BACKGROUND:
In October 2004, the U.S. Department of Health and Human Services announced the loss of half of the domestic influenza vaccine supply. In response, the Centers for Disease Control released interim influenza vaccination recommendations identifying priority groups for vaccination.

OBJECTIVE:
To describe the process undertaken by a major suburban local health department to distribute available vaccine to local physicians.

METHOD:
Initially, the local medical and pediatric societies surveyed their members to assess the number of doses each practice ordered, had in stock, and the estimated number of additional doses required to vaccinate priority group patients. The Department of Health sent an “Agreement to Accept Influenza Vaccine” form to providers who completed the survey. The agreement restricted vaccination to priority group patients, required providers to maintain a list of patients vaccinated in each priority group and advised that the health department reserved the right to review the medical records of those vaccinated. Subsequently, all county physicians were included and sent the survey and agreement.

RESULT:
The number of requested doses of vaccine far exceeded supply. Less than 1% of physicians declined vaccine after receiving the agreement form. Due to an inability to meet physician demand for vaccine, distribution was restricted to providers in the following specialties: internal medicine and its subspecialties, family medicine, pediatrics, and obstetrics and gynecology. 13,000 doses of vaccine were made available over two distribution phases. Those physicians who declined to accept vaccine or who were not eligible received patient education materials for distribution in their practices.

CONCLUSION:
A coordinated approach that actively solicits the involvement of the local physician community can lead to a more fair distribution of vaccine when shortages exist.

LEARNING OBJECTIVES:
Apply innovative approaches to achieve an equitable distribution of limited medical resources.