BACKGROUND:
In October 2004, the influenza vaccine supply available to the United States was decreased by almost half. In response, CDC issued interim recommendations for influenza vaccination and established a distribution system for the remaining doses.

OBJECTIVE:
To establish just and equitable guidelines, principles and methodologies for distribution and ultilization of the reduced vaccine supply available to the county.

METHOD:
The extent of the vaccine needs were determined through a survey of hospitals, nursing homes and health care providers. Meetings of representatives of the major health care providers and local government administration were convened to develop a concensus opinion for distribution and utilization of the limited vaccine supply.

RESULT:
Since the initial available information indicated that hospitals and nursing homes would receive vaccine separately, the decision group recommended that the initial 9,500 doses that the department received should be provided equitably to all eligible seniors. Subsequently, government administration directed that the vaccine go to seniors who had pre-registered for the annual government flu vaccine program. When the state later released 2,610 doses to the county, the decision group reconvened and recommended that this vaccine be provided to the individual health care providers who had responded to the needs survcy. The decision group reconvened again when the local health unit was informed that CDC planned to distribute the remaining vaccine to state health departments and that, in New York State, vaccine was going to be redistributed to all counties. The decision group recommended that the additional supplies go to nursing home residents and individual health care providers.

CONCLUSION:
Decisions about allocation of scarce health resources on a local level were most effectively accepted when made by concensus agreement among representatives of all health care providers.

LEARNING OBJECTIVES:
A methodology to determine equitable allocation of scare resources.