DALLAS -- More than a month after the swine flu vaccine began arriving in Texas, the doses are still showing up in piecemeal fashion, frustrating doctors who can't tell their patients exactly when the vaccine will arrive.
"We're being bombarded with requests to see when we're going to have it," said Dr. Armando Jarquin, president of the Harris County Academy of Family Physicians.
He said many family practitioners in the Houston area still hadn't gotten any vaccines, while others had received a dozen or so doses. Jarquin, who has his own private practice in Katy, said that he hadn't gotten any of the 750 doses he ordered and that his office was fielding 15 to 20 calls a day asking when they would arrive.
"I'm not really optimistic that I'm going to get what I ask," Jarquin said.
Meanwhile, Dr. Jonathan MacClements, family medicine program director for the University of Texas Health Science Center at Tyler, said that in the last three weeks the center had started getting enough vaccine regularly to give it to the high-risk groups. But he said it's still tricky getting information to patients because officials at the center never know how much will arrive.
For now, the Texas Department of State Health Services is focusing on getting the vaccine to hospitals, private practices and local health departments, spokeswoman Carrie Williams said. The state had been allocated 3.2 million doses as of Thursday, with the highest numbers going to hospitals, she said.
Swine flu has sickened about 22 million Americans since April and killed nearly 4,000, including 540 children, according to startling federal estimates released Thursday.
The Centers for Disease Control and Prevention's latest report, calculating the first six months of the H1N1 strain's spread, from April through mid-October, shows that:
* Some 98,000 people have been hospitalized from this new flu or its complications, including 36,000 children, 53,000 adults younger than 65 and 9,000 older adults.
* Deaths could range from a low of 2,500 to as many as 6,100, depending on how the data are analyzed. CDC settled on 3,900 as the best estimate.
* Some 8 million children have become ill, as well as 12 million adults younger than 65 and 2 million older adults.
And tight supplies of vaccine to combat the illness continue: Not quite 42 million doses are available in the United States, a few million fewer than CDC predicted last week.
In Texas, state officials are working their way through priority groups and adding groups as more vaccines arrive, Williams said. They are targeting pregnant women, those in close contact with babies 6 months and younger, children 6 months through 4 years, children 5 through 18 with high-risk conditions and health workers.
Williams said they were not allocating doses to "community vaccinators," companies that only provide vaccines.
There have been hiccups in the system, though, with the state cutting off doses to a Dallas-area company that Williams said misrepresented itself as a private practice provider but was operating more like a community vaccinator and was not focusing on giving shots to high-risk groups.
Williams said Star Medical Group was cut off by the health department at 11,000 doses.
Elaine Vitt, a spokeswoman for Star Medical Group, which had requested about 360,000 doses, said the company did not misrepresent itself and was working with the state to clear up any misunderstandings. She said the company was an integrated health practice and that when it first got the shots, it contacted its high-risk patients. But after a local television station featured it while doing a story about the arrival of swine flu shots, the company was inundated with hundreds of people.
So, Vitt said, the company decided it could serve its patients and the public and took non-patients on their word that they were part of the high-risk groups.
Part of the confusion, she said, may have occurred because its sister company gives mass inoculations.
Last week, the state announced that it would increase the amount of vaccines to local health departments, giving them 20 percent of the state's weekly allotment.
Dr. Fernando Guerra, director of health for the San Antonio Metropolitan Health District, said he thought more than 20 percent should be given to health departments, which are being contacted to help back up supplies for entities that haven't gotten their supply yet.
Zachary Thompson, director of Dallas County Health and Human Services, said that so far, the department had gotten 10,700 doses, which have gone to high-risk patients in the uninsured group it usually covers. With an expected upcoming shipment of 19,000 doses, it plans to work with pharmacies and other groups to get the vaccine out to both the uninsured and insured in high-risk groups.
Thompson said the problem has been that the doses are only trickling in to health departments and doctors' offices and haven't gotten to pharmacies, causing a dilemma when the insured can't get the vaccine at a doctor's office and then seek it out at the health department.
"In terms of a pandemic, we should not be in this situation of trying to decide who gets the vaccine or not," he said. "We should be in the business of getting the vaccine to whoever wants it."
Thompson said he favors letting people know which entities are getting the vaccine while also making it clear that people shouldn't just show up at locations.
But Williams said the state had decided not to list on its Web sites which doctors and organizations are getting the doses for fear those location will be inundated. She did say the state would provide that information if someone specifically asked for it.
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