Explainer

I Want a Flu Shot

Does the doctor have to give it to me?

The good kind of pain

The Food and Drug Administration says it’s highly unlikely that 46 million flu shots manufactured by Chiron Corp. will make it to the United States this winter. The company’s Liverpool factory was shuttered by British regulators after traces of bacterial contamination were detected in some vaccines. As a result of this last-minute shortfall, the Centers for Disease Control is asking that high-risk groups like babies and the elderly get top priority in receiving flu shots. Can a doctor or clinic refuse a healthy adult’s request to get vaccinated?

They sure can, just as a fast-food restaurant can refuse to serve fries to a customer sans shoes or shirt. The administration of flu shots is considered a private transaction between a health-care provider and a patient, and the former party is under no legal obligation to provide the service if it doesn’t want to. Already, several major operators of flu clinics, such as Maxim Health Systems, have agreed to limit flu shots to those the CDC considers high-risk patients: infants between 6 months and 23 months of age, adults over 65, and women who may soon become pregnant, among others. If you’re planning to pick up the vaccine at a drug store, be prepared to fill out a questionnaire designed to assess whether you fit into one of the above categories.

On the other hand, there’s nothing about the CDC’s directive that requires doctors to turn away healthy adults. Since these medications are purchased privately, the CDC has no legal authority to control how health-care organizations distribute their vaccines. A flu clinic is perfectly within its rights to take all comers; the CDC is simply hoping that everyone will understand the gravity of the situation and adhere to its voluntary rationing scheme. A similar plea was issued during a less severe shortage in 2000, and the country muddled through the winter just fine.

The CDC does have a vaccine stockpile of its own, containing approximately 2 million doses. But this is a mere drop in the bucket, given that the nation was expected to require in the neighborhood of 100 million shots. Now it seems that in the best-case scenario there will be fewer than 60 million doses in the United States this flu season.

Bonus Explainer: Canada isn’t in such dire straits. The country doesn’t buy its doses from Chiron, but rather from France’s Aventis Pasteur and the Vancouver-based ID Biomedical. The latter company currently has about 1 million surplus doses on hand. Unfortunately, those shots won’t be heading stateside: ID Biomedical hasn’t received FDA approval to sell flu shots in the United States.

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