Plenty of flu shots promised; now push is to get them all used

WASHINGTON -- Come one, come all: After years of shortages and confusion, this fall promises plenty of flu vaccine to go around -- up to 132 million doses, more than the nation has ever produced.

The ample supplies have the government urging vaccinations not just for people at highest risk of dying from influenza, but for anyone who wants to avoid a week of aching misery.

"Flu is a formidable foe," Dr. Julie Gerberding, head of the Centers for Disease Control and Prevention, said Wednesday. "It is not an illness we should be complacent about."

But new CDC data show only a fraction of people who need flu shots the most get them, including just one in five babies and toddlers. And there's wide geographic variation, with Rhode Island reporting the most high-risk adults vaccinated and Nevada the fewest.

Shots aren't the only option. Wednesday, the government ruled that it's safe for younger children to try a nasal-spray vaccine called FluMist. Once only an option for people ages 5 to 49, FluMist now can be used by children as young as 2.

Flu usually peaks in February, so a winter vaccination isn't too late. Still, Gerberding advised seeking vaccine early in case flu begins striking before the usual November.

Indeed, there already are reports of sick schoolchildren in Hawaii, although the geographic distance makes it impossible to predict if that signals an unusually early flu season for the rest of the country.

Perhaps of more concern, the CDC is closely monitoring whether a new strain that emerged near the end of Australia's flu season will cause illness here -- a strain that this year's vaccine doesn't specifically target.

Each year's vaccine contains protection against three influenza strains -- two Type A strains, an H1N1 and an H3N2 version, plus a milder Type B -- that experts predict will cause the most illness. The vaccine isn't always a perfect match, and this year's contains a different H3N2 version than the newly emerging one, nicknamed H3N2/Brisbane-like.

Get vaccinated anyway, Gerberding stressed. The other two strains in the vaccine are causing illness around the world, and even if the newer one travels here, too, the vaccine should provide some cross-protection.

Every year, flu infects up to 20 percent of the population, causes the hospitalization of 200,000 people and kills 36,000.

Who's at highest risk? Anyone over 50 or under 5; people of any age who have asthma, heart disease, weakened immune systems or other chronic illnesses; and pregnant women.

Vaccine also is particularly recommended for relatives and caregivers of those people, and health care workers -- people who may be robust enough to recover themselves, but could infect the more vulnerable before they realize they're ill.

"The day before you become sick, you're already excreting the virus," warned Dr. William Schaffner of Vanderbilt University, vice president of the National Foundation for Infectious Diseases.

That equals 218 million people who should be vaccinated each year. Nowhere near that many seek vaccine. Last year, about 18 million of the nearly 121 million doses produced weren't used and had to be thrown away.

But the CDC's new estimates of how many high-risk patients get vaccinated, gleaned from public-health surveys, shed new light on the most troubling gaps.

People 65 and older are most likely to get vaccinated, 69 percent during the 2005-2006 flu season, the latest count available.

But that's still well under the national goal of vaccinating 90 percent of seniors -- even though Medicare provides them flu shots for free.

Just over a third of 50- to 64-year-olds are getting vaccinated, and just 30 percent of high-risk younger adults, CDC found.

Flu vaccine is a little more complicated for young children, because they need two doses a month apart the very first year they're inoculated. Just 21 percent of youngsters ages 6 months to 2 years were fully vaccinated, and just over one in 10 who needed two doses got both, CDC reported.

If a young child missed that necessary second dose last year, health officials are recommending that he or she make it up this year with two shots.

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On the Net:

CDC: http://www.cdc.gov/flu

National Foundation for Infectious Diseases: http://www.nfid.org