The national H1N1 flu vaccine shortage is hitting the University of California, where campuses and medical centers have scant supplies.
UC can't purchase flu vaccine doses itself. The university and other health care providers in the state rely on local public health departments to supply them.
"The H1N1 vaccine is trickling in at best at the medical centers and it's almost nonexistent at campuses," said Grace Crickette, UC chief risk officer. "Our expectation is that the public health departments will give us some, but it's going to be limited and sporadic."
Meanwhile, Kaiser Permanente -- which has about 6.6 million members in California, including almost 32,000 UC employees -- does have larger amounts of H1N1 vaccine, which it is giving to high-risk groups first. Kaiser has a larger supply of H1N1 vaccine because it entered a 1998 partnership with the state Department of Public Health and the national Centers for Disease Control and Prevention to augment flu surveillance efforts. As part of Kaiser's participation in the California Influenza Surveillance Project, that allows it greater access to flu vaccine.
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Vaccine priority groups include pregnant women, children 6 months to 18 years old, young adults 19 to 24 years old, caregivers of children younger than 6 months, adults 25-64 years old with chronic health conditions and health care and emergency workers.
While UC would like to inoculate all UC employees who fit those priority groups, employees should get vaccinated outside of UC if they can, Crickette said. UC employees with Kaiser health insurance should get vaccinated there, and employees with other insurers should check with their physicians or public health departments, she said. Similarly, UC would like to offer H1N1 flu clinics for students, but due to the vaccine shortage, students should take advantage of any other opportunity to get vaccinated.
"Pharmacy departments are under considerable pressure from providers and patients to deliver vaccine," said John Grubbs, pharmacy director for UC Davis Medical Center. "I spoke on the phone last week with a patient who wanted to know why she can't get her child vaccinated and why we don't have vaccine when other providers (i.e., Kaiser) have had it for several weeks. She even said since it's now open enrollment for health insurance, she's considering choosing a provider other than UC Davis because she wants to be confident that she can get her vaccines next year."
H1N1 remains widespread. Of the nation's colleges tracking influenza-like illnesses, 97 percent have reported cases, according to the American College Health Association. While most cases have been mild, the virus can be deadly. UC continues to promote good hygiene among faculty, staff and students, but getting vaccinated is the best thing people can do to prevent hospitalizations and deaths related to flu, public health experts say.
The problem is finding the vaccine. Although manufacturers are increasing their production of the vaccine, only 17 million doses of H1N1 vaccine had been shipped nationally as of Oct. 28, according to the CDC. That includes 2 million doses to California out of 20 million expected this season.
At UC's medical centers, Davis had no H1N1 vaccine as of Oct. 30. UCLA Medical Center received only 500 doses, UC Irvine Medical Center about 670 doses and UC San Diego Medical Center received about 4,500 doses -- of which 3,000 were given to staff and medical and pharmacy students. UC San Francisco Medical Center said Monday (Nov. 2) that it received about 2,100 doses in its first shipment of H1N1 vaccine -- which will go to employees who work in high-risk and high-prevelance clinical units as well as to its highest risk patients such as children and pregnant women. UCSF expects its next shipment within two weeks.
"At those medical centers where supplies have been limited, appropriate risk stratification has been developed to ensure that those employees working directly with patients in high-risk areas are the first to receive immunization with the H1N1 vaccine," said Eugene Spiritus, M.D., chief medical officer at UC Irvine Medical Center.
At UC campus student health centers, Davis, Irvine, Merced, Riverside, San Diego and San Francisco had no H1N1 vaccine as of Oct. 30. Berkeley received only 30 out of 70,000 requested doses of H1N1 vaccine. UCLA and UC Santa Barbara had very limited amounts of H1N1 vaccine. UC Santa Cruz did receive 2,000 doses of H1N1 vaccine from its local public health department -- and gave out 1,900 of them through three student vaccination clinics and health care/first responder staff immunizations. UC lacks the authority to re-allocate to other campuses and medical centers vaccines that have been provided by public health departments.
"We are making daily requests to the local public health departments for supplies, including seasonal flu vaccine, which some of our locations are out of; H1N1 vaccine, which most of our locations have not received; and N95 masks," Crickette said.
Health care workers use N95 masks, or fit-tested respirators, for additional protection. But it's also a challenge for UC to get those needed supplies. UC has made a commitment to purchase 194,800 N95 masks and expects to receive them in three equal portions shipped in November, December and January.
UC officials are monitoring the situation daily and will continue to provide updates, Crickette said.
Alec Rosenberg is coordinator of health science communications at the UC Office of the President.