Federal health officials issued an urgent warning yesterday to people at high risk of catching influenza: Get your flu shot.
Because of mild flu seasons and memories of past shortages, a small fraction of those who should be immunized - including 20 percent of children younger than 2 - are getting the shots. But experts said the past is no guarantee of a mild season this year and that vaccine supplies are plentiful for the coming season, which runs from October to March.
"Flu is a formidable foe," said Dr. Julie L. Gerberding, head of the U.S. Centers for Disease Control and Prevention.
"They truly do have a benefit: People's lives are saved, and people's illnesses are reduced," Gerberding said of the shots.
Officials say the seasonal flu virus kills an average of 36,000 people a year and causes more than 200,000 hospitalizations.
The CDC extended the recommended flu shot season yesterday, so anyone who can't get a shot in October should have a chance to get one as late as January. The traditional peak of the flu season is in February, but in many areas, flu shots have been offered only until December.
The Baltimore City Health Department has received an initial supply of vaccine and plans to begin giving shots in city clinics and other locations beginning early next month, said Dr. Joshua M. Sharfstein, the city health commissionier. Vaccine is scheduled to arrive in physicians' offices, health clinics and hospitals in coming weeks, health officials said.
City and county health departments statewide have ordered 110,000 doses for adults and children, said Greg Read, program manager of the Maryland Center for Immunization. An additional 120,000 doses have been ordered for children who are uninsured or served by Medicaid, Read said.
"If we see an increase in flu cases or increased public demand, we can respond" with additional vaccine orders, he said.
At the University of Maryland Pediatric Ambulatory Center, physicians administered about 1,000 doses of flu vaccine to children last year, and that will probably rise to 2,000 or more this year, said Dr. James King, a professor of pediatrics at the School of Medicine and a flu vaccine expert. "I'm sure we're not the only ones increasing our order," he said.
Giant Food will begin giving flu shots Sept. 29, said Jamie Miller, a company spokesman. Rite Aid announced yesterday that its pharmacies will hold one-day flu shot clinics from Oct. 16 through Oct. 18.
CDC officials expect a record 130 million doses of vaccine to be available this season, about 10 million more than last year. About 102 million doses were shipped to health clinics, hospitals and doctors last year, said Dr. Jeanne Santoli, the CDC's immunization chief.
Manufacturers Sanofi Pasteur, GlaxoSmithKlein, Novartis and MedImmune are supplying flu vaccine, experts said. But public demand typically peaks in October, and production and shipments are not completed until January.
"It's not so much how many doses are available in the country as how it's distributed," King said.
As a result, not everyone who seeks a shot in the fall can find one. This has been problematic in recent years, when public service campaigns have boosted early demand. Many gave up the search too early.
"We have to sustain the demand so that people who want a shot can get one, even if they may have trouble getting one at first," Sharfstein said.
The CDC recommends flu shots for health care workers, people in long-term care, pregnant women, children ages 6 months to 5 years, anyone older than 50 and people of any age who have asthma, diabetes, heart disease or other chronic illnesses.
Those older than 65 also should be immunized against pneumococcal pneumonia, the CDC said. Unlike yearly influenza vaccinations, this type of pneumonia requires a one-time shot or at most a booster after five years for high-risk patients.
The CDC also recommends flu shots for household contacts who live with a high-risk person or with a child under 6 months of age for whom vaccination is not recommended.
The CDC wants 90 percent of health care workers and people 65 and older to receive annual flu shots by 2010. Currently, 40 percent of health workers and 65 percent of the elderly get the shots.
At Johns Hopkins Hospital, health care workers will be vaccinated or be required to sign a form documenting that they have declined. Last year, more than 80 percent of the hospital's health care staff was vaccinated, and this year's target is 100 percent, said Polly Ristaino, associate director of hospital epidemiology and infection control.
At University of Maryland Medical Center, a group of nurses gives flu shots to employees at their work stations, specifically to encourage the practice, said Dr. Craig Thorne, medical director for employee health and safety.
The Food and Drug Administration announced yesterday the approval of expanded use of the nasal influenza vaccine FluMist to include children ages 2 to 5.
Approval of the weakened-virus vaccine, made by Gaithersburg-based Medimmune Inc., had been limited to healthy children ages 5 and older and to adults younger than 50.
Gerberding called the FDA's approval "good news" because it gives health care providers another tool for fighting the flu.
Who should get a flu shot
Health care workers
Residents of long-term-care facilities
Children ages 6 months to 5 years
Those 50 and older and those of any age who have asthma, diabetes, heart disease or other chronic illnesses
Those who live with a high-risk person or with a child younger than 6 months
[Source: U.S. Centers for Disease Control and Prevention]