BY EDWARD D. MURPHY

Portland Press Herald

Maine has received far fewer than half the number of H1N1 flu vaccine doses it was told to expect just three months ago and is now seeing shortfalls in weekly shipments, leaving a large part of its at-risk population unprotected.

"It's an incredibly frustratingly low amount of vaccine for what we need," said Dr. Dora Anne Mills, director of the Maine Center for Disease Control and Prevention. "We don't know, from week to week, what we will get for vaccine."

Mills said federal officials told Maine in late August that it could expect 527,000 doses by this week. In late September, that estimate was cut to 321,000 doses.

So far, the state has received only 210,400 doses, Mills said Thursday. That falls short of the number needed to treat pregnant women and young children, who are considered most at risk of catching swine flu.

"We don't have enough vaccine to cover even two-thirds" of the estimated 300,000 young children and pregnant women in the state, Mills said at a news conference.

That's especially true because doses were allocated for health care workers and people 25 to 65 years old with underlying medical conditions, who also are considered at risk, she said.

Mills said the state gets weekly updated estimates of vaccine shipments. Last week it got only 30 percent of what had been anticipated just six days earlier.

She said the U.S. Department of Health and Human Services arranged a Saturday shipment that boosted the total slightly, but it was still well below what state officials had been told to expect.

The H1N1 flu has been a factor in five deaths in Maine, including two in the last week, Mills said. Fifty people were hospitalized for flu symptoms in the last week, half of them younger than 18; about one in six emergency room visits has been related to the flu; and 143 schools reported high absenteeism in the last three weeks.

Two schools closed because of the number of students and staff members who were out sick.

Mills said the state is seeing a "surge" in the flu that may be a couple of weeks away from peaking -- and conditions are worsened by the vaccine shortage.

Adding to her frustration, Mills said, are reports that some states have more than adequate supplies.

She said Oklahoma, for instance, announced recently that it has enough vaccine to expand its program beyond high-risk groups and will provide it to anyone who asks for it.

Despite Maine's shortfall, Mills said, about 95 percent of the schools have provided flu shot clinics for students, and the rest are expected to provide vaccinations in the next couple of weeks.

An estimated 60 percent to 70 percent of students opt to get the shots, she said, which is considered high by public health experts but leaves a sizable number of schoolchildren vulnerable.

Mills said she discounts reports that only half of the vaccine that has been distributed in Maine has been administered. She said clinics, hospitals and schools that have offered vaccinations are so overwhelmed that many have failed to fill out reports on vaccinations, and she's confident that no one is stockpiling the doses.

She also said the state has plenty of Tamiflu and other antiviral medications that can reduce the intensity and duration of the flu.

At Maine Medical Center in Portland, a pandemic plan is being followed to allocate vaccine that is "trickling in," said Tiffany Townsend, the hospital's director of employee health.

Townsend said the plan identifies high-risk patients, such as those in the emergency department, maternity wards and the children's hospital, and targets employees in those units for vaccinations so they don't get sick and pass the virus to patients.

The patients themselves are vaccinated, Townsend said, but shipments of vaccine that aren't large enough for the need forces Maine Medical Center to make tough choices on who gets it.

She said the plan allows the hospital to make that decision quickly, based on priorities.

"As soon as we receive it, we're getting it into the arms of folks," she said.

One mother worries that the littlest arms are being overlooked.

Zakia Nelson of Scarborough noted that schools are vaccinating older children, hospitals are vaccinating workers, and older people can push for vaccine themselves -- but she has been searching fruitlessly every day to find vaccine for her children, 18 months and 4 years old.

Nelson, who was an epidemiologist with the federal Centers for Disease Control and Prevention before moving to Maine a year ago, said her pediatrician hasn't been able to keep the vaccine in stock.

She recently switched pediatricians for her youngest child after being told that a practice has vaccine, and she hopes the supply holds out until her daughter's paperwork is transferred.

For her 4-year-old, she found a day-care provider that will hold a vaccination clinic in December and passed the word to other mothers, said Nelson, who is pregnant and got a vaccination from her doctor.

"I think they've gotten left to the end, even though they're high-risk," Nelson said of her children and others their ages. "I've been searching high and low for clinics for them."

She's counting the days until she can take her youngest child to the new pediatrician and her 4-year-old to the clinic at the day-care center.

"That's three weeks from now," Nelson said. "Hopefully, no one's gotten sick in the interim."