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California might miss swine flu inoculation goal because of vaccine shortage

November 5, 2009 |  1:42 pm

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