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Hospitals Overrun by Flu Vaccine Requests

But Physicians Suggest Saving Vaccinations For Those at High Risk

By Carrie L. Zinaman

Hoping to get immunized against a possible sniffling, head-aching, won't go away winter flu? Good luck, say local health care officials, who have lately been so inundated with requests that they've been suffering shortages of the vaccine and have been forced to order additional supplies from manufacturers.

Demand for the vaccine has increased by nearly 300 percent this year at University Health Services (UHS) and at the Massachusetts General Hospital (MGH), according to UHS Director Dr. David S. Rosenthal '59 and Nancy S. Bryant, head unit nurse at the MGH medical walk-in clinic. Cambridge Hospital and Beth Israel officials also cite heavy demands.

"We've given close to 2,000 vaccines to employees of MGH and we ran out last week," says Linda Thomas, a employee health nurse at MGH.

Other organizations cite similar shortages. Kate McCormack, a spokesperson for the Massachusetts Department of Public Health, says that the department's order of 475,000 units for the entire state was inadequate and that 25,000 extra doses had to be obtained.

But why such an increased demand? "For a long time many people were not open to getting a vaccine--especially a flu vaccine--because they thought they could get the flu from it," suggests McCormack. "Finally, people are becoming more responsive to getting the vaccine."

This is also the first year that Medicare, the federal program which provides funds for elderly patients, has provided the vaccine free to those elderly people at greatest risk.

The vaccine, which works by "priming" the body's immune system against subsequent infection by the virus, is recommended for certain target populations: those who have autoimmune deficiencies, are over 65 or who have chronic medical conditions such as asthma and heart disease. The population also includes doctors, nurses, medical students and other health care workers who could potentially expose themselves or their patients to the virus.

But the shortages may have been exacerbated by some healthy individuals, not included in the target population, who have also rushed to be vaccinated and avoid the aches and pains associated with influenza. Most experts, however, do not recommend that the general public be vaccinated.

Dr. Larry C. Madoff, assistant professor of medicine at the Medical School and a specialist in infectious diseases at Beth Israel Hospital, urges the public to avoid vaccination, which can be risky.

"It hurts, it's inconvenient, it takes time," says Madoff. "For those who need the vaccine, the very small risk of a vaccine is worth it. But for normal, healthy people it's a close call."

Madoff recommends that limited vaccine supplies should be reserved for those who need it the most.

Dr. Dennis L. Kasper, Channing professor of medicine at the Medical School, agrees with Madoff's suggestion.

"The recommendation has not come out for every one to get the vaccine," says Kasper, who also serves as chief of infectious diseases at Beth Israel. "I think it would be imprudent of us to recommend otherwise."

This year's surge in requests for vaccinations came after a late August announcement by the Centers for Disease Control (CDC) regarding the detection of the type A-Beijing strain of influenza in Louisiana.

The type A-Beijing strain, along with the A-Texas and the B-Panama strains, are the three influenza viruses against which this year's vaccine has been formulated to protect.

The multiple formulation is necessary, according to Dr. Kenneth E. Sands, a research fellow at the Medical School and associate director of hospital epidemiology at Beth Israel Hospital, because of the ability of the influenza virus to change its appearance on a yearly basis by mutations.

Each year the CDC coordinates the effort to customize the vaccine for the expected strain or strains. In order to be protected from new strains of the virus, patients must get immunized every year.

Most hospitals and clinics hope to meet the high demand this year by increasing supplies. "We got 1,000 extra doses [of the flu vaccine] from the state health department at the beginning of the season and we do not anticipate running out," said Jane P. Taylor, director of public health nurses at Cambridge Hospital.

According to UHS's Rosenthal, however, the demand for the vaccine still consistently exceeds the supply. Because of the shortage, he said, UHS has been forced to put people on waiting lists.

Marta R. Weiss '96 was told that UHS had run out of the vaccine and that she would not be able to get vaccinated by the health services until the middle of November at the earliest. She was referred to Cambridge Hospital, where vaccinations will be available this week.

But not all young adults are enthusiastic about the shot in the arm.

"We've all had exams for the past few weeks, so we haven't had a weekend to be sick in bed," says Elizabeth M. Doherty '96. "I'll probably talk to some people and see what they advise, but I'm not stressing out about it."

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