Immunization for the winter flu season has begun, but delays in delivery of flu vaccines may force many potential recipients to wait weeks or longer for vaccinations.

The delays, caused by slow worldwide vaccine production, are likely to be especially pronounced for members of the Clalit health maintenance organization, which has thus far received only 5-10 percent of the influenza vaccine it ordered for the season.

According to Dr. Giora Werber, Deputy Head of Clalit Health Services, there is a very high probability of delays in providing flu vaccinations to those who are not included in target or high-risk groups.

	Advertisement

Clalit, the largest HMO in Israel, will first vaccinate housebound members and elderly, ill, and disabled residents of institutions and old age homes who cannot come to clinics to be vaccinated, Werber said.

Later, as additional supplies arrive, Clalit will gradually vaccinate healthy elderly people and chronically ill individuals of all ages, before offering vaccinations to other members.

"In principle, there is no problem, because instead of finishing our vaccination campaign in November and the beginning of December, we will finish it in December and the beginning of January," Werber told Israel Radio on Monday.

"This delay truly has no medical significance."

However, current Ministry of Health recommendations state that it is "desirable to vaccinate from early October, and highly recommended to vaccinate no later than the end of November, although it is possible to vaccinate after that date."

Moreover, the ministry recommends that healthy infants between the ages of six and 23 months, who have never before been vaccinated, receive two doses of flu vaccine, with a month between the first dose and the second, and that the vaccinations be completed by the end of November.

Delays in availability of the vaccine could make it difficult to abide by the ministry recommendations.

The Health Ministry position is in line with the U.S. Centers for Disease Control. The CDC has stated that October and November are the best months in which to vaccinate all individuals, regardless of age.

Research conducted for the Maccabi HMO in 2003 showed that members vaccinated in late November were hospitalized more frequently and stayed in the hospital longer than those who were vaccinated in early October, despite the fact that those vaccinated in late November were a younger, healthier group.

In contrast with Clalit, "Maccabi expects only a brief delay," Ido Hadari, spokesman for Maccabi Healthcare Services, told Haaretz.

Maccabi is to vaccinate healthy infants between the ages of 6-23 months in the initial wave along with high-risk adults and children.

Maccabi will begin vaccinating its members on October 15, following the holidays. "We ordered 20 percent more vaccines than we did last year ? a total of some 270,000 vaccinations. We will vaccinate target [high-risk] populations for the first three weeks and then offer vaccines to other members," Hadari said.

The Meuhedet HMO has already begun its campaign to vaccinate housebound members, members in closed institutions, healthy elderly members over the age of 65, and chronically ill children and adults.

Meuhedet will offer infants and children vaccinations near the end of the month, "immediately following the end of the campaign to vaccinate the high-risk population," it said.