Corporate Programs get First Shot at Flu Vaccine

      Already a month late, shipments of this year''s flu vaccine are first going to private businesses that paid top dollar for them, relegating public health programs that vaccinate the poor and elderly to the back of the line.

      Federal health guidelines recommend vaccinating high-risk patients -- health care workers, the elderly and the chronically ill -- first. But the hospitals, clinics and nursing homes that vaccinate these folks are still awaiting vaccines that may not arrive in time for the approaching flu season.

      Meanwhile, employees at conscientious companies across the country -- including The Chronicle -- are rolling up their sleeves for influenza vaccinations, and shoppers are lining up at supermarkets and drugstores for free or low-cost shots.

      "The people who need it most are at the low end of the totem poll," said Dr. Annemary Franks, a Berkeley pediatrician who worries about children with asthma and heart disease who will have to wait. "We''ve been told the `end of November,'' by our distributor, but that''s late," she said.

      The problem has caught the attention of Surgeon General David Satcher, who urged young and healthy people yesterday to postpone their flu shots until December so older patients can be vaccinated first.

      "We need you to help in a public health strategy," he said."

      `ON THE PHONE ALMOST DAILY''

      Many corporate programs already have received their vaccines while the state program that supplies 700,000 doses of flu vaccine to public health clinics and nursing homes around California keeps waiting.

      "We''ve been on the phone almost daily, trying to get our vaccine," said Dr. Natalie Smith, immunization branch chief for the California Department of Health Services. So far, only 35 percent of the order has been delivered.

      California''s flu season usually begins in mid-December and peaks in January and February. Because it takes two weeks for a flu vaccine to build up immunity, even a late November vaccination will probably do the job. But with the stakes so high -- influenza is a killer in nursing homes -- this year''s distribution snafu is leaving little margin for error.

      "It''s a major issue for us, not just for our patients, but for our employees. They''re the ones who catch it and bring it into the building," said Paul Tunnell, regional director of operations for Vencor, which runs 11 nursing homes in Northern California.

      Tunnell said none of his facilities has received vaccines from county health programs, which get their supplies from the state.

      "If it (the flu) hits before mid-November, people are going to die because of this," he said.

      Julie Billington, a Berkeley mother of two small children, said she is outraged that health care providers are not getting the vaccine first.

      "It seems unbelievable to me that doctors'' offices aren''t getting the vaccine, yet a healthy adult can walk into the supermarket, or their office, and get one," she said.

      SLOW-TO-GROW VIRUSES

      Doctors have known for months that this year''s flu vaccine would be late. Flu vaccines are grown in banks of fertilized chicken eggs and always have been tricky to produce. The current vaccine is made from three strains of influenza virus that turned out to be slow to grow in the eggs.

      Adding to the delays, the Food and Drug Administration ordered one manufacturer, Parkdale Pharmaceuticals, to suspend production of about 9 million doses because of quality-control problems. A second manufacturer, Aventis Pasteur, agreed to pick up the slack and will produce 35 million doses this year.

      "Normally, this whole cycle takes place over a three-month period. Now, it''s a four-to-five-month period," said Len Lavenda, a spokesman for Aventis, a Swiftwater, Pa., firm.

      Lavenda said that because of the unexpectedly slow growth of the vaccine, manufacturers have been caught in a financial bind. "It''s costing us. It''s had a negative impact on our bottom line," he said.

      The vaccine makers are locked into contracts with their distributors, which decide who gets the vaccines first, he said.

      Many of the mass immunization clinics offered in the Bay Area are run by Sutter Visiting Nurse Association & Hospice, which provides flu shots for $12 a pop at shopping center stores such as Longs Drugs. This year, the organization ordered 150,000 doses. Sutter VNA spokeswoman Gerri Ginsburg said the organization is confident it will receive enough vaccine to start the first of 2,000 flu shot clinics in Northern and Central California on Nov. 7.

      "We''ve been subject to the same delays as everyone else," she said. "But we are confident we will get 100 percent of the vaccine we have ordered."

      Corporate programs frequently contract for immunization services with smaller health care companies, which get their vaccine from the distributors. The Sacramento firm Clinical Health Appraisals, for example, provides vaccine for more than 30 different clients -- including The Chronicle, where a program to vaccinate employees began Tuesday.

      "I got my shots when I asked for them," said Michael Otto, president of Clinical Health. "I have a relationship with a distributor, which has a relationship with a lab. As a businessman, I was able to deliver for my clients."

      Otto said price does play a role in who gets the vaccine first. "I bought mine at twice what some other companies are paying. They told me, if you want it, this is what I''ve got to pay," he said. He had to lock in his vaccine supplies, at $47 a vial, in April.

      State programs supplying nursing homes, on the other hand, are paying $17 for a 10-shot vial, according to the state health department.

      KAISER ALSO WAITING

      Big health care providers such as Kaiser Permanente also have had to wait for their vaccine. According to Kaiser spokesman Tom Debley, deliveries of 1.5 million doses from manufacturer Wyeth-Ayerst have begun, but clinics will not be ready to provide shots until Nov. 20. Doctors, nurses and other staff members, as well as high-risk patients, already are being offered immunizations.

      Because Kaiser serves roughly one in six Californians, the health care giant is also tapped by the state to serve as an early warn

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