Flu may have peaked in Massachusetts as vaccine supplies dwindle

Some Massachusetts doctors have run out of flu vaccine and the state Department of Public Health exhausted its supply this week as health officials urged almost everyone to protect themselves against the more severe virus strain circulating this year.

But state and federal health data released Friday suggest that the flu season may be on the downswing here and in some other states, with a drop in the percentage of patients visiting doctors offices during the first week of January who had flu-like symptoms.

Increased demand for the vaccine—fueled partly by Boston Mayor Thomas M. Menino’s declaration on Wednesday of a public health emergency—has led some Massachusetts residents to search for the immunization in vain.

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Chelmsford pediatrician Dr. Mark Gilchrist said via e-mail that he didn’t receive an anticipated shipment of vaccine from the state health department for his pediatric patients, which has never happened to him in the past. He was informed earlier this week that his practice was being put on a wait list to receive more doses as they became available. “The best lesson to take home from this in the future,” he wrote, “is to get your influenza immunization as early as possible.”

State health officials sent an e-mail to health care providers on Wednesday to let them know that they have “no remaining flu vaccine” and that they have established a waiting list for doses requested for children. They directed physicians to order immunizations from the manufacturers, who say that they have remaining supplies but that delivery may take some time.

Dr. Lauren Smith, interim state health commissioner, said in an interview Friday that the health department gained access to some additional pediatric vaccine doses and would be making them available to doctors by the middle of next week. Local boards of health that contacted the health department requesting vaccine this week, she added, would be receiving doses from clinics elsewhere in the state that have some extra supply.

“There are spot shortages of the flu vaccine across the country, and you may have to check several places to find a vaccine,” said Dr. Thomas Frieden, director of the federal Centers for Disease Control and Prevention during a press briefing on Friday. “Most of the more than 130 million doses have already been given.”

Some pharmacies have also experienced shortages of Tamiflu (oseltamivir), an anti-viral medication used to treat the flu, especially in pediatric formulations. The CDC recently issued instructions to pharmacists on how to create liquid suspensions for children from adult pills, Frieden said.

After the emergency declaration, Boston provided 4,500 vaccine doses to 21 community health centers that will be given out for free over the weekend in addition to whatever supplies the clinics have left, according to Nick Martin, a spokesperson for the Boston Public Health Commission. Here’s where to find a free flu shot. The city bought the vaccines directly from manufacturers.

The worst of the flu season, however, may be over if the latest data from the state health department is any indication. During the first week in January, 2.9 percent of doctor visits were for flu-like illness compared with 4.4 percent of visits during the last week in December. Whether that means the flu has reached its peak in Massachusetts remains unknown, said Smith. The drop could also be due to a surge in patients getting treated for norovirus, a gastrointestinal illness that is sweeping the region.

While the flu has officially reached epidemic proportions throughout the country, the CDC said the number of states with severe outbreaks has declined, and the virus appears to have peaked in some Southern states.

Vaccine manufacturers say they have some extra supply on hand, but it may take doctors several days or even weeks to get immunizations after placing an order. MedImmune, maker of the FluMist vaccine, has more than 380,000 doses of the spray—which contains an attenuated form of the live virus and is often the vaccine of choice for children age two and older. “Additionally, we have a reserve order for 250,000 FluMist doses that would be shared between Medicaid’s Vaccine For Children’s (VFC) program and the Department of Defense,” spokeswoman Melissa Garcia said.

Sanofi Pasteur, the biggest flu vaccine manufacturer, has injections of Fluzone available for immediate shipment for adults ages 18 to 64 and a high-dose form for those age 65 and older. The company said in a statement that shots for children over age six months, however, are out of stock and won’t be shipped until the end of January.

This year’s flu vaccine appears to be somewhat less effective than in previous years, even though it’s well-matched to the circulating virus strains. In testing conducted by the CDC, the vaccine was found to be effective only 55 percent of the time against the H3N2 strain, according to results released on Friday. This strain accounts for nearly all of the flu infections in Massachusetts and has been causing more severe symptoms than other strains, including fever, cough, and body aches, as well as occasional diarrhea and vomiting.

The CDC acknowledged that, as in the past, the vaccine is even less effective in people who are elderly or have impaired immune systems that make them more susceptible to life-threatening complications that occasionally occur with the flu. “The people most susceptible to influenza are the most likely to not have effectiveness from vaccine,” the CDC’s Frieden said. While he called the vaccine “far from perfect,” he added that “it’s still by far the best tool we have to prevent the flu.”