As people across the country clamor to obtain doses from a severely depleted supply of the influenza vaccine, the two main health institutions at Penn are working on adapting their immunization efforts to the current climate.
Both Student Health Service and the University Health System have been affected -- directly and indirectly -- by the flu vaccine shortage.
Students requesting vaccinations from SHS are being rigorously screened -- and at times turned away -- in order to ensure that only those who meet the criteria of being at high risk are immunized.
Available doses nationally have been reduced from an expected 100 million to 35 million, due to a bacterial contamination in a British factory.
Though SHS succeeded in securing the 3,000 doses it requested, the UPHS did not fare as well. Only one of the three constituent hospitals received the vaccines.
"If you didn't guess right as to which provider you bought from, you were out of luck," SHS Director Evelyn Wiener said.
SHS has responded to the shortage by rationing its doses and sharing a portion with the University hospitals.
The atmosphere at both UPHS and SHS remains a bit tense.
"The calls are coming in, galore, from students and parents," Wiener said. "People are calling and saying, 'Can you make an exception?' And the answer is, 'There's no exception.'"
Yet, administrators back the rationing methods wholeheartedly.
"It's part of our role as being a member of the community," Wiener said. "We see this as being a collaborative effort."
Hospital of the University of Pennsylvania Director of Healthcare, Epidemiology and Infection Control Neil Fishman applauded Wiener's approach, adding that the main focus of those in the health care system is "making sure that the greatest number of high-risk individuals are protected."
In an effort to remain true to that goal, SHS has restricted flu shots to those "with a reduced capacity to fight off the flu" -- a group which includes the very old, the very young and people with health problems that make them susceptible to complications, according to Wiener.
Vaccines are also being allocated to health care professionals who deal directly with patients.
"It's funny, because one of our usual initiatives is we want to immunize more of the campus ... but this year our goal is reducing that number," Wiener said. Because immunizing more members of the community -- including those who are healthy -- can decrease flu rates even among those who are not vaccinated, SHS has typically conducted flu shot promotional campaigns.
"In the past few years, we've been enthusiastically, aggressively marketing the vaccine for everyone," she said. Though SHS sends out e-mails to high-risk students in late September encouraging them to receive flu shots, only 400 of the 3,500 students who received flu shots at SHS last year were in the high-risk category.
Wiener said that SHS had planned 35 "outreach clinics" over the next few months, designed to bolster public awareness by administering flu shots in college houses, Houston Hall and other public locations.
However, after receiving word on Oct. 5 of the national shortage, SHS discontinued its clinics for the year and decided to restrict its supply to those in the high-risk category. Before that point, SHS had already conducted two of the 35 planned clinics and immunized 387 people, "some of which were just the general public," Wiener said.
Though Wiener said that she thinks many students without special circumstances are aware of the shortage and therefore are not even requesting the shots, SHS has had to turn away 17 students who were not in the high-risk category. The office is in the process of evaluating the records of about 25 students to determine the severity of their medical conditions.
HUP is still determining its course of action.
"We are waiting to see what our resources are, and then we'll distribute," Fishman said, indicating that he hopes to start a vaccination campaign by next week. The hospital is also looking into obtaining a version of the vaccine that contains the live virus and is administered through inhalation.
The heightened public awareness of the flu vaccine that has resulted from the shortage seems to have increased the public's desire for it.
"I still have this sense that the people who want the vaccine the most are not really the people that need the vaccine the most," Fishman said.
But SHS nurse Doris Shank said that students have been very cooperative.
"They're very understanding after they have a conversation and understand the severity of the shortage," she said of the students who she has not been able to vaccinate.
Though SHS independently made the decision to ration its vaccines, some health organizations have been forced to reallocate their shares.
"There have been states and municipalities and public health agencies that have gone to clinics and said, 'This is how you will use the vaccine or we will take your vaccine or we will fine you," Wiener said, noting that Oregon, Wyoming and Maryland have all imposed formal restrictions regarding the allocation of the vaccine.
Fishman said he favors government intervention.
"I am very concerned that the supermarkets and pharmacies in the area have been allowed to distribute vaccines indiscriminately, and I've actually urged the state Department of Health to intervene," he said.
