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That company was shut down after it was determined vaccines may have been compromised, said Ms. Ayers, and a back-up order of 1,000 doses from Adventis Pasteur has yet to be delivered.
"We have nothing in house as we speak," she said. "We are working with the state health department and have let them know how much we had ordered and from where. We now must prioritize the at risk population."
When vaccines are available, the County Health Department will issue a statement, said Ms. Ayers. "We're hoping to get some by the end of the month," she added.
Annually, the county gives between 2,400 and 3,000 flu shots a year, for both at-risk and healthy people.
"We used to begin in September, but were told (by the Centers for Disease Control) that in this area we shouldn't start until mid-October as flu season here really doesn't begin until the end of the month," said Ms. Ayers. "Getting the vaccine later will give people better coverage."
According to information provided by the state Office for the Aging, the Centers for Disease Control was notified by Chiron Corporation October 5 that none of its influenza vaccine would be available for distribution in the United Stated for the 2004-05 flu season.
The company said the Medicines and Healthcare Products Regulatory Agency in the United Kingdom, where Chiron's vaccine is produced, suspended the company's manufacturing license for three months.
"This will reduce by approximately one-half the expected supply of flu shots available in the U.S.," said Ms. Ayers.
The remaining supply of flu vaccines that is expected to be available in this country this flu season is about 54 million doses, manufactured by Aventis. Of those doses, some 30 million have already been distributed.
In addition, approximately 1.1 million doses of the vaccine manufactured by MedImmnune will be available this season.
State Department of Health spokesperson Kim Volean confirmed the state is in the process of fully assessing the impact throughout the state.
"We're not dispersing the vaccine at the state level until this process is done," she said. "We're in touch with hospitals, clinics, nursing homes, home health care agencies, physicians and the business community. We have to know everyone's situation and then will be better able to determine where the vaccines need to go."
Local doctors have received a very small number of doses compared to what they ordered and need. One family doctor's office in Schodack reported getting 100 shots.
A receptionist there said it has been hard to figure out who to give the shots to. The practice cares for between 500 and 600 people.
Other health care facilities in the area are reporting similar circumstances, receiving fewer vaccines than they need.
But some local residents received flu shots and are not feeling guilty for doing so.
Maggie and Tom Snow of Schodack are in their early 90s and late 80s, respectively, and are therefore eligible for the vaccine.
"Even last year after I got the shot, I ended up in the hospital with some sort of upper respiratory infection that never did get diagnosed," said Mrs. Snow. "I think it was the flu. I can't imagine how sick I would have gotten had I not had the shot."
Mr. Snow was willing to give up his shot for someone in more need, but his wife insisted he get one.
"I'm pretty healthy and think I could have gotten by, but Mag said no way, that I was to take care of myself and her first," he said. "I guess that's good advice."
Because of the situation, the Centers for Disease Control, in coordination with its Advisory Committee for Immunization Practices, issued interim recommendations for flu vaccines during the 2004-05 season.
Priority groups for vaccination with inactivated influenza vaccine this season are on a first-come, first-serve basis. The groups include
+All children aged 6 to 23 months;
+Adults aged 65 years and older;
+People aged 2 to 64 years with underlying chronic medical conditions;
+All women who will be pregnant during the flu season;
+Residents of nursing homes and long-term care facilities;
+Children 6 months to 18 years of age on chronic aspirin therapy;
+Health care workers with direct patient care;
+Out-of-home caregivers and household contacts of children ages less than six months.
People in those priority groups are encouraged to search locally for shots if their usual health care provider does not have the vaccine available.
People not included in one of the priority groups should be informed about the lack of vaccine and asked to forego or defer vaccination.
Two local nursing homes did not return calls for comment in time for this article.
Victoria Lane was one patient at the Schodack doctor's office who was told she and her children could not get shots this year.
"I'm not angry," she said. "I want someone who needs the shot more to get it, but if we do get the flu I think someone should help pay for the associated heath care costs."
State Health Commissioner Antonia Novello is urging New Yorkers to take simple precautions to prevent the spread of the flu virus and to help health practitioners and officials better ensure that the currently available doses get to those who need them most.
"It's important to realize that for most healthy people, coming down with influenza is uncomfortable, but not a serious health threat," Dr. Novello said in a prepared statement.
The state is implementing several initiatives to ensure that New York State is comprehensively monitoring all aspects of flu activity and vaccine supplies by using the state's innovative Health Emergency Response Data System to collect vaccine information from hospitals.
Dr. Novello is also sending letters to health care providers and organizations requesting, among other measures, their full compliance with emergency protocols that will allow the state to act quickly and appropriately to address this vaccine shortage.
She recommends residents take an active role in preventing the flu by checking with their health care provider to determine if the intra-nasal vaccine is appropriate, of which an additional 1.1 million doses are available; practicing good respiratory hygiene and hand washing; and remaining home when sick.
Those who get the flu need to get prompt treatment.
Ms. Volean said the state is also working with the Consumer Protection Board and wants to know immediately if residents have complaints regarding price gouging because of the lack of availability of the drug.
New Yorkers are asked to call the Consumer Protection Board at 1-800-697-1220 or email www.nysconsumer.gov.
