Public health officials in Craig waited anxiously Friday for 300 doses of influenza vaccine, but several faxes they received made them wonder if the vaccine would ever arrive.
"I spent the weekend wondering where the flu was," said Susan Bowler, the Northwest Colorado Visiting Nurse Association's public health nurse manager.
The vaccine arrived Monday, but as Bowler had feared, it was the last shipment of available vaccine to be found.
Beginning Friday, the VNA received dispatches from the Centers for Disease Control and Prevention (CDC) and the Colorado Department of Public Health and Environment (CDPHE) that foretold the coming shortage.
"They gave us a heads-up," Bowler said. "A little later we got a couple memos starting to talk about prioritizing."
One notice limited the eligibility for a federal vaccination program called Vaccines For Children. The other notice informed Bowler that manufacturers' supplies of the influenza vaccine were depleted.
The VNA began rationing the flu vaccine Monday.
The VNA administers vaccines through two mechanisms.
- Vaccines For Children is a federal program that provides states with money for vaccines for children whose families meet certain income guidelines. The cost for vaccination is based on a sliding scale, up to $15 a dose.
- The VNA also purchases flu vaccine with its own money and administers the vaccine to the public for $18 a dose.
As of Monday, the VNA has restricted eligibility to both programs. Using guidelines provided by the CDPHE and the CDC, the VNA now will dispense the flu vaccine only to people in the following target groups:
- Infants between the ages of six months and 23 months
- Adults ages 65 and older
- Individuals with certain chronic medical conditions
- Children and teenagers six-months-old to 18-years-old who are on long-term aspirin therapy and could develop Reye's Syndrome after the flu
- Women who are more than three months pregnant
While the VNA is bound to abide by the federal Vaccines For Children guidelines, it could ignore the restrictions in choosing how to dispense the vaccine doses it purchased on its own. In this sense, the VNA is like a private practitioner that can give the vaccine to anyone it chooses.
However, Bowler decided to apply the restrictions across the board.
"Because I trust the CDC and Dr. Calonge (the state's chief medical officer), we're going to follow their recommendations," Bowler said.
The VNA administered about 4,000 doses of flu vaccine this season in Moffat and Routt counties. It has 300 doses remaining.
"All Craig clinics are out, and it doesn't sound like they're going to be able to get any more," Bowler said.
But she said she there is another vaccine that comes in a nasal spray. It can only be given to healthy people between the ages of five and 49. Clinics in Craig may have supplies of the nasal vaccine, Bowler said.
Bowler said she has referred many patients to Steamboat Medical Group, which had 500 doses of flu vaccine Monday.
Dr. Steven Ross, who practices in Steamboat, also has some remaining vaccine, Bowler said.
Media coverage of flu deaths has caused many parents to become overly afraid, Bowler said. Parents have told her, "The news scared me."
Bowler admits there is cause for concern, but she advises parents to use common sense, practice diligent hand-washing and keep their children away from others who are sick.
She echoed Calonge's advice to consult a physician if a child is:
- Suffering from a fever that will not respond to over-the-counter medications, such as acetaminophen or ibuprofen.
- Not interested in playing or other activities, especially after the fever comes down
- Inconsolable or irritable and cannot be calmed down
- Not drinking fluids or is unable to keep fluids down
- Having difficulty breathing or exhibits fast, hard breathing
"Every child that gets influenza isn't dying, and not every child that dies had the flu," Bowler said. "There are children dying of other things."
Bowler has contacted local schools, who have promised to notify her if they begin to see significant absentee rates due to flu-like illnesses. Although the schools are reporting illnesses, they aren't reporting much influenza, Bowler said.
"They're not seeing a large number of influenza in kids," Bowler said. "That's not to say it's not going to come."
The schools have reported cases of pinkeye, children with symptoms of sore throat and illnesses involving diarrhea and vomiting.
"Schools have other illnesses they're seeing, but not a lot of flu," Bowler said.
Jeremy Browning can be reached at 824-7031 or firstname.lastname@example.org