Kansas City, MO – Kansas City, Missouri has received some 22,000 doses of the new swine flu vaccine. That's enough for about one in every 25 residents. The number will change as more of the vaccine becomes available. Even so, the initial shipments have been delayed and sporadic. And for parents of children with severe health issues, the quest for a vaccine has been all consuming.
Patty and Michael Reynolds say that in many ways, their daughter Sophia is like any other energetic preschooler.
[Sound of Sophia running around...]
"Are you going to open the other one?" Michael asks Sophia. "Yeah," Sophia replies.
It's Sophia's fifth birthday. After having her favorite dinner - cheese ravioli - she tears open some presents.
[Sound of Sophia opening presents...] "Woah!" Sophia Shouts, "Woah!"
It's a couple books. The Reynolds says Sophia loves to read and learn.
But she hasn't been to school very much this year. They say that's because Sophia was born with a congenital heart defect. She's undergone several surgeries, but the condition means she's easily prone to infections. In the past year or so, she's developed pneumonia and wound up in the hospital about five times.
Michael says whether or not to get a flu vaccine each year is not up for debate.
"I mean the fact of the matter is that something even as simple as the common cold can put Sophia in the hospital," he said. "And something as dangerous as the flu, we just don't know how bad it would be. And that's very terrifying to us."
The Reynolds say avoiding any potential exposure to the virus is key. But as swine flu becomes more and more widespread, getting Sophia vaccinated is critical.
And that, they say, has been an aggravating process. Sophia can't get the nasal spray because she has a pre-existing condition. She needs the shot. Patty, who's a full-time mom, says she's spent a lot of time and energy, to no avail, trying to track down the vaccine.
"The conversation started with my pediatrician...Time went by and I expanded my search and called the local children's hospital...My next step was my doctor...From there I went to Sophia's pharmacist...Then I started calling all those places once a week...About 3 or 4 weeks ago I stepped it up a notch and called the local health department...I called the Missouri health department...We're still waiting," Patty said, "and if you hear fear in my voice it's because it's there."
"We're swamped," said Kathy Swann, Sophia's nurse. "We don't have the answers to anyone's questions which is frustrating for us and for the patients."
The Reynolds love Swann. Swann says her office sees thousands of patients but has only received a handful of vaccines.
She says the doctors there put in orders each week to the health department, but they don't know what type of vaccine they're getting, when they're getting it, or how much of it they're getting.
She says many of the kids she sees with fragile health, like Sophia, need the vaccine. But the low supply is putting her office in an increasingly difficult situation.
"There isn't any real way to distribute it fairly," Swann said. "I mean I keep lists of people who need them and why they need them, and I have to keep phone numbers. But if you only have a couple, you can't put on your website we've got it."
In the meantime, Swann says her office has been inundated with general swine flu inquiries.
"I pray for someone to call me and ask me about vomiting or diarrhea - just someone to ask me about something different," she said. "We are overwhelmed with it, with the questions. Everyone is very panicked and people who never wanted flu vaccine before want it now, demand it now, and we can't help them."
That demand is managed in a four story building on a hill overlooking downtown Kansas City.
[sound of walking down a hallway and doors shutting...]
On the second floor of the Kansas City Missouri Health Department, Emergency Response Planner Bonnie Martin leads me down a hallway and into a conference room.
"We call it our operations center," she said. "And this is really where we get together for briefings, for situation updates, for major decisions."
Martin is one of the main people who coordinates H1N1 vaccine distribution in Kansas City. She says the federal government divides up the vaccine on a per capita basis.
But shipments to Kansas City have been pretty shaky so far.
Martin says the department had anticipated some delays in the vaccine delivery.
Federal officials overestimated how much would be initially available, partly because vaccine manufacturers have been producing a new vaccine for a completely new virus in a pretty short period...and much more of it than they'd make for a typical flu season.
But even under shortage conditions, Martin says the department's received less than half of what they were expecting.
"And it really is getting a little tense now because we haven't received everything that we ordered even for the last shipment, and so we're still waiting on that," Martin said. "And different jurisdictions are getting vaccines at different rates and then the health care providers want to know why."
Martin says she doesn't know why.
Last week, the health department also discovered that some 6,000 doses of the vaccine - or about a third of its first allotments for the city - had been lost and never made it from the manufacturer to local doctors. They say the order's been resent.
In the meantime, the department's decided to not hold any public clinics. Instead, Martin says all the shipments are going directly to public and private health care providers, like five year old Sophia Reynold's doctor, who've agreed to give the limited vaccines to those who fit within the CDC's high priority groups.
"It's really tough to take vaccine that's in such short supply out of the hands of pediatricians and ob-gyns to hold a public clinic," Martin said. "It's for us much more reasonable to make sure that health care providers that see those patients are receiving the vaccine."
[Sound of 'Happy Birthday' singing...]
Back at the Reynolds house in midtown Kansas City, Sophia is standing in front of a chocolate cake that's smothered in frosting. She joins in singing with her parents.
[Sound of Sophia singing Happy birthday...]
Michael Reynolds says each birthday marks a big milestone for his daughter.
"She's really worked for every one," he said. "We've been through a lot of hospitalizations, physical therapy, occupational therapy, we're really proud of her."
Since her birthday last week, Sophia has gotten the vaccine.
It doesn't kick in immediately, so her parents are still worried she could get sick in that interim period. Patty Reynolds also says she's still frustrated by the lack of public information about the whole situation, and she doesn't know what to tell other parents who are trying to find the vaccine.
For now, the Kansas City Missouri Health Department says it's best for residents to check in directly with their providers, because the vaccines are going directly to those places.
And as for the actual vaccine supply? Officials say they're hopeful that more of it will arrive any day now.
*UPTDATE (11/09/09): Since KCUR reported on this story, the Kansas City Missouri Health Department says they've received all of their initial vaccine shipments. The department's also announced they'll be holding their first public H1N1 vaccine clinic on Wednesday, November 11th, for those who are in high priority groups.
Funding for health care coverage on KCUR has been provided by the Health Care Foundation of Greater Kansas City.
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