Lines have been forming at the few remaining flu clinics in Rhode Island, where state health officials say there is little flu vaccine.
Hundreds of people waited for hours on Wednesday only to be turned away from supermarket clinics in Cranston and Narragansett, because each clinic had only 200 shots. Hundreds more phoned senior centers, doctors' offices and state offices seeking vaccine.
Rhode Island and other states face a major shortage of flu vaccine because a company that was to make half the nation's supply was shut down by British authorities.
Except for a few remaining clinics at supermarkets, the vaccine that was shipped to Rhode Island has been used up and it will be weeks the state gets more, said Robert Marshall Jr., assistant director of health. About 2,500 doses donated by CVS Corp. are being held in reserve for an outbreak or an emergency.
Rhode Island is not requiring doctors and others to report or turn over their vaccine stocks, but it is requesting they do so.
With scarce supplies of flu shots, prices go up -- way up
At Wesley Medical Center, Wichita, Kan., Jack Bond's hospital pharmacy needed 2,800 flu shots, but his supplier couldn't provide them. Plenty of other distributors were ready to meet his needs, though -- for a price: as much as $600 for a vial of 10 flu shots that normally costs around $80.
With no other choices, medical center officials thought about paying that price "as a last resort," said Bond, the hospital's pharmacy director.
Fortunately, other health providers in the area came to the rescue, sharing their supplies.
Around the country, health officials say some suppliers are trying to cash in on the flu shot shortage.
Connecticut officials have received numerous complaints about price gouging, state Attorney General Richard Blumenthal said. Blumenthal on Thursday urged Gov. M. Jodi Rell to declare a vaccine emergency. He said that would allow swift prosecution of profiteers.
Blumenthal said some private clinics reportedly were charging as much as $100 per dose, when the usual price is $20 to $30 per dose.
"Obviously the shortage of a vaccine combined with these very alarming abuses make these people victims twice over because they lack the vaccine and they may be price-gouged," Blumenthal said.
Rell ordered the state Department of Public Health to ask doctors, hospitals, visiting nurse associations and other healthcare providers to immediately report suspected cases of price gouging.
In Colorado, where hospitals have been offered vaccine for about $100 a shot, police were investigating the theft of 60 boxes of vaccine -- enough for 620 children -- from a suburban Denver medical office.
In south Florida, one hospital was told the price would be $140 a shot, according to vaccine maker Aventis Pasteur, currently the only company providing flu shots this year.
And those are prices for the hospitals. Typically, a consumer can pay as little as $20 for a flu shot, depending on the location.
Hospitals and federal health officials were caught off-guard at the start of the flu season when the nation's other major vaccine producer, Chiron Corp., announced it would be unable to provide the estimated 48 million shots expected this year. That's nearly half the supply federal health officials had counted on.
The British government banned Chiron's factory in Liverpool from shipping its vaccine because of contamination problems.
Because it takes months to develop vaccine, Aventis can't make more vaccine in time for the flu season. Aventis has only about 55.4 million doses available for this season, simply not enough to go around. The government is negotiating with other vaccine makers in hopes of shaking loose a bit more.
When a flu shot leaves the factory, Aventis charges $8.50 for it, and the company says it has not raised the price since Chiron's announcement. But prices easily can rise under the existing distribution system, which allows vaccine to travel from manufacturer to middleman before it reaches a hospital or doctor's office.
"There are companies out there that buy up and speculate on drugs that they think are at short supply and turn around and resell them at 10 to 100 times the mark up," said Bryant Herring, assistant pharmacy director for Wellmont Health System in Kingsport, Tenn., which has declined flu shot offers ranging from $65 to $100 a dose.
"It drives up healthcare costs and also limits the availability for patients who may not be able to afford it or need it most," Herring added.
Federal prosecutors could use a variety of fraud, conspiracy and other charges to pursue individuals or companies thought to be engaging in price-gouging. Some states are taking their own action. In Kansas, Attorney General Phill Kline is suing Fort Lauderdale, Fla.-based Meds-Stat for allegedly trying to seek "unconscionable profits" by offering another Wichita pharmacy flu shots for about $90 each.
Julie Gerberding, M.D., director of the Centers for Disease Control and Prevention, said her agency is working with states to help prosecute price-gougers.
"Shame on the people who are price-gouging," she said. "There's no room for this kind of behavior in an environment where we need to pull together as a country to protect our vulnerable populations."
There are many such vulnerable people -- 98 million, the CDC says -- who should be immunized against the flu virus.
Those people include babies and toddlers ages 6-23 months; anyone 65 or older; anyone with chronic medical conditions such as heart or lung disease; pregnant women; residents of long-term care facilities; children on chronic aspirin therapy; health workers who care for high-risk patients; and caregivers and household contacts of babies under age 6 months.
As one remedy to problems caused by the shortage, the CDC and Aventis Pasteur announced Tuesday a plan to redistribute the company's remaining shots directly to pediatricians, nursing homes and other places that care for high-risk patients.
"The new distribution plan ... will minimize price-gouging because it will keep the vaccine out of that rather diffuse distribution system of professional distributors and sub-distributors," said vaccine expert William Schaffner, M.D., chairman of preventive medicine at Vanderbilt University in Nashville.
It also will provide a shot-in-the-arm to areas completely devoid of the vaccine.
"You can't get a flu shot at any price in Nashville -- they're gone," Schaffner lamented.