Albertas supply of high-dose flu vaccine running low pharmacists say

For the first time, all Alberta seniors are being offered a high-dose flu vaccine but distribution problems are making it tricky for pharmacists to get their hands on it.

The Fluzone high-dose vaccine is described by Alberta Health as "the vaccine of choice" for people in that age bracket.

The high-dose shot was previously offered only to Albertans 65 years and older living in long-term care facilities. Other seniors who wanted the shot had to pay $75. The shot is now free of charge.

This year, pharmacists say the demand is there â€" but the stock isn't.

"We ordered 10 boxes, we got one," said pharmacist Zicki Eludin, who owns Crescent IDA Pharmacy in Lac La Biche, Alta. "We're probably getting 10 per cent of what we order." 

Eludin said his orders for the high-dose vaccine were initially filled, but the number of available doses has recently dwindled. He ordered 50 doses for last week but was only given a single box of five shots.

Most of his clients opt for the standard flu shot but he would like to offer them the improved protection of a high-dose vaccine.

The high-dose vaccine contains four times the antigen â€" the part of the vaccine that stimulates the body's immune response â€" than the standard dose.

When Eludin ran an immunization clinic at a local seniors home earlier this month, he didn't have any high-dose shots to administer. 

"[Alberta Health] are still so focused on the COVID thing that, I don't know, maybe the logistics department didn't do their homework."

Doses dispersed in small amounts 

Alberta Health said the province has ordered more than 400,000 high-dose vaccines this season. 

The doses are enough to immunize all Albertans 65 and older living in congregate care, and to immunize 68 per cent of the entire population of eligible seniors, Alberta Health said. 

"The doses are dispersed in small amounts across the province," Alberta Health said in a statement. "This is to ensure access for as many Albertans as possible." 

Alberta had zero lab-confirmed flu cases last year but experts have warned that the province is unlikely to avoid the flu season twice. Three cases have been confirmed in Alberta so far. 

Mohamed Elfishawi says he quadrupled his orders for the shot anticipating that demand for the doses would outstrip supply. (David Bajer/CBC)

Randy Howden, owner of Crowfoot Medicine Shoppe in Calgary, is frustrated by the ongoing supply issues.

He said the vaccine was distributed to the warehouses based on "market share" and then allocated to individual sites.

Alberta Health is "micromanaging" the situation to the detriment of some smaller operators, he said. 

"We didn't get anywhere near what our pre-book was, and we're told now that there's no vaccine remaining for us to order," Howden said. 

The flu season immunization campaign is especially critical amid the pandemic but distribution issues have caused confusion with the high-dose campaign, he said. 

"Our seniors are the most avid to get their flu shot," he said. "And we didn't have the vaccines that we needed to support them and serve our clients." 

Alberta Health says the full order of high-dose vaccines was received and distributed through usual channels to wholesale distributors, AHS and physicians.

"[Wholesalers] work with pharmacies, consider the pre-order requests and previous influenza season orders and, based on available inventory, distribute the vaccine to the pharmacies," Alberta Health said. 

'They don't give us the chance'

Mohamed Elfishawi, who owns the Terwillegar and Terra Losa pharmacies in Edmonton, said he was anticipating the shortage. He "quadrupled up" on his early orders and got "just enough."

He initially ordered 250 shots from one wholesaler and 200 from another. He received 10 doses.

He said the distribution issues hit during the critical early days of the campaign but smaller independent stores like his often struggle with supply shortages.

"This is a trend," he said. "Even with the COVID vaccine, most of the supply is coming through the big chains and the small pharmacies didn't get enough.

"We are capable of doing large amounts of immunizations and helping the system but they don't give us the chance." 

Seniors should aim to get the high-dose shot whenever possible, Alberta Health said. 

"Delaying your influenza vaccination is not recommended.  

"Seniors can choose the standard dose if they wish, however, the high dose vaccine is the vaccine of choice for individuals 65 years of age and older."

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