Lack of swine flu vaccine creates confusion, frustration

Mary Katz, who is due to deliver twin Mary Katz, who is due to deliver twin girls on Thursday, has been unable to get the H1N1 flu vaccine. She wants to protect her three-year-old twin boys Timothy and Benjamin. Photo Credit: Michael E. Ach

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Mary Katz is on a deadline.

The East Meadow mother is scheduled to give birth to twins by Caesarean section next Thursday and wants the swine flu shot. But she hasn't been able to find anyone who has it.

Katz said she has spoken with her obstetrician, pediatrician, several local hospitals, clinics, pharmacies, the Nassau County Health Department, the New York State Department of Health, the U.S. Department of Health and Human Services and the Centers for Disease Control and Prevention. She even went on Facebook.

It hasn't mattered that pregnant women top the CDC's list of who should get the vaccine. "Everyone says I should get it, but no one can tell me where," she said.

The state has never before administered a program to deliver a flu vaccine for the entire state population, and so far its efforts are generating frustration and confusion. Long Island doctors say the system for ordering vaccine is complicated, and they don't understand why some practitioners are getting it and others are not. What's more, 35 percent of available vaccine statewide has been the nasal spray, which can't be given to some high-risk groups such as pregnant women and asthmatics.

A Huntington dermatologist, Dr. Michael Dennenberg, received 100 single vial doses of the shot on Monday. But four obstetrician-gynecologists interviewed - including Katz's doctor - said they had not gotten any yet. A Mineola pediatrician, Dr. Gerald Ente, said his office got 300 doses about two weeks ago, but none of his pediatrician friends has received the vaccine.

"I cannot explain it," he said.

Claire Pospisil, a state health department spokeswoman, said the problem will fade once there is more vaccine.

"The bottom line is that there is not enough vaccine and we're trying to give what is available based on an allocation system," she said. So far, the health department has taken 6.4 million orders from providers, but has had only about 1 million doses to ship, Pospisil said.

 

New way of ordering shots

Normally, doctors order flu vaccine directly from the manufacturers. But with the swine flu vaccine, the CDC, which ordered the vaccine from the manufacturers, has been dispersing it to states based on population. New York has been allocating it to providers in each county, also based on population.

New York requires health care providers to register online to order vaccine; so far 5,035 providers have registered. On average, the state gets 390 calls daily from providers, Pospisil said.

 

Preferred variety unavailable

The doctors must estimate how many of their patients fall within a high-priority group - a factor in who gets vaccine, Pospisil said. Doctors are assigned specific days they can place their orders. All must pledge they will first provide the vaccine to high-risk groups.

But the type of vaccine available doesn't always jibe with what practitioners have ordered. Pospisil said 35 percent of available vaccine has been the newer, less popular nasal spray, which pregnant women cannot take. There's plenty of nasal spray because its producer has had fewer problems than those making the flu shots.

And with the shot, many doctors have ordered the single-dose vial, not the multidose vial, which takes less time to produce. The single-dose vial does not contain the preservative thimerosal, which some patients are concerned about, though studies have not shown any ill effects from it.

The system is "a little confusing, to say the least," said Laura Doti, a nurse practitioner in the offices of Drs. John Wagner and Ted Goldman, obstetrician-gynecologists in Huntington.

Her office registered on Sept. 16. "Lo and behold, on Oct. 23, we were finally permitted to order," she said. They ordered 400 doses of the single-dose shot, none of which they have received, Doti said.

Others said they are also frustrated. "It doesn't seem like great organization from a public health point of view," said Dr. Victor Klein, Katz's obstetrician in Great Neck. "We just want to give the vaccine and we don't have it."

But some say it's not the dispersal plan that's the problem: It's the lack of vaccine. Dr. Aaron Glatt, president of New Island Hospital in Bethpage and a spokesman for the Infectious Diseases Society of America, said the state and CDC had done "an admirable job." But, he added, "admirable jobs aren't perfect."

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