Looking for H1N1 shot? You'll have to get in line

A second shipment of H1N1 flu vaccine is headed to Minnesota next week, but state health officials have a message for all the people who are clamoring for it: Don't call your clinic -- they'll call you.

The 30,000 doses will be the first H1N1 vaccine available to the general public here. But the vaccine is trickling in so slowly that, for at least the next two weeks, the Minnesota Department of Health will distribute it on a random basis to pediatric clinics across the state that care for the sickest of sick children. Officials will recommend that rather than allowing parents to line up their kids for shots, doctors decide which of their most fragile young patients should get the vaccine first, and call them in.

"We fully recognize that it's not ideal," said Kris Ehresmann, director of the Health Department's vaccine program. "This is not how we would have chosen to roll this out. But given that we have very limited supplies, we have to do something that is fair and equitable."

Supplies will improve in late October, she said. Shipments could grow as large as 100,000 or 150,000 doses by then. But it means that many people in the high risk groups, such as pregnant women and children with asthma, might not get immunized until mid-November, she said.

"We will let people know when it's available," she said, noting that supplies are equally thin across the country.

Minnesota's first shipment, 30,500 doses of nasal spray vaccine that arrived this week, went to health care workers across the state. Some of the next shipment will go that group as well. The rest, and the shipment coming in the following week will be designated for vulnerable pediatric patients.

In the meantime, health officials and medical clinics are asking the public not to tie up clinic phone lines by calling to ask about swine flu vaccine.

"People can't get through to make appointments," said Jeremiah Whitten, spokesman for Park Nicollet Health Services. "Everyone is flooding our call center, saying 'When can we get H1N1?' We can't handle it."

Officials from other clinics said Thursday that their phone lines are busy, but not swamped.

But clearly, said Ehresmann, the drumbeat about H1N1 has raised expectations and demand for the swine flu vaccine. Demand will get higher before it's over, she said.

"It's frustrating," she said. "There is this perception out there that 'I should be able to get it.' But they are running into a brick wall."

Meanwhile, because of spot shortages, finding a shot for seasonal flu is getting to be a lot like finding Waldo -- if you're persistent, you'll find one. But only if you're persistent.

"It's a very mixed bag and it's yet again another confusing message for the public," Ehresmann said.

Demand for seasonal flu shots is much higher than usual, health officials and clinics say, even though so far no cases of seasonal flu have been reported in Minnesota.

But shipments from manufacturers, which are also making H1N1 vaccines, are spotty and unpredictable, providers say, leaving a confusing patchwork for consumers.

Park Nicollet, Allina Medical Clinics and Fairview Health Services all said they have received and used 60 to 65 percent of the seasonal flu vaccine they ordered last February. But the rest of their orders won't come in until November -- if at all.

Meanwhile, the MinuteClinic chain said it just received a large shipment and has plenty available at its 24 locations around the Twin Cities. The Minnesota Visiting Nurses Agency has canceled some big clinics but expects to hold some. Laura Silvernale, spokesperson for the agency, said the situation changes daily.

At the Mayo Clinic, the vaccine supply is down to FluMist, a nasal spray vaccine, and children's flu shots, according to a spokesman.

At Children's Hospitals and Clinics of Minnesota, officials say they have enough vaccine for patients with scheduled appointments, but not enough to offer flu shots to the public.

"We expect to get more here in October and have a full supply by November," said Patsy Stinchfield, the director of infectious disease at Children's.

To add to the confusion, Children's has started vaccinating employees with the newly arrived H1N1 flu vaccine, but doesn't have enough seasonal vaccine for staff, she said.

In the meantime, the number of flu-related phone calls and emergency-room visits continues to grow, she said. On Wednesday, about 160 children showed up at the emergency room at Children's in St. Paul, compared with 100 a day during a typical winter flu season, Stinchfield said.

"We're still very busy," she said, though not as busy as in June, when nearly 200 children a day flooded the emergency rooms during the first wave of H1N1 flu.

To find locations offering seasonal flu vaccine, go to the Minnesota Department of Health flu clinic site at www.mdhflu.com, or the Minnesota Visiting Nurses Agency site at www.mvna.org.

For more information on both seasonal flu and H1N1 go to the Health Department flu website at www.health.state.mn.us/divs/idepc/diseases/flu/index.html.

marcotty@startribune.com