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Flu vaccine shortfall no problem because many shun inoculations

Though top officials with the Centers for Disease Control and Prevention stressed Thursday that they want everyone older than 6 months of age to get a flu shot to prevent sickness and death, they also said only enough vaccine will be available for about half of the nation's more than 310 million people.

But that won't be a problem, the health officials suggested during a Washington, D.C., teleconference with news media across the nation.

Misconceptions about what a flu shot does -- such as causing an individual to get the flu -- continue to keep people from being vaccinated, said Dr. Daniel Jernigan, deputy director of the CDC's influenza division.

Having enough vaccine for everyone, the health officials said, would only mean that much of it would have to be thrown away.

There is no problem in Las Vegas finding the flu vaccine. Retail pharmacies have had it for more than a month. And the Southern Nevada Health District begins to offer flu shots on Monday.

The good news is that unlike last year, when public health officials advised people to get both a seasonal flu shot and one for the H1N1 virus, one shot covers the three flu strains that have circulated from July through September -- H1N1, H3N2, and Influenza B.

That public health officials have a difficult time convincing even half the nation to get flu shots doesn't surprise a longtime Las Vegas physician.

"I can only convince about 50 percent of my patients to get a flu shot," said Dr. Ivan Goldsmith, an internist who has a sign in the lobby of his Flamingo Road office advertising flu shots. "The problem you have is trying to convince people that there isn't a government conspiracy. They always bring up what happened with the swine flu in the 1970s."

After a Fort Dix, N.J., soldier died in February 1976 and more than 200 other recruits were quickly infected with a flu that scientists feared could be as lethal as the influenza pandemic of 1918 that killed 500,000 Americans and more than 50 million people worldwide, the CDC began a mass inoculation effort that went terribly wrong.

Twenty-five people died and hundreds of others were permanently paralyzed by the vaccine while only one person died from the flu that was a distant cousin of the 1918 virus.

Those kind of problems were corrected long ago, Goldsmith said, noting that there were no hitches with the H1N1 vaccine that was rushed into production last year to combat another flu strain that was loosely related to the 1918 virus. But he said many people remain scared, no doubt because parents have passed on stories to children about what happened during the '70s.

"It's time we get over that fear," Goldsmith. "It's irrational and a lot of people get sick or hospitalized or needlessly die from the flu."

According to the CDC, millions are sickened by the flu each year. As many as 200,000 people are hospitalized annually and deaths associated with the seasonal flu have ranged from 3,349 to 48,614 during the past 30 years.

Retail pharmacies in Las Vegas advertise flu shots from $24 to around $30. The price at the health district will be $32.

The reason for the price differential isn't difficult to figure out -- buy in quantity from a manufacturer and the price is lower. A retailer such as Walgreens orders millions of doses for stores across the country. The health district got a few thousand.

About half of the health district's 30,000 doses came at no charge from the CDC to give to uninsured and under-insured children. And as the health district's Vicki Swanson points out: "If somebody who shows up at the health district doesn't have any money or insurance, we don't turn them away. We definitely don't make a profit. We give a lot of it away to the needy."

At 24 hour drugstores, pharmacists can give shots day and night. But Mike DeAngelis, a spokesman for CVS drugstores, noted that pharmacists can't give shots to children in Nevada under the age of 9. Nurse practitioners who run drugstore clinics, such as Walgreens' Take Care and CVS's Minute Clinic, are able to inoculate children as young as 18 months.

"It is important to remember that the health district is not in competition with retail pharmacies or private practitioners regarding the distribution of flu shots," said Stephanie Bethel, a spokeswoman for the health district. "We encourage people to receive their annual flu shot and if they can locate a source that provides shots at a lesser cost, this is good news. The health district serves as the 'safety net' for many when it comes to immunizations of any kind."

H1N1 flu shots were offered free last year, she said, in the wake of the CDC declaring a health emergency.

While spokesmen for Walgreens, CVS and Albertsons say they're in the business to make a profit, they say profit information about this year's flu shots is proprietary.

Bethel said the cost of flu vaccine can range between $8.90 and $24.50 per dose from private manufacturers.

Robert Elfinger, a Walgreens spokesman, said the drugstore chain has already reported giving 2.5 million flu shots through Sept. 30 with a goal of 15 million vaccinations in the next year.

At least until this year, health care workers have been roundly criticized for not practicing what they preach when it comes to flu vaccinations.

But in a survey of 400 primary care doctors released at the press conference by Dr. William Schaffner, president of the National Foundation for Infectious Diseases, 95 percent of the physicians said they were planning to get a flu shot this year.

According to the American Academy of Pediatrics, just 40 percent of health care workers generally get vaccinated.

Schaffner said it is now time for everyone who works in a hospital, from security officials and receptionists to nurses and lab workers, to get vaccinated.

"We have to protect our patients," he said.

Dr. Ron Kline, president of the Nevada State Medical Association, said he believes the H1N1 scare last year made a big difference in the way health care workers are dealing with flu vaccinations this year.

"I would say it sensitized people to the issue," he said. "It's increased support for flu vaccination among health care workers, just as I hope it has among the general public."

Paul Harasim at pharasim@reviewjournal.com or 702-387-2908.

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