Minn. clinics urged to hold H1N1 vaccines for high-risk groups

Some clinics have apparently been offering H1N1 vaccine to people outside of high-risk priority groups, even as vaccine supplies remain limited for those patients.

The Minnesota Department of Health is urging clinics to only provide H1N1 vaccine to people in high-risk priority groups, such as pregnant women and adults with pre-existing health problems.

Minnesota Public Radio News has learned of at least five cases where H1N1 vaccine was offered to patients, even though the individuals did not fall into any of the high-risk categories for priority vaccination. Four of the cases occurred at two different clinics southeastern Minnesota and one case was in St. Paul.

In some of the cases, clinic workers allegedly told the individuals that they had more vaccine than they needed for their high-risk patients.

Health Department vaccinations expert Kris Ehresmann said that's surprising, given the short supply of vaccine in Minnesota.

"It makes me think that perhaps they over-ordered and requested more than they should have to reach out to that group if they have enough vaccine to sort of be branching out to the whole population," Ehresmann said.

Clinics that ordered vaccine for their entire patient population, rather than just their high-risk groups, would have received too many doses. The Health Department said it gave clinics instructions on how to fill out their orders, but the agency didn't have the time or resources to review the orders closely. Ehresmann doesn't know how many clinics might have made this mistake.

In other cases though, it's clear that clinics are looking for ways to use up valuable vaccine after experiencing a lower than expected demand from their high-risk patients. Ehresmann doesn't think the problem is widespread. But she said at least eight, mainly rural, counties have told her that they've done as much as they can to reach out to their priority groups and they now want to expand their vaccination campaigns to include more people.

She said counties and clinics need to resist that urge.

"We're still getting emails and phone calls from people who have cystic fibrosis, who have asthma, who have yet to get an H1N1 vaccine," she said. "So to have someone else who doesn't fall into those categories, get a vaccine isn't appropriate."

So far, there's only enough vaccine for less than half of Minnesota's estimated 2.7 million residents who are in high-risk categories. Ehresmann said she's heard from many metro-area counties where demand for vaccine is still very high and the supply is very short.

She said any clinic that has excess vaccine should share its doses with other clinics.

"Definitely, if they have vaccine to share it, to open up their clinics so that there's more access for more people," she said.

All of the providers that offer H1N1 vaccine have signed an agreement in which they promise to abide by the state's vaccination recommendations. Clinics that violate the agreement could face sanctions. For example, they could be kicked out of future vaccination programs.

But the Health Department said it would rather work with the clinics to bring them back into compliance than taking tougher measures.

The vaccine supply is expected to remain tight for the rest of this month. Kris Ehresmann said people who are not in a high-priority group will probably be able to get vaccine sometime in January.

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