Oct. 12 (Bloomberg) -- Fear of pandemic swine flu has heightened public vigilance in the U.S. against seasonal influenza as well, causing vaccine shortages at doctors’ offices, clinics and retail drugstores.

The two influenza strains, which carry similar symptoms and outcomes, may circulate concurrently in the U.S. for the first time beginning this month, normally the official start of the flu season, the Centers for Disease Control and Prevention said. They require separate vaccinations that can be given at the same time, government health officials said on Oct. 9.

About 77 million doses of seasonal vaccine have already shipped in the U.S., more than ever before at this time of year, the CDC said. Still, doctors are reporting delays in getting the product, and CVS Caremark Corp. and Walgreen Co., the two largest U.S. drugstore chains, last week reported spot shortages. The first doses of vaccine for swine flu, also known as H1N1, were given to health-care workers and children on Oct. 8, with about 6.8 million doses available for ordering.

“Every doctor I know has run out or never received any” seasonal vaccine, said Brett Buchmiller, an allergist and immunologist at Allergy & Asthma Specialists in Dallas. “I have had to tell my patients, ‘do not wait for me.’”

Buchmiller ordered 1,200 doses in January for delivery in mid-September. He said he hasn’t received any of his shipment and was told by his distributor that he may not get any.

Doctors’ Offices

Shortages at doctors’ offices and health clinics have also been reported in upstate New York, Vermont, Minnesota, North and South Dakota, Illinois and Arizona, according to the Web sites of local newspapers including the Addison County Independent in Vermont, the Star Tribune in Minneapolis and the Grand Forks Herald of North Dakota.

CVS MinuteClinics in Austin, Texas, and New York ran out of the seasonal-flu vaccine within the past week before restocking, according to calls to 13 stores by Bloomberg News. Calls to eight Walgreen stores in Manhattan on Oct. 5 determined none had it at the time. There are also shortages in the South and Southeast, said James Cohn, a Walgreen spokesman.

Demand for seasonal-flu vaccinations has soared because of public awareness of swine flu, Walgreen’s Cohn said. While the Atlanta-based CDC is no longer counting swine flu cases, it reported last week that H1N1 is spread widely in 37 U.S. states.

Americans are demanding both vaccinations, even though about 99 percent of laboratory tested flu viruses are of the H1N1 variety. Walgreen administered 2.5 million seasonal flu vaccine doses last month, more than twice as many as in the entire 2008 flu season, Cohn said.

Given Simultaneously

The vaccinations can safely be administered simultaneously, Anthony Fauci, director of the National Institute of Allergy and Infectious Disease in Bethesda, Maryland, said last week, citing studies in 800 people. Supplies of the H1N1 vaccine, though, may be limited for the next few weeks, according to the CDC.

As for seasonal flu, “everyone wants their vaccine now,” said Donna Cary, a spokeswoman for Paris-based Sanofi-Aventis SA, the supplier of almost half of the seasonal flu vaccine in the U.S. “Whether everybody is trying to get the vaccine early this year or if there’s truly an increase in demand has yet to be determined.

“Every single customer that we have has gotten at least their initial shipment from us,” Cary said.

More doses are being shipped, and in a few weeks, there should be enough of both vaccines for everyone who wants to get them, said Anne Schuchat, head of the National Center for Immunization and Respiratory Diseases at the CDC, on Oct. 9.

Good News, Bad News

“The good news is that we have more seasonal-flu vaccine out than we typically would this time of year,” Schuchat said. “The bad news is that more people want it than can seem to be able to get it.”

When retail pharmacy chains run out of vaccine at one location, they can redistribute doses from areas where demand isn’t as great. That’s not always the case for doctors.

“We tried to go to several other manufacturers and distributors and have had no luck,” said Adam Stracher, director of primary care for the Weill Cornell Physician Organization in New York, in an Oct. 9 telephone interview. “Distributors are telling me they haven’t gotten their full shipments yet.”

Stracher ran out of vaccine for his doctors’ offices after receiving 1,800 doses of his 7,000-dose order from Sanofi. He said he’s expecting another shipment of about 2,000 vaccines in the next two weeks, and that Sanofi couldn’t guarantee the rest of his order.

‘Call Back’

Patients calling Weill Cornell Medical Associates, a physician practice on the upper east side of Manhattan where Stracher works, are greeted with a voice message saying the office has run out of the seasonal vaccine and instructs them to “call back after Oct. 19 for an update.”

Five vaccine suppliers -- Sanofi, London-based AstraZeneca Plc and GlaxoSmithKline Plc, Basel, Switzerland-based Novartis AG and CSL Ltd. of Australia -- are making 114 million seasonal- flu doses, and 251 million swine flu doses for the U.S., according to the Health and Human Services Department.

Delays are causing shortages in some areas, Sanofi’s Cary said in a telephone interview. The company is “a few weeks” behind schedule, and has distributed more than 30 million of its 50.5 million doses allocated to the U.S.

New York City public hospitals have “ample supply” of seasonal flu vaccines, said Pam McDonnell, spokeswoman for NYC Health & Hospitals Corp., the largest municipal hospital and health care system in the country, according to the New York City web site.

‘Still Early’

“We expect that everyone who wants a flu shot will be able to get one this season,” McDonnell said in an e-mail. “It’s important to keep in mind that it’s still early -- the seasonal flu season generally runs from December to March.”

Some manufacturers have shifted their efforts to make sure swine flu vaccine is available as soon as possible, the CDC’s Schuchat said. The current wave of H1N1 is infecting people at higher rates than the February peaks of two of the last three flu seasons, the CDC’s Schuchat said.

About 4,500 people have died of swine flu since the virus emerged in April, the World Health Organization reported last week. More than 600 of those deaths are from the U.S., where about 36,000 people die each year from causes related to seasonal forms of the illness, according to the CDC Web site. About 5 percent to 20 percent of the population gets the flu, the CDC reports.

“We are experiencing very high demand for seasonal-flu shots and we are working closely with multiple suppliers to meet this demand on a day-to-day basis,” said Michael DeAngelis, a spokesman for CVS, in an e-mail. “When we experience isolated shortages of vaccine supply we do all we can to replenish these locations.”

While Rite Aid hasn’t had any seasonal-flu vaccine shortages, it also hasn’t yet received all its ordered doses, Cheryl Slavinsky, a company spokeswoman, said by telephone.

To contact the reporters on this story: Tom Randall in New York at Trandall6@bloomberg.net; Carol Wolf in Washington at cwolf@bloomberg.net; Pat Wechsler at pwechsler@bloomberg.net

Last Updated: October 12, 2009 00:00 EDT