OFFICIAL: Go to the back of the office please if you just came in. We will call your number when we're ready. Thank you.
TOM BEARDEN: In the Denver area, people have been lining up to get influenza vaccinations.
OFFICIAL: Do you have a doctor's order?
WOMAN: I do.
OFFICIAL: Okay, they have a standing order for us.
TOM BEARDEN: People came from all over the state to the few clinics that still had vaccine available, trying to get shots for their children.
OFFICIAL: You need to get your hand away from my hand. Can you wait for ten minutes afterward?
TOM BEARDEN: Erica Braun had been at it for two days.
ERICA BRAUN: Came in yesterday, and the line was just ridiculously long, wrapping around the hallways, so I decided to try to come back this morning, get here about an hour before they opened. And it looks like they started actually earlier than they scheduled to.
TOM BEARDEN: The reason it's difficult to find vaccine is because the flu season started unusually early. Parents poured into hospitals and clinics after the deaths of 11 children in the state from respiratory complications due to the flu. And 36,000 people die from the flu nationwide every year.
ANGELA BENNINGFIELD: Actually I wasn't going to have him get a flu shot originally because he stays home with me. However, after the media, you know, letting everyone know how many children died this year, I went ahead and got him his flu shot.
WOMAN: Do you know, ballpark, what the wait is?
OFFICIAL: All the nurses should be here now, so I think we'll be maybe an hour.
TOM BEARDEN: This clinic has had to extend its hours and has been taking in more than three times as many as patients as last year.
OFFICIAL: The wait's been an average of two hours plus. Yesterday's clinic started out to be two hours. It ended up being about three and half hours. We've been doing pretty well, though. It's been averaging about 300-plus every day since about last week, so ... we will probably get a shortage here soon, because we've been doing so many, but we're trying to hold some back for the booster shots, of course, for the second half for people's children.
TOM BEARDEN: But in other areas of Denver, thousands had to be turned away as vaccine stocks were depleted. This week the state health department distributed an emergency supply of about 4,000 doses, but they were far short of the demand. Once crowded clinics, like the Concentra Healthcare location in boulder, are now empty.
TOM BEARDEN: What's your supply like now?
BRIDGET JOHNSON, Concentra Healthcare: We are out of vaccine. There are few more Concentras in the Denver area that have a few left, but unfortunately, we ... our supply is gone.
TOM BEARDEN: Expect any more?
BRIDGET JOHNSON: We do not. They are saving the companies that manufacture, are saving for, you know, high risk and other states that haven't received their supplies yet. So unfortunately we aren't able to get anymore.
TOM BEARDEN: Dr. Mary Glode is the head of pediatric infectious disease at Children's Hospital in Denver.
DR. MARY GLODE: I think that we have certainly seen more cases of flu this season than we've seen probably in 20 years, and I think that children are disproportionately affected with it, and my personal explanation for that would probably be one of susceptibility that this is a strain to which they have no immunity. So if it's in the community and being transmitted, they're really at very high risk. They're just not immune to it.
TOM BEARDEN: More than 7,500 cases of the flu have been reported in Colorado, and more than 40 percent of those have occurred in children under 5.
DR. MARY GLODE: Most at risk are certainly the younger children, and that I think relates to the known complications of flu which are a croup-like disease, viral pneumonia. Children have very small airways, so when they get inflamed and infected, they may get compromised for those airways easier than an adult with a larger airway.
TOM BEARDEN: Chuck Stout heads the Boulder County Health Department. He says the county is now rationing the very few doses of vaccine they have left, and suggesting adults ask their physicians about using an alternative, nasal mist.
CHUCK STOUT: Well we have probably 200 doses left that we are prioritizing now only for very young children, six months to 23 months. And referring healthy adults, 5 through 49, to physicians for nasal mist, but we virtually have no additional vaccine that we can give to the general population.
TOM BEARDEN: But Stout says the nasal mist, a flu vaccine inhaled through the nose, contains live virus and should only be used by healthy individuals over the age of 5. It's also expensive, at about $65 a dose. On Tuesday the federal centers for disease control announced that the U.S. has obtained an additional 375,000 adult doses of vaccine from Europe.
While the vaccine is never 100 percent effective, this year's batch could be even less effective than in the past. Every year the Food and Drug Administration tries to identify which strain of influenza will be predominant in the coming flu season. Public health officials were aware that the A-Fujian virus would likely hit the U.S. this year. But it wasn't included in the vaccine because they didn't have a well-tested way to culture it. So they decided to use A-Panama, a strain of the virus that is similar to A-Fujian, but not a direct match.
SPOKESMAN: Finally I conclude with a few comments about SARS...
TOM BEARDEN: Dr. Theodore Eikoff is a member of the FDA panel that makes decisions on what viruses will be included in each year's flu vaccine formula. He says the problem is the available A-Fujian strain can only be cultured in animal tissue. Typically flu vaccines are cultured in eggs.
DR. THEODORE EICKHOFF: The problem is that once one passes influenza viruses, such as this A-Fujian strain, in tissue culture systems, there is the chance that it might pick up some bits of RNA Or DNA from the host tissue, the host cell in the tissue culture system. And this introduces safety considerations. So most tissue culture systems are still ... still raise a big red flag for the people at Food and Drug Administration who do not want to use those kinds of strains for vaccine production.
TOM BEARDEN: Dr. Eikoff says even though the vaccine does not contain A-Fujian, he thinks people should still take it.
DR. THEODORE EICKHOFF: There is some protection. We don't know how much, and it will probably be the end of the season before we have a good estimate of how effective. My own guess is somewhere in the ballpark of 40 to 60 percent effective.
TOM BEARDEN: On Tuesday, the Department of Health and Human Services announced they would give vaccine producers $50 million to increase production and develop new technologies to target and reproduce emerging strains of the virus.
SPOKESPERSON: Should I stop trying to pick it up?
TOM BEARDEN: In Colorado, state health officials have said they think the worst is over, but Dr. Eickoff is still worried.
DR. THEODRE EICKHOFF: I'm fearful that they're wrong and that we'll see another wave of influenza, if you will, particularly among the elderly and the chronically ill.
OFFICIAL: This is his first shot, correct?
TOM BEARDEN: With the virus supply being depleted around the country, physicians are reinforcing their message of prevention. Doctors say the best advice they can give is to try to avoid contact with people who are ill and to wash one's hands frequently.
Dr. Glode says a large influx of vaccine into Colorado is unlikely, so parents should be vigilant in monitoring whether their children are having trouble breathing, have a bad cough, and a high fever. She also points to a new test available for physicians to diagnose the flu, which can help speed treatment.
DR. MARY GLODE: This is test that's used a great deal by the physicians in our emergency department, so when they see a child and they're suspicious about whether or not it's the flu, they can obtain a nasal wash from the child, send it to the laboratory, and in about ten minutes now, sort of similar to a pregnancy test, you can identify whether the patient has influenza "A" or influenza "B" rapidly. This then allows the physician to make a rapid diagnosis, counsel the patient and the family about the appropriate therapy.
OFFICIAL: Well, she is great.
TOM BEARDEN: With all 50 states reporting flu cases, health officials worry about a difficult road ahead with still three months remaining in the flu season.