October 14, 2004
A Headache and a Fever: Long Lines for Flu Shots
http://www.nytimes.com/2004/10/14/health/14flu.html?oref=login&th=&pagewanted=print&position  (must register to view original article)

AVON, Mass., Oct. 13 - Every fall, Catherine DeMayo, a retired nurse, eagerly helps out at flu clinics around Massachusetts, administering doses of vaccine to people at pharmacies and grocery stores.

"It's usually such fun," said Ms. DeMayo, 64, who likes the work and the experience of meeting people.

But this year, flu shots are suddenly a holy grail, with places able to offer them mobbed by desperate vaccine seekers.

At one pharmacy, there were so many people that Ms. DeMayo and other nurses kept what was supposed to be a three-hour clinic open for seven. At another, the store lost electricity in a power failure, but the nurses kept the injections coming.

And with clinics trying to make sure that the most vulnerable people are getting the vaccine first, Ms. DeMayo and her colleagues have had to turn people away: middle-aged men who have wanted a flu shot in an effort to protect their children from the illness, mothers who want to keep themselves healthy to care for their families.

"We had a little girl about 3 years old who waited on line for four hours," Ms. DeMayo said. "She waited all that time, but we don't do children. The little girl was crying, the mother was very upset."

Another woman was too weak to get out of her car, so Ms. DeMayo went out to the parking lot to administer the shot. Others try earnestly to present proof that they are infirm enough to deserve the scarce doses of vaccine.

"People are so anxious and so fearful," said Kathleen Owens, a nurse who, with Ms. DeMayo, was giving out flu shots Wednesday at a Costco store in Avon, 20 miles south of Boston. "You're doing it as fast as you can, but they're so afraid and that's the hard thing. One woman wanted to open her shirt to show me her transplant scar. Others say 'I have papers from my doctor' or 'Here, I have my meds.' ''

When British regulators shut down Chiron Corporation's Liverpool factory on Oct. 5, citing concerns about bacterial contamination, they cut off about half the supply of flu vaccine the United States normally receives, or 46 million to 48 million doses. The other major supplier, Aventis Pasteur, a French company, is supplying 55.4 million doses this year, but all but 22.4 million doses have already been distributed.

As a result, the federal Centers for Disease Control and Prevention issued guidelines giving certain groups priority to receive flu vaccines: infants, people over 65, people with chronic medical conditions, pregnant women, and health care workers with direct contact with patients.

On Wednesday, the Massachusetts public health commissioner, Christine C. Ferguson, ordered providers to give vaccines only to high-risk groups and to give an accounting of their flu-shot supplies to the state.

The clamor for shots is so pitched that on Wednesday, the police in Aurora, Colo., said that 620 doses of vaccine had been stolen from a pediatrician's office. Health officials around the country say some suppliers are trying to cash in on the shortage, The Associated Press reported. In Wichita, Kan., for example, the pharmacy at the Wesley Medical Center could not get the 2,800 shots it needed from its regular supplier. But other distributors were prepared to supply the vaccine for up to $600 for a vial of 10 shots that normally costs about $80.

Many public and private health agencies, unable to get any vaccine at all, have been forced to cancel scheduled flu clinics. All 14 flu clinics in Cambridge, Mass., have been canceled because the state cannot provide the city with the expected 1,300 doses of vaccine, said Ricki Lacy, Cambridge's director of public health nursing services.

So on Wednesday, when the first two clinics were to be held at a senior center and a housing complex for the elderly, nurses instead stationed themselves at the doors, turning away about 60 people who had not heard that the clinics were canceled.

Jean Campbell, 62, who has emphysema and recently battled pneumonia, walked to the center from her home, a trip that should have taken 20 minutes but took her 45 because of her breathing problems.

"I'm very angry," Ms. Campbell said, when told the clinic was canceled. "It's scary. Too many people depend on it."

At the Costco in Avon, scores of people, most of them elderly and some in wheelchairs or hobbling on canes, had begun lining up hours before the first shot was to be dispensed at 3 p.m. By 3:25, there were 330 people wanting shots, and the line snaked across the entire back aisle of the cavernous warehouse store.

Sandra Pedersen, 63, had driven 20 minutes to get there at 1 p.m. with her husband, Elliot, and her 85-year-old mother, Ida Nisby. She and her mother had been calling pharmacies and health departments and hospitals for several days.

"The CVS in East Bridgewater canceled, the town board of health said they didn't know if they would have it, and Brockton Hospital said maybe on Nov. 21, if they get it," Ms. Pedersen said.

Concerned that she might be turned away because she was under 65, Ms. Pedersen arrived with a stack of appointment cards from her doctor, showing that every three weeks she is treated with B-12 shots for an immune deficiency. The store had said it would vaccinate only Costco members, but Ms. Pedersen, who is not a member, was relieved that neither the store nor the nurses were asking to see membership cards.

Perched at a table against a row of jumbo packages of tampons and adult diapers, Ms. DeMayo did a subtle double take when Nadia Brupbacher, 23, took a seat at her table. But she soon noticed what Ms. Brupbacher's mother, Fatiha, described as her daughter's "developmentally delayed" condition.

"If she doesn't get it, she almost dies," the mother said. "She gets really sick in the winter."

Anne Bregoli, another nurse giving shots, was trying for some levity.

"You're not pregnant today, are you?" she asked Edward A. Loiacono, who has emphysema and bronchitis and waited three hours to be 10th in line.

"We pretty much have to rely on the person to be honest about their condition," Ms. Bregoli said. "We're not the flu police."

Allan Hirschel, 74, traveled from Hull, about an hour away, and thrust his heart medication, Metoprolol, under Ms. Bregoli's nose.

"Well, I hope that guarantees you a healthy winter," she said after giving Mr. Hirschel his shot.

Costco dispensed all 502 doses of vaccine it had received, said Dan Gordon, the store manager.

"We had to tell some people that we didn't have any more," Mr. Gordon said. "We started letting them know at the door. We could have been here all night."

Katie Zezima contributed reporting for this article.