Doctors stand in flu-shot line too

For more than a week, occupational nurse Janet Li-Tall has been giving the H1N1 flu vaccine to a short list of fellow healthcare workers at Ronald Reagan UCLA Medical Center. But she cannot get the coveted vaccine for herself.

“I just have to wait with everyone else,” said Li-Tall, 28.

She is among tens of thousands of local healthcare workers who find themselves in the same position as the general public: scrambling to get vaccinated.

Federal officials -- who list healthcare workers among those at greatest risk for H1N1 flu -- had promised California 6.2 million doses by now. But the state has received just 2.7 million doses due to manufacturing shortages, said Mike Sicilia, a spokesman for the state Department of Public Health. It is the same story nationwide, where only about 27 million of an expected 40 million doses are available.

Among the five highest-priority groups, Sicilia said California ranks healthcare workers third, after pregnant women and caregivers of children under 6 months old. But officials here, unlike some in Ohio, New York and Wisconsin, have not set aside vaccines for healthcare workers.

With so few doses in hand, doctors and nurses say they have been forced to wait in line or volunteer at public clinics to get vaccinated.

It comes down to simple math: L.A. County’s three public hospitals ordered 110,000 vaccines but have received only about 18,000, according to Michael Wilson of the county’s Health Services Department. They have vaccinated about 2,500 front-line staff, a fraction of the 24,000 workers who need it, he said.

So far, UCLA’s two hospitals have received 1,000 doses for 10,000 staff and 35,000 patients expected in coming months. They set aside 550 for staff, but say that’s hardly enough.

“There is anxiety. Many staff for sure would like to receive the vaccine,” said Bill Dunne, the hospitals’ director of emergency preparedness. “We as a hospital cannot make it come any faster. We’re trying to manage the supply and make hard decisions.”

Nurses unions have threatened to strike, arguing their members need more protection, particularly after a 51-year-old nurse in Sacramento died of H1N1 flu last summer.

“Why take that chance?” asked registered nurse Carole “C.C.” Mazer, who works in a San Fernando Valley emergency room. “They should have offered it to us first.”

Mazer, who said her emergency room has been inundated with H1N1 patients, has been trying for weeks to get the vaccine for herself and her 8-year-old son. She said the state’s decision not to prioritize healthcare workers was “baffling.”

“It’s asking us to fight a war without protection,” said Mazer, 48.

Last month, 13,000 members of the California Nurses Assn., one of the state’s largest nurses unions, threatened to strike at more than 30 Catholic Healthcare West hospitals in California and Nevada over H1N1 safety. On Monday, union officials announced they had reached an agreement with the hospitals to create a joint safety task force.

In a typical flu season, about half of California healthcare workers get vaccinated, according to Jim Lott, a spokesman for the California Hospital Assn. This year, with so many workers yet to be vaccinated for H1N1, hospital officials fear they may end up with staffing shortages due to illness as flu patients surge.

Dr. Lee R. Weiss, who manages five emergency departments in L.A. and Orange counties and the Bay Area for Emergent Medical Associates, has been unable to vaccinate hundreds of staff against H1N1.

“From a public health standpoint, here’s the choice you have: vaccinate a fraction of the population, which means the other large fraction of the population is at risk, or get your hospitals vaccinated so they’re open when the catastrophe strikes,” Weiss said. “We need to vaccinate the people who are on the front lines of the battlefield so that when this thing really pops -- and it’s popping now -- they don’t go down.”

Weiss recalled being among the first vaccinated during the national flu outbreak in 2004 and President Ford’s antiflu campaign in 1976, when he was a medical student. Last weekend Weiss, still unvaccinated, took his 9-year-old son to a county clinic in the San Fernando Valley but left because the line was too long.

Local doctors also are worried. Dr. Jeffrey Penso, a Culver City pediatrician, has yet to receive the H1N1 vaccines he ordered. In the meantime, he said his staff of eight is exposed to several children with H1N1 each day. “It’s a big risk for them going to work and doing this every day,” he said.

As of last week, L.A. County had vaccinated 80,000 people at public clinics but had not tracked how many were healthcare workers. So far the county has received 474,000 vaccines of 1.3 million promised by now. Of those, 114,000 went to public clinics and 360,000 to private providers, said Dr. Alonzo Plough, director of emergency preparedness and response for the county health department.

Plough said healthcare workers’ needs must be balanced against those of children and pregnant women. He said epidemiological studies show that vaccinating youths age 2 to 18 is one of the most effective ways to protect the public.

Efforts to mandate vaccination for healthcare workers elsewhere have been controversial. In New York, where state officials required healthcare workers to get vaccinated by Nov. 30, some nurses sued. On Oct. 22, facing vaccine shortages, state officials lifted the mandate. By then, many hospitals had vaccinated about 50% to 80% of their staff, a state health department spokeswoman said.

In Southern California, some hospital chains have made an effort to vaccinate most of their staff.

MemorialCare Health System required staff at its four hospitals in L.A. and Orange counties to either get vaccinated for seasonal and H1N1 flu, or wear a surgical mask during flu season. At its Long Beach facility, officials said they expect to have vaccinated 5,500 of 7,200 employees by today, including all staff who access patient rooms.

In the long lines for free vaccines at L.A. County clinics, many waiting said they assumed healthcare workers had already been vaccinated.

“They’re the ones handling other people,” Tasha Melgarejo, 23, said as she waited late last week with her 2-year-old daughter and more than 200 others at Salazar Park in East Los Angeles. “We’re all equal, no matter our position, but let them go first.”

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