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DEBORAH AMOS, host:

It's that time of year again, when the Centers for Disease Control and Prevention tells Americans to get their flu shots, or the nasal spray vaccine for those who are eligible. Apparently, it's also time for annual confusion about just when flu vaccine will be available, and where.

NPR's Richard Knox has this report.

RICHARD KNOX: Family physician Leonard Finn ordered flu vaccine for his patients last February. But so far, he and his colleagues in Needham, Massachusetts have gotten only 10 percent of what they need.

Last week, Finn asked 22 family doctors from around the Northeast if they were in the same boat. All but three said yes.

Dr. LEONARD FINN (Physician, Massachusetts): We're talking about 19 out of 22 doctors with zero or less than 10 percent of their usual order, while big chains everywhere have all the flu vaccine they need.

KNOX: It irks Finn to hear federal health officials urge Americans to get immunized against the flu before doctors have the vaccine.

Dr. FINN: It's very frustrating for them to say, yeah, there's vaccine, and then for patients to come in and see you don't have it. It's infuriating.

KNOX: CDC officials say they don't control the nation's complicated flu vaccine distribution system. But Jeanne Santoli, of the CDC, says the agency urges manufacturers and distributors not to favor big retail chains over doctors offices. She says the CDC wants to be sure people at highest risk for flu complications get vaccinated.

Ms. JEANNE SANTOLI (Centers for Disease Control): Everybody serves some patients who are at the highest risk. A provider's office certainly does, Walgreens certainly does.

KNOX: So it doesn't make sense, she says, to disadvantage doctors, who provide 70 percent of flu vaccinations.

Santoli says the vaccine suppliers say they're cooperating.

Ms. SANTOLI: What we've heard from the manufacturers and the distributors is that they are not favoring larger customers or orders over others.

KNOX: But Mark Mlotek, of Henry Schein, Incorporated, perhaps the largest distributor of flu vaccine to doctors' offices, says the CDC has not put out a clear message about how the vaccine should be distributed.

Mr. MARK MLOTEK (Henry Schein, Incorporated): I would have to say no, we don't have that recommendation from the CDC this year.

KNOX: In the end, the CDC says there should be no shortage of flu vaccine this year. In fact, there'll be more than ever before. But Mlotek says it's only beginning to ship from his suppliers.

Mr. MLOTEK: We don't have a lot of flu vaccine yet. It's going to be coming every week from now until December.

KNOX: Until shipments ramp up, he predicts there will be feast and famine on the vaccine landscape.

Mr. MLOTEK: Will there be Wal-Mart's who have it and doctor's offices who don't? Yes, I believe that that will happen again this year.

KNOX: The CDC is mindful of the problem, so this year it's putting out a more nuanced message: not just get your flu shot, but get your flu shot, but not too soon. It's okay to wait until November, December, or even later.

The bigger problem is indicated by a new national survey. Less than half the respondents say they plan to be immunized against the flu. But the CDC says nearly three-quarters of Americans should get vaccinated.

Richard Knox, NPR News.

AMOS: The CDC is also changing its recommendations on who should get the flu vaccine. You can get that information on npr.org/yourhealth.

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