N.E. pushes to find takers for flu shots

Three months after the emergence of an unprecedented national shortage of flu vaccine, public health departments across New England are struggling to find takers for remaining doses, raising the prospect that surplus shots will be thrown away at the end of the flu season.

In Vermont, the governor offered himself as the poster boy for a push to get rid of 5,000 remaining doses, rolling up his sleeves Monday for a shot. The Boston Public Health Commission is imploring homeless shelters, nursing homes, and community health centers to find recipients for 1,500 doses. And the Bay State's commissioner of public health appears poised to lift all restrictions on who is eligible to be vaccinated against a disease that takes 800 to 1,000 lives each year in the state.

The Boston Globe has determined that more than 300,000 doses of flu vaccine may still be available in all six New England states.

The unexpected turn of events in what started out as a season of scarcity appears to be the product of a combination of stringent rationing in October and November, forcing the cancellation of flu shot clinics at worksites and pharmacies, and a flu season that was slow to get started, with significant numbers of cases appearing only in the past two to three weeks.

The federal government was also able to secure more doses of vaccine than originally expected when the shortage was announced.

The result: Thousands of flu shots are languishing on the shelves of health departments, clinics, and physicians' offices in New England, even as federal authorities prepare later this month to take delivery of an additional 2.6 million doses.

"We've been beating the drums, trying to get the word out to people that the flu vaccine is available," said Carol A. Collord, chief nursing officer at the Cambridge Health Alliance. "But now people are going to be looking at the calendar and saying, 'It's mid-January; should I roll the dice and not get the vaccine?' "

Flu season in Massachusetts typically peaks in February. Because a flu shot starts providing some protection as soon as it's administered and full coverage within two weeks, doctors continue to urge patients to be immunized.

"I'm trying to offer them as frequently as I can, so they don't go to waste," said Dr. John Goodson, an internist at Massachusetts General Hospital.

When contamination at a British vaccine factory run by Chiron Corp. resulted in the loss of about 46 million doses of vaccine, nearly half the expected US supply, federal and state health authorities rushed to impose restrictions on who could get shots, limiting them to people in greatest peril of dying from the flu, especially the elderly.

The shuttering of the Chiron plant in October reduced the nation's vaccine supply from an expected 100 million doses to 54 million. But because the lone remaining supplier of US vaccine, Aventis Pasteur, was able to increase production and because the government bought doses from abroad, the total number of shots available rose to 61 million.

Massachusetts had ordered 462,000 shots from Chiron, and hospitals and clinics had arranged privately to purchase thousands more from the company. That left public health authorities in early October worried that the state would fall far short of the amount of vaccine it needed. So state Public Health Commissioner Christine C. Ferguson restricted shots to seniors 75 and older, infants between 6 months and 23 months old, and patients with chronic medical conditions.

But when public health departments and private medical practices in the state wound up getting more vaccine than the year before, a total of about 1.3 million doses, Ferguson moved twice to ease the age restrictions, first to 65, and then last month to 50.

The state was able to secure more shots than last flu season because of a complex allocation system worked out between federal regulators and Aventis Pasteur. That formula, in part, favored states that had a commitment to using state funds to purchase vaccine, and Massachusetts has the most expansive government initiative in the country to provide immunizations against the flu as well as such childhood diseases as measles and polio.

A spokeswoman for the state Department of Public Health estimated that 80 percent to 90 percent of the 1.3 million doses that have come into the state have been administered, which means that as many as 260,000 shots could remain in Massachusetts alone.

Now, Massachusetts public health officials said, Ferguson may drop all restrictions on flu vaccine eligibility, and anyone wanting a shot could get one. Nicole St. Peter, a state public health spokeswoman, said Ferguson expects to decide this week about relaxing the restrictions.

Meanwhile, public health departments in the five other New England states are moving aggressively to remind patients that reserves of vaccine exist.

"But we have our work cut out for us to reorient people's thinking," said Dr. William Kassler, medical director of New Hampshire, where authorities expect the state will have 9,000 doses available at the end of the week. "At the beginning of the season, the message was if you're not in one of these high priority groups, you have to step back. Now, the message is exactly the reverse: Even if you just want the vaccine because you think you need it, please come forward and get it."

Stephen Smith can be reached at stsmith@globe.com.