Distribution Of Swine Flu Vaccine Faces Challenges

The first shipments of the swine flu vaccine have now been sent out to every state in the union. But the Centers for Disease Control and Prevention says that demand is still outstripping supply.

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The first shipments of swine flu vaccine have now been sent to every state. But the Centers for Disease Control says demand is outstripping supply. Only a relatively small amount of the vaccine was ready this week. As NPR's Robert Smith reports, the logistical challenge of distributing hundreds of millions of doses is unprecedented.

ROBERT SMITH: In New York City, people will line up for anything that seems scarce: tickets to the musical "Wicked," the raved about hamburgers at something called the Shake Shack. But Dr. Jane Zucker, of the New York City Department of Health says, so far despite the rarity of the swine flu vaccine, New Yorkers aren't mobbing the clinics.

Dr. JANE ZUCKER (Assistant Commissioner, Bureau of Immunization, New York City Department of Health): So far people are calm, and I thank them for that.

SMITH: Good thing too. The city of New York has received 68,000 doses so far. To put that in perspective, that would barely vaccinate the people who attended Bruce Springsteen show last night at Giants Stadium. So, Zucker says, so far they haven't advertised the availability of the vaccine and only sent out a few hundred doses each to doctors who requested it.

Dr. ZUCKER: That's really not very much to be able to handle what maybe a very large crowd. We've been focused on making sure that hospitals, for example, can start vaccinating their healthcare workers, which are part of the priority group.

SMITH: Zucker, and the CDC, say the same line over and over again: please be patient. Anne Schuchat with the CDC updated reporters today about the progress.

Dr. ANNE SCHUCHAT (Director, National Center for Immunization and Respiratory Diseases, CDC): There's probably more demand than supply but that's expected because the tap has just opened and we're just beginning with the supply.

SMITH: Schuchat says that they have 6.8 million doses ready this week and states and large cities have sent in orders for about half that. Now, that may sound like a surplus, but there's a lag time involved here. Everyday, states get an update from the CDC and make new orders based on what's available. The CDC has contracted the medical supply company, McKesson, to ship every dose directly to doctors and hospitals via FedEx. And this whole thing takes a little longer than the states would like.

Dr. SCHUCHAT: It's a little bit tricky for them because they'd like to be offering more and we don't have enough vaccine yet for them to really do the large scale rollout that we expect to occur in a couple of weeks.

SMITH: For instance, New York City won't open public vaccination clinics until the first week in November. It's put off school immunization until they have enough to do the roughly one million schoolchildren in the city. You might think a city like New York could throw it's weight around since it had a major outbreak of swine flu in the spring, but it doesn't work that way. The CDC is distributing the vaccine based on population. New York City has 2.7 percent of the population of the United States, and that's exactly the percentage of the vaccine it gets when the stuff becomes available. That leaves health departments with a dilemma: How do you start to push for mass immunization when the supply isn't there yet? Jeffrey Levi, director of the nonprofit group Trust for America's Health, says they have to carefully match supply and demand.

Mr. JEFFREY LEVI (Director, Trust for America's Health): We have this two-edged concern, one is that we'll throw party and everyone comes at the same time or we've thrown the party and not enough people come.

SMITH: And so health departments have the ads and public service announcements ready to go. Once it seems like enough of the vaccine is in place, they'll make sure you know about it.

Robert Smith, NPR News, New York.

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