kidding? My pediatrian got one small does of the vaccine, one time, and then ran out. I am on page 13 of the waiting list. I have Blue Cross PPO insurance - so NOT FAIR. This is such a bad example of GOVN'T RUN HEALTH CARE.

[Kristi]

I would also like to mention that the majority of the children and children's caretakers who are receiving the very rare H1N1 vaccine are here in this country illegally. This may not bother some people but for people like me who have to go to work everyday so that the illegal immigrants can collect their welfare checks, food stamps and medical benefits, I don't have time to stand in live all night and all day to get my vaccine!!! How fair is the democratic state??? Why not just give it to the Dr.'s offices who order it for their patients so hardworking people like me can have a fair chance of getting one of these vaccines!! On the other hand, when all the hardworking Americans come down with it.....who will support all the lazy illegals?

[h]

The public has been alarmed and want the vaccine while the agencies responsible have been unable to process and distribute sufficient amounts. Ask people who are trying to inoculate their children or adults who qualify. Ask Pediatricians who have to deal with anxious parents. What is going on?

[dean]

what happened to the promises of the federal government? I don't understand this at all. You build schools and bridges in iraq but california is left blowing in the wind? Give me a break.

[Christine]

This swine flu is serious and we won't know the full numbers of people who have it because the doctors are not testing everyone. I took my son to the doctor with a severe case of the flu in which he was having difficulty breathing. The doctor said that her office has not been testing all of the patients because it takes 5 days to get results back. Instead they are just writing out prescriptions for zithromax to clear up the virus. How are we supposed to get adequate numbers of vaccine if the doctors aren't properly reporting the virus?

[Doctor]

What a bunch of crap. Keep trying to scar us into getting this vaccine.
We are not buying your lies anymore

[Joel]

I have never posted on an LA Times article before, but this H1N1 distribution mess has become ridiculous. And anyone who says that the government is concentrating on "priority" or "high risk" recipients (a claim I have heard repeatedly) is flat-out lying. Thankfully I know that because I witnessed the opposite first-hand.

I spent 5 hours in line with my 19-month old daughter at Santa Monica College yesterday, only to be told that they had run out of vaccine. This, after I watched thousands of non-priority adults readily obtained vaccine for hours. I even watched as middle-aged women baldly lied that they were PREGNANT just to get the vaccine (and skip ahead of others in the process), even if it meant stealing precious doses of the only vaccine pregnant women safely can obtain. Then, this morning I heard that Wall Street banks have secured doses of the vaccine.

The problem? On the one hand the government is treating distribution of the vaccine like any other, while on the other hand it is telling us that this is an "emergency" and is not typical. The result? The government has scared people into panic mode, pushing them to take advantage of the existing system to the detriment of those in the "high risk" groups who remain un-vaccinated and need the vaccine the most. I saw it yesterday: it's each man, woman, and child for itself out there. And frankly, to me, that's far scarier than the virus itself.

Making matters worse, the solution is so simple: Set up a new distribution system for H1N1 vaccine. Supply the vaccine ONLY to service providers in closest contact with the "priority" groups -- first responders and healthcare professionals, pediatricians and/or schools, OB/GYN's, hospitals and clinics. And make it UNLAWFUL to give or receive the vaccine if you are not in such a group until sufficient doses have been manufactured. When the "high risk" folks have received their doses, then open it up to the general population -- even Wall Street.

In the meantime, any healthy adult over the age of 25 who manages to procure a dose of the vaccine should know that in doing so he or she has taken it from someone who needs it more. (Unless the adult is a healthcare worker, cares for a *true* infant, or is pregnant.) And for those women out there who are lying about their pregnancy in order to secure the most precious of doses, I have one word for you: KARMA.

[CM416]

Does it really matter at this point? Everyone I know has aready had it....too late...

[Mildred Marter]

Yeah and the people that are getting it first are illegals, indigents, and the uninsured. God forbid we give it to people who are either insured or who can pay for it.

[Dr. Ken]

As a practicing general internist in Los Angeles I have treated about 10 patients with presumptive H1N1v influenza during the last two weeks. All were approximately age 50 and under, the two sickest patients, who required oseltamivir prescriptions, were not obese or chronically ill, and the sickest was age 18. I have not as yet seen influenza-like illness in my elderly patients. Granted these numbers are small and not statistically significant, but it does represent a microcosm of what is being seen currently in the community.

[peter wolf]

So we only got half the doses we expected. But isn't that like California anyway? No matter what you spend you only get about 50% of what you expected? Government services, quality of help in restaurants and stores, etc.

[peter wolf]

So we're only going to get half of the flu vaccine doses we expected. How typical in this state. You only get about half of what you paid for, be it government services, quality of help in restaurants and shops, etc.

[JoeS]

Incompetents. I can hardly wait for them to run all of our health care. Less Health Care, Higher Taxes.

[Yong-Jin Lee]

this seems to be one of the government's flaws recently

[Yong-Jin Lee]

this seems to be one of the government's flaws recently

[m]

.......and I am supposed to have faith in goverment run health care......they cannot even handle a vaccination program

[Garry Barnes]

I was wondering since the H1n1 or swine flu isnt the primary cause of death. The secondary bacterial pneumonia is causing these deaths why not innoculate more people with the pneumonia vaccine?

[scarceshika]

wassup to the staff and readers of the LATimes.
The way swine flu hit nyc they had Vice President Joe Biden advise Mayor Mike Bloomberg to chill from taking public transit. He's renown for choosing to take the subway to work down to City Hall. The public transit system of nyc is very congested and there have been govt. intervention in controlling this. They made laws to have the citizens carpool from the upper east side district down to mid-town. They are also swaying people to ride bikes more. From the statistics it shows nyc got hit with the flu harder than other towns around the world. Hundreds of school were closed becouse of the contagious sickness. Whats silly is that i was parley'n around with my neighbors and on told me she refused to go back to school becouse of the field she was in. She was in the field of healthcare. They were all mandated into taking the vaccination. Her argument was that the FDA didn't approve of this vaccination and that only the state of ny as well as other special states were mandated to have their healthcare employees take the vaccines. I guess it was becouse of the demographics of the flu that made certain stated mandated and not by the FDA. It's ironic that you guys out in LA are afraid of experiencing a shortage of the vaccine. I hope you guys keep a mini anti-bacterial hand sanitizers with you, you don't know what kind of germs are out their. Even besides the swine flu. www.scarceshika.com/blogs.html

[Joel]

I love how people try to turn everything into an "immigration" issue. The merits of the immigration debate aside (and as someone who remembers that he is a grandchild of immigrants, you can probably guess which side I'm on), when it comes to public health -- especially transmittable disease -- there should be no distinctions. Vaccines, by their nature, only work on a macro level if a certain percentage of the population is vaccinated.

More fundamentally, do we really believe that a person is less worthy of the vaccine -- and therefore their life less valuable -- simply because they have not been given the privilege of citizenship or legal residency? If that's the case, why do we even bother engaging in humanitarian aid?

This is not an immigration issue. It is a public health issue. It affects each of us regardless of our residency status: the virus doesn't discriminate between legal and "illegal" residents. It is no less horrible if an "illegal" pregnant woman or child gets infected, and frankly it is no less dangerous to the rest of the population.

[lilly of the valley]

I stood in line for two hours today in Ventura county to get my H1N1 shot. I am in the high risk group. I am 51 and I have asthma. I was not asked to prove that I was in that group. I had proof, my inhalers and my prescriptions. The health care nurse said a lot of people were claiming they were "asthmatic". If they are not screening people for proof that they are in the risk group, How do they regulate who gets it first?

[lilly od the valley]

I waited 2 hours in line yesterday to get my H1N1 flu shot.
I am in the high risk group, 51 yr old/asthmatic. The health clinic did not request any proof that I was in a high risk group. I had proof, my prescriptions. Why are the clinics not requiring some proof that people are really in the risk groups? Apparently everyone in the line I was in was asthmatic.

[Jorge Sanchez]

This whole arbitrary prioritization system is screwed up and flawed logic. The best way to prevent high risk individuals from dying is to reduce contact between the unhygenic (poorly raised children) and to indiscriminately immunize as many people as possible as quickly as possible. Each time a state receives a shipment and takes a week to distribute it and then send it to a county that sends another 10 days setting up a clinic for it and distributing it, the disease spread is compounding exponentially. This stuff should be coming straight out of the manufacturing and testing process into people's arms on location. The less people you come in contact with who have it the less likely you'll be to get it, so cutting down on the exponential multiplication factor is far more important than targeting those at risk.

Further, if 90% of the infected are children, yet they make up only 10% of the deaths...how in the world are they an at risk group? The most at risk group is the 25 to 50 year old population in terms of fatalities, and they seem to be the ones that have been ruled out. Is this a preview of the efficiency of government engineered healthcare?

[aarti madan, md]

As a physician I am shocked that the H1N1 vaccine has been administered to many people who are not in a high risk group. I just discovered that movie studios are vaccinating their crews (who are not high risk) to avoid absenteeism and save money. I hope someone at the la times picks up this story and finds out which "health care provider" sold their H1N1 flu vaccine to the highest bidder instead of vaccinating high risk groups.

btw - no health care worker at my office has received the vaccine. I wonder how many patients one health care worker could infect before they realize they have swine flu. But the crew of the new Spiderman movie is safe! I am so disappointed in our public health department.