One of the worst US flu seasons in a decade has created shortages of vaccine and the Tamiflu treatment for children, raising the prospect that people considered at high risk of getting the flu might not get the protection they need.
Though shortages are not unusual, the flu's early arrival and this year's especially nasty strain mean the situation could worsen.
"People who haven't been vaccinated and want to get the vaccine may have to look in several places for it," said Tom Skinner, a spokesman for the Centers for Disease Control in Atlanta.
Sanofi SA, the largest flu vaccine provider in the United States, said on Thursday it had sold out of four of the six different dosages of Fluzone seasonal flu vaccine due to unanticipated demand. The vaccine is made in different sized vials and pre-filled syringes.
"At this point we are not able to make any more vaccine because we are gearing up for next year's vaccine," said Michael Szumera, a spokesman for Sanofi. Because flu strains mutate, vaccine makers must reformulate seasonal flu vaccine every year.
Most conventional flu vaccines in the United States are still made using a 60-year-old process in which the vaccine is grown in fertilized chicken eggs, a method that can take several months to complete. But this is changing.
In November, Novartis won US regulatory approval to sell its cell-based flu vaccine, which uses a speedier manufacturing process. But it is not yet widely available.
AstraZeneca Plc also sells flu vaccines in the United States.
SHORTAGES FOR KIDS
Henry Schein Inc, the nation's largest distributor of flu vaccines to physicians' offices, said it has vaccine available from Novartis for its customers immunizing patients four years old and older.
However, it said "we do not have the pediatric vaccine for children aged six months to four years old due to its unavailability from the manufacturer, Sanofi."
Roche Holding AG has a shortage of the liquid form of Tamiflu, given to children who already have the flu to slow or stop symptoms.
Roche said it told wholesalers and distributors in recent weeks that temporary delays in shipments were imminent. A spokeswoman for the US Food and Drug Administration confirmed that there have been supply interruptions in some locations.
In the meantime, pharmacists can make a substitute by dissolving Tamiflu capsules in a sweet liquid, according to a spokeswoman for Roche's Genentech unit, which makes Tamiflu.
Roche said an unexpectedly severe flu season has also hit Canada