If you’re 2 to 65, do without vaccine, cross your fingers

Two weeks ago, the clinic got the bad news: Our wholesaler could not deliver the promised flu vaccine for our employees, who are exposed daily to the coughs and sneezes of our patients. Our clinic services director began calling around madly to see if we could find some vaccine, somewhere. No go. Everyone she called was facing the same agonizing problem – there was no vaccine to be found.

What was going on? We found out the next day when the story hit the press. Britain’s Medicines and Healthcare products Regulatory Agency, the British equivalent of our FDA, suspended the license of Chiron Vaccines, forbidding them from releasing any vaccine for three months. That means their vaccine is essentially unavailable for this flu season. Chiron is one of only two companies licensed to produce flu shots for the United States market. MHRA cited concerns about the manufacturing practices in Chiron’s Liverpool plant, where bacterial contamination had been discovered in some vaccine lots. (None of Chiron’s vaccine has been shipped to the U.S.)

In a classic case of “he said … he said” MHRA claims, according to the Washington Post, that it notified the FDA on Sept. 13 that there could be problems with the vaccine supply. The acting director of the FDA denied that the agency had received any advance notice. Whatever. I suppose this will be battled out in various congressional committees, but it’s hard to think that three weeks’ notice would have made much difference.

Chiron was scheduled to supply us with some 48 million doses of vaccine. The other vaccine manufacturer, Aventis Pasteur, will supply 54 million doses, and two million doses of a nasal vaccine (recommended only for healthy adults who are not pregnant) will also be available. It would be nice to think that Aventis could just ramp up production, but it’s not all that easy. In order to make the flu vaccine, which is composed of dead viral particles from three different strains of influenza, the viruses must be grown, and this takes a while. It is unlikely that Aventis could make up for the shortfall.

Dr. Julie Geberding, head of the Centers for Disease Control, is urging us not to panic. The CDC is attempting to redirect the available flu vaccine so that high-risk individuals can get the vaccine. The CDC has issued interim guidelines about who should be vaccinated this year:

People 65 or older

Children ages 6 months to 23 months

Adults and children older than 2 with chronic lung or heart conditions like heart disease and asthma

Pregnant women

Adults and children 2 years or older with chronic metabolic diseases like diabetes, kidney disease, blood disorders or weakened immune systems (such as HIV/AIDS)

Children and teenagers who take aspirin daily

Residents of nursing homes or long-term care facilities

Household contacts or out of home caregivers of children younger than 6 months

Healthcare workers who provide direct, hands-on care to patients

So, those of us between 2 and 65 who are healthy should cross our fingers and not get the flu shot so these other folks can.

Here are some other things we can do to avoid getting the flu or giving it to others:

If you’re sick, stay home! Tell your boss he’d rather do without you than have you pass on the flu to the rest of your colleagues.

Wash your hands. A lot.

Sneeze or cough into a tissue, or (forgive me, mom) into your sleeve. Then wash your hands. Again.

Anti-viral drugs do exist for the flu, so if you’re high risk and can’t get the vaccine, ask your doctor if they might be appropriate for you, either taken preventively or when you develop flu symptoms.

According to the CDC, up to 20 percent of us get the flu each year. About 200,000 are hospitalized with complications and 36,000 people die from the flu. So, be careful out there!