A dose of anger, doubt over swine-flu vaccine shortage

Hospital attorneys getting swine-flu vaccinations ahead of asthmatic kids.

Healthy young adults inoculated while hundreds of nurses, doctors and other front-line health workers still await their H1N1 shots.

A coveted cache of vaccine at a Safeway pharmacy, but reserved only for health-care workers without medical conditions.

Take an acute shortage of swine-flu vaccine, two distinct forms of it, plus latitude given by the state to local health officials about how to dole it out — and what do you get? Widespread confusion and anger about who, when and where residents in the Puget Sound area can get protection against swine flu.

But first the good news: King County by today is expected to receive its single largest shipment of H1N1 vaccine. The anticipated 67,000 doses would be three-quarters of the amount it received during all of October.

The bulk will be delivered to area hospitals, community clinics, long-term-care facilities and doctors' offices. About 15,000 doses will go to pharmacies, which could have the vaccine available to customers by the beginning of next week.

That won't come soon enough for people like Maureen Fonken, of Carnation.

Fonken's 10-year-old daughter, Rachel, got sick last week with what likely was swine flu. Mother and daughter, both of whom have asthma, repeatedly had been turned away after seeking the vaccine from pharmacies, their doctor's office and public-health clinics.

Fonken said she was particularly incensed after hearing that Snohomish County on Saturday gave out 28,000 doses at free clinics to virtually anyone who endured the hours-long wait.

The vaccines were meant only for people in priority groups, including pregnant women, children and people 24 and younger and those under 65 with certain chronic conditions. But officials in Snohomish County took people at their word and did not require identification or medical records.

"I want to know why other people are getting vaccinated and we aren't," said Fonken, who often gets bronchitis after catching the flu or a serious cold. "I want to know why we are not getting equity."

The answer is largely that there is not enough of the vaccine, said Matias Valenzuela, a spokesman for Public Health — Seattle & King County. The county has received less than 10 percent of the nearly 1 million doses it had ordered from the federal government. The shortage scuttled the county's plans to hold mass vaccination clinics or set up swine-flu-shot stations at schools, Valenzuela said.

Instead, King County doled out the vaccines to hospitals, clinics and physicians' offices. A small fraction — 4,000 doses — was sent to retail pharmacies. Most were distributed with specific conditions on who can get them, and health-care workers were in front of the line for much of the initial supply.

That meant many people seeking to be vaccinated were turned away even when doses were available because they did not fall into the specified high-risk group, Valenzuela said.

That the vaccine comes in a nasal-spray form as well as an injectable shot has further complicated the picture. The FluMist version is made with live virus, making it unsuitable for people with existing health problems — the very people who are at greater risk of complications from swine flu.

Some residents may have been denied the vaccine while others with seemingly less urgent needs got it, Valenzuela acknowledged.

"It's a challenging situation for everyone," he said.

The state Department of Health acts as a clearinghouse for vaccine orders but largely leaves it up to county health authorities to decide how to allocate their supply.

Snohomish County has taken a more coordinated approach than King County to distributing the vaccines. It reserved much of its first batch for health-care workers, said Suzanne Pate, spokeswoman for Snohomish Health District. Next, it opened up the supply to pregnant women and children under 5. Then last Saturday, it opened 10 free H1N1 flu clinics to anyone in the priority groups.

But on Wednesday, Snohomish County said it would cancel mass-vaccination clinics scheduled for this month because of dwindled supplies. The remaining vaccines will go to doctors caring for high-risk patients. Pharmacies and some physicians in Snohomish County won't be receiving more doses until vaccine supplies are replenished.

The unexpected shortage has forced health providers to scramble in other ways, too.

In Seattle, Swedish Medical Center used its initial batch to vaccinate all employees — including possibly staff attorneys and others uninvolved in patient care — before realizing it wouldn't have enough to cover all essential personnel, said Dr. John Pauk, Swedish's chief of infectious-disease control and epidemiology.

"When we found out that there was a shortage, we quickly changed the policy," Pauk said.

Kyung Song: 206-464-2423 or ksong@seattletimes.com