State faces shortages of swine, seasonal flu vaccines

By Elizabeth Cooney and Kay Lazar, Globe Correspondent and Globe Staff

Swine flu vaccine shipments to Massachusetts are running three weeks behind schedule, forcing the state to direct local health departments to cancel vaccine clinics scheduled for next month.

At the same time, shortages of the vaccine against seasonal flu strains are also being reported, as unusually high demand is outpacing the supply. Communities from Scituate to Somerville and Cambridge said they were postponing vaccine clinics aimed at protecting the public against both types of the flu.

The problems seen in Massachusetts reflect a nationwide shortage, as production facilities - pressed to make two types of vaccine at once - have been unable to churn out adequate amounts of either one.

“We will do everything within our power to get vaccine to the residents of the state as soon as possible,’’ state Public Health Commissioner John Auerbach said in an interview yesterday. But the state now expects to receive only about 700,000 doses of the swine flu vaccine by the first week of November, down from previous projections of 1.2 million.

“I certainly understand and share the frustration of those who want to have access to the vaccine,’’ Auerbach added. “We’re disappointed that it’s not here now, but we understand that it is an enormous challenge for companies that are producing it and for the federal government, and we think they are doing their best.’’

So far, Massachusetts has distributed 300,000 swine flu doses, less than one-tenth of the total the US Centers for Disease Control and Prevention has allocated for the state. Those early doses have been reserved for people at the highest risk, including pregnant women and young people, who have accounted for a disproportionate share of both hospitalizations and deaths nationwide from the novel H1N1 virus, which first surfaced in the spring.

Twelve swine flu deaths have been reported in Massachusetts, but only two since July. The federal government calls flu activity - which includes both swine flu and seasonal flu - widespread around the country, but here, doctors have seen a smaller rise in the number of patients coming in with flu-like symptoms this fall.

“Compared to other years in October, we are seeing an increase in influenza-like illnesses, but compared to what other states are seeing right now, we are not seeing the significant uptick they are,’’ said state public health spokeswoman Jennifer Manley. “We do expect the numbers to increase. We don’t think we are immune to H1N1.’’

The state had been working with local health authorities to plan swine flu vaccination clinics next month, but was informed by the CDC late last week that production was lagging. On Friday, it alerted local health departments by e-mail that “public and school based clinics tentatively scheduled for November should be postponed indefinitely.’’

For local public health boards, the delays have been frustrating.

In Scituate, Public Health Director Jennifer Sullivan said she had to put off swine flu clinics tentatively planned for the middle and high schools.

“They’re asking us to schedule clinics, and then they tell us there isn’t any supply for those clinics, then they tell us to plan clinics because supplies are coming, and then they tell us it isn’t,’’ Sullivan said.

Somerville city officials also have put vaccination clinics on hold. “We’re kind of on a just wait and see basis,’’ said city nursing manager Maureen Monagle.

Physicians and community leaders report unusually heavy demand for the vaccines, leading many places to exhaust their supply of seasonal shots and nasal sprays.

The Cambridge Public Health Department yesterday postponed eight remaining vaccination clinics after running out of the seasonal vaccine on Saturday, when workers inoculated about 1,350 adults and children in just over two hours and had to turn away at least 50 others.

“About twice the number of folks showed up at our early October clinics than in previous years,’’ Suzy Feinberg, spokeswoman for the Cambridge Public Health Department, said in an e-mail. In the past 10 days, Cambridge has given nearly the same number of flu vaccinations as it typically does in the entire flu season.

Dr. Ben Kruskal, director of infection control at Harvard Vanguard Medical Associates, one of the largest physician groups in Eastern Massachusetts, said that by the end of September, Harvard Vanguard had dispensed about 50,000 doses, a total that isn’t typically reached until sometime in November. But the seasonal vaccine is almost gone.

Harvard Vanguard received only about 500 doses of the H1N1 vaccine, a “pittance’’ compared with the group’s 400,000 total patient population, Kruskal said. Those vaccines have been distributed to the patients most at risk for complications from swine flu.

Patients who encounter shortages at their physicians’ offices are not faring a whole lot better at pharmacies. CVS has announced that it will end its seasonal flu clinics tomorrow - more than a month early - because of vaccine shortages. The company said its MinuteClinics will continue to administer the shots, as long as their supply is “replenished as frequently as possible.’’

Auerbach said the state has received 70 percent of its allotment of seasonal flu vaccine, which it sends out to local health departments and some health providers. The balance of the state’s order will arrive by the end of November, he said, before the traditionally busy months for the seasonal flu.

Swine flu vaccine is being distributed only by state health departments. Auerbach said he is talking to local boards of health about possibly holding swine flu clinics in schools rather than town halls when shipments finally arrive, to target children and young adults, a group at high-risk.

People who don’t fall into the high-risk categories may have to wait until December or January, when the rest of the state’s 3.5 million-dose H1N1 vaccine allotment is expected to arrive.

“When we get to having that amount of vaccine is not easy to predict,’’ Auerbach said. “I would just say this is totally an estimate. We have learned not to use any of these [estimates] as a certainty.’’

Globe correspondent L.E. Crowley contributed to this report.