Most healthy adults should delay or skip getting flu shots this year so that the elderly and others most at risk from influenza can get scarce supplies, health officials said Tuesday as they scrambled to manage a surprise - and record - shortage.
British regulators abruptly shut down major flu-shot supplier Chiron Corp. Tuesday, cutting in half the U.S. supply of vaccine just as flu season is about to begin.
The Bush administration urged the public and doctors to begin voluntary rationing of the roughly 54 million flu shots that will be available this year.
Because of the drastically diminished supply, Carson City Environmental Health is considering shutting down its flu vaccine clinic scheduled for Oct. 16. The city health department has only 2,000 vaccines in stock.
"We want to be able to ensure we can provide vaccines to high-risk people," said Christi Smith, Carson City Environmental Health Specialist. "We need to sit down and take a look at the problem and make sure we can meet those needs."
Vaccine should be reserved for babies and toddlers ages 6 month to 23 months; people 65 or older; anyone with a chronic condition such as heart or lung disease; pregnant women; nursing-home residents; children on aspirin therapy; health-care workers who care for high-risk groups; and anyone who cares for or lives with babies younger than 6 months.
Nevada Health Division Epidemiologist Randall Todd said Carson health-care providers who have ordered vaccine from the other major U.S. supplier, Aventis Pasteur, will receive their vaccines, but doctors and clinics who ordered from Chiron Corp. may be out of luck.
Smith said Clark County health departments received the 34,000 vaccines they ordered from Chiron, Corp.
"It doesn't look good for them," she said.
For everyone else, "take a deep breath. This is not an emergency," said Dr. Julie Gerberding, head of the Centers for Disease Control and Prevention. "We don't want people to rush out and look for a vaccine today."
The government cannot impound existing vaccine to enforce the recommendations. It has urged voluntary rationing before, during a shortage in 2000 - but never before has the nation lost half its supply.
"We will need the help of the public," said Health and Human Services Secretary Tommy Thompson.
On Tuesday, British regulators suspended the license of Chiron Corp. for three months, citing manufacturing problems at the factory in Liverpool, England, where Chiron makes its leading Fluvirin flu vaccine.
The sanction means more than a delay, Chiron officials said: The company will ship no Fluvirin anywhere this year, including the 46 million to 48 million doses originally planned for the United States.
The rest of the U.S. flu shot supply - the 54 million doses - is coming from Aventis Pasteur, which already has begun shipping.
Chiron's problem started in August, when it discovered contamination in 4 million doses. But less than two weeks ago, top U.S. health officials assured the public that close FDA monitoring of the rest of the supply showed it was fine and there would be no shortage.
British officials didn't explain why they disagreed. U.S. Food and Drug Administration officials headed to Britain Tuesday evening to investigate, but wouldn't say if they would ask British regulators to release any of the shots for use here if the flu season proves to be a bad one.
It's unclear how the sanction will affect other countries. The Chiron factory in question supplies mostly the United States.
The government is taking other steps to ease the shortage:
-- Thompson asked Aventis to try to produce additional doses. The company didn't return a phone call seeking comment.
-- CDC is working with Aventis to alter its distribution plan so that shipments go to parts of the country that need them most for high-risk patients. That is important because some states had bought more vaccine from Chiron than Aventis.
"We don't have much leeway here and we're going to have to be very careful and parsimonious in the geographic distribution of this vaccine," Gerberding said.
-- FDA and NIH are studying whether Aventis' vaccine could be diluted to get two doses out of each original shot. A small NIH study several years ago suggested doing so could provide enough protection for healthy people, said Dr. Anthony Fauci, infectious disease chief for the National Institutes of Health.
Appeal staff writer Robyn Moormeister and Associated Press reporters Emma Ross in London, Marilynn Marchione in Milwaukee, Diedtra Henderson in Washington and Daniel Yee in Atlanta contributed to this story.
FLU FACTS
• High-risk patients depend on flu shots because the injections are made of killed influenza virus.
• For others, there is another option. About 1 million doses of an inhaled flu vaccine, MedImmune Inc.'s FluMist, will be available for healthy 5- to 49-year-olds.
• Flu shot campaigns usually start in October, a month before the flu season typically begins in the United States. In an average year, flu kills 36,000 people and hospitalizes another 114,000, mostly the elderly.
• Trading in Chiron's stock on the Nasdaq Stock Market was temporarily halted Tuesday morning. Share price dropped $7.69 a share, or 17 percent, to $37.73 after trading resumed.