Trying to do more with less
County agencies looking for ways to stretch flu shots

10/08/04
The Houston Chronicle
By LEIGH HOPPER

The Harris County Hospital District is hoping it can snag a few thousand of the 24 million doses of flu vaccine that haven't been shipped by vaccine maker Aventis Pasteur.

Aventis is discussing with federal officials how to distribute its remaining supply in the wake of the abrupt shutdown Tuesday of a factory that makes half of the nation's flu vaccine supply.

"We're hoping we might work our way up the totem pole and get that vaccine," said hospital district spokesman Brian McLeod. "We think we've got a case for needing it."

The hospital district learned this week its 60,000-dose order from Chiron Corp. was canceled when the British government closed the company's Liverpool, England, plant. British regulators cited contamination with a bacterium called serratia for the closure.

The canceled order has hospital district officials struggling to find a way to get flu shots to the thousands of people who depend on the county for influenza protection. Health departments in surrounding counties also are coping with a limited vaccine supply.

Children's vaccines, which are made by Aventis, are not expected to be disrupted.

In addition to trying to get a stash of Aventis vaccine, the Harris County Hospital District is busily acquiring antiviral drugs that can treat flu if used by people within two days of getting sick.

Currently, there's no flu circulating in Houston. But last year, Harris County saw an early and unusually severe flu season. At least two Houston children died.

"This is going to have a domino effect during the winter months," McLeod said. "You can expect to see more hospitalizations because the population will be sicker."

Chiron was to produce 46 million to 48 million doses, and Aventis was making most of the rest of the United States' 100 million doses. No vaccine from Chiron has been distributed in the United States. Aventis has already shipped 30 million shots to providers.

The hospital district placed its order with Chiron because the company offered a better price and had supplied the county in the past.

The most needy
The Chiron plant closure prompted the U.S. Centers for Disease Control and Prevention to recommend rationing vaccine to keep it available to people at highest risk of flu complications, including people older than 65; children between 6 months old and 23 months old; pregnant women; adults and children with chronic medical conditions; children on aspirin therapy; health care workers involved in direct patient care; nursing home residents; care-givers; and household contacts of children younger than 6 months old.

"There's not enough vaccine on the market to cover those at-risk populations," McLeod said. "You do want to direct it to the most needy."

Jim McCrone, public information health specialist for the Fort Bend County Health Department, said the county's small supply of adult flu vaccines has run out, with the last doses used Wednesday. He said the county placed an order for 1,200 doses with Aventis Pasteur in the spring and has received about 10 percent of the order.

"They have our order, we just don't know when we are going to get it," McCrone said Thursday.

McCrone said the health department still has doses for children, ages 3 to 18.

'More cases of the flu'
In Galveston County, health officials ordered 6,600 doses of the flu vaccine from Aventis and have received 4,450, said Kurt Koopmann, spokesman for the Galveston County Health District. Officials don't know when the rest will be delivered, he said.

"We feel we can adequately address the needs of those individuals we have traditionally served," Koopmann said. "The unknown we are dealing with is how many (patients) may be sent our way by private providers and others who have not received the vaccine they ordered. If that occurs we will make every effort to serve as many citizens as possible."

The Brazoria County Health Department, which provides flu vaccines only to children, said it has been assured by state health officials that its supply is forthcoming.

Dr. Leo O'Gorman, director of the Brazoria County Health Department, predicted that some other programs in the county, as well as many private physicians, will have trouble meeting the demand: "We're going to see more cases of the flu."

'We just don't know when'
Montgomery County clinics expect their flu-shot business to be brisk despite the vaccine shortage.

At Lone Star Family Practice clinic in Conroe, the county's major indigent patient facility, nursing manager Gail Shenck reported plenty of vaccine on hand and more on its way.

The Chambers County Health Department has received only 350 of the 1,300 doses of the flu vaccine that it normally administers each season.

By late Thursday afternoon, only a few doses remained, even though the department had limited shots to those with chronic illnesses or to people older than 65.

"We're supposed to get more, but we just don't know when," spokeswoman Sylvia Chavez said.

'We're still waiting'
In Liberty County, where the state health department administers flu shots, no vaccine was available Thursday.

According to a release from the Texas Department of State Health Services, of the 543,000 doses ordered by DSHS, 125,500 were from Chiron. Those doses were earmarked for DSHS regional offices to use in vaccinating adults in counties not served by local public health departments.

"We're still waiting to learn when we may get a shipment," said Sandra Ford, who works for the state health department in Liberty County.

Reporters Ruth Rendon, Richard Stewart, Terry Kliewer, Eric Hanson and Cindy Horswell contributed to this report.

For More Information Contact:
Kurt Koopmann
Public Information Officer
Galveston County Health District
(409) 938-2211
kkoopman@gchd.org