Members of the general public might have to ride out the holiday season without getting vaccinated for H1N1 influenza.
Stanislaus County health officials have been trying to get the county's fair share of the vaccine to give to people in high-risk groups, and with the death toll rising, seemed to make a breakthrough this week.
The flu virus has caused serious illness in the county for 21 consecutive weeks, resulting in 10 deaths and the hospitalization of 154 patients. The most recent deaths were a 33-year-old man who died Nov. 2, a 48-year-old woman Oct. 21 and a 45-year-old woman Oct. 27, health officials said Thursday.
Last week, the county notified state health officials that it had not received an equitable amount of H1N1 vaccine compared with other counties, said Dr. John Walker, the county's public health officer.
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"We have been assured that our doctors and other health care providers will receive a high priority for receiving vaccine," Walker said Thursday. "There is evidence they are clearly making an effort."
As of Thursday, a national distributor had shipped 50,600 of the 67,700 doses ordered by local health care providers for people in high-risk groups, or about 75 percent of the vaccine ordered. Not all of it has arrived.
Two weeks ago, only 27 percent of the orders had been filled.
Guidelines on who gets it
Federal and state guidelines say the vaccine should go to parents and caregivers of children who are less than 6 months old, children age 6 months to 17, pregnant women, adults with underlying health conditions and health care workers.
County public health has held back on ordering the vaccine for public vaccination clinics so that available vaccine can be shipped to private physicians, nonprofit health clinics and hospitals. Last week, the county immunization clinic on Scenic Drive in Modesto designated 600 doses of the vaccine for pregnant women because local obstetricians had not received many doses.
"They are the ones who take care of the patients in targeted groups, who have the records and can identify the people who are at highest risk," Walker said.
The California Department of Public Health had expected to have 6.2 million doses from manufacturers by this month, but with the production problems has received 4.5 million, which hasn't been distributed equally to counties.
"We have taken concrete steps to level that out," Dr. Mark Horton, state public health director, said at a news conference. "We continue to see an increased number of doses being released and ultimately there should be enough for targeted groups."
Horton said he has stopped trying to predict when California will get its full allotment of the vaccine, but believes it will be after Jan. 1. An estimated 18 million Californians are in the categories considered vulnerable to the novel flu virus, including young to middle-aged adults.
Modesto-based Sutter Gould Medical Foundation, a major physicians group serving Stanislaus, Merced and San Joaquin counties, received about 4,000 doses of the injectable vaccine this week, just under 15 percent of its total order, spokesman Craig Baize said.
Its obstetrical centers are contacting pregnant patients to come in for shots. The vaccine also is going to health care workers who have direct contact with patients and the rest has been distributed to its primary care centers for patients 6 months to 24 years old, and adults age 25 to 64 with chronic health conditions, Baize said.
"We are giving vaccine to patients that already have scheduled appointments," Baize said. "When we receive more of the vaccine, we plan to have flu clinics, much like our seasonal flu clinics."
Doctors Medical Center received its first shipment of vaccine and started Thursday to give it to nurses, physicians and other staff who work with patients.
Local hospitals are moving toward tighter visitation restrictions to prevent the spread of H1N1 in their facilities. The Kaiser Modesto Medical Center has posted signs barring children 14 and younger from being in patient rooms.
Doctors Medical Center could have a policy in place by Monday, requiring those 16 and younger to stay with a guardian in the lobby. DMC spokeswoman Carin Sarkis said hospitals in the county have agreed to comply with the guideline from county public health.
The policies are based on clinical evidence that children are susceptible to H1N1 and also contagious for a longer time after being infected. Both Kaiser and Doctors said they will make exceptions in special cases such as the final wish of a terminally ill patient.
Christine Hoover, staff development director for Evergreen Rehabilitation Care Center in Modesto, suspects long-term-care facilities might be the last to get H1N1 vaccine "since the state thinks the elderly are among the least vulnerable." She conducted an orientation Thursday at which staff members were fitted with N95 masks.
The vaccine shortage has prevented the health workers from being vaccinated so far, she said. "If they are not vaccinated, my fear is they could bring it into the building or I could have a staff shortage due to illness," Hoover said.
The Safeway supermarket pharmacy on McHenry Avenue said it hopes to offer the vaccine starting Dec. 1, available permitting.
Bee staff writer Ken Carlson can be reached at firstname.lastname@example.org or 578-2321.