Nov. 2--Caitlyn Martino rushed into the Solantic Urgent Care Clinic on South Orange Avenue with her 18-month-old son, David, in her arms, and peppered the front-office staff with questions about the swine-flu vaccine.
"What if the virus mutates? Is it really safe for pregnant women?" asked Martino, who was 18 weeks pregnant. "Do I have to get more than one shot? What type of vaccine should I get? Should my husband get it as well?" she asked.
The mother-to-be learned that although she was among the priority groups to receive the vaccine, no shots were available. The clinic had only the nasal mist, which is not recommended for pregnant women and those with long-term health problems or weakened immune systems.
"She's typical of the kinds of questions we get, especially from pregnant women," said John Reschke, a Solantic staff member.
Public concerns about the vaccine's safety, a short supply of the vaccine -- especially the injectable form -- because of production delays, and its unregulated distribution have created unprecedented confusion among local residents.
"There's definitely a lot of misinformation out there about the vaccine," said Dr. Rebecca Rey, head physician at the Solantic clinic. "A lot of people have concerns about the safety of the nasal mist because they've heard that it contains live virus. There's also been a lot of publicity about the preservative used in the vaccine. We do our best to present them with facts from the [ Centers for Disease Control and Prevention] and what research shows, but some people just aren't convinced."
The nasal mist, which began to show up in area clinics two weeks ago, is safe for people age 2 to 49 with no underlying health problems. Still, because it contains attenuated -- or weakened -- influenza virus, some are opting to wait for the injectable form, which has been available in very limited quantities locally.
The flu shot contains killed influenza virus, but some formulations contain a mercury-containing preservative called thimerosal that some think is linked to developmental problems in children. However, the vast majority of research does not support such an association, according to the Food and Drug Administration.
For Maria Barrera, it came down to the lesser of two evils.
"I've been going online every day to find a clinic that's giving the flu shot because I don't want the spray," said the Orlando resident after checking to see whether the Solantic clinic had injections. "Preferably, I want to find a shot that doesn't have the preservative in it."
But at age 36 and not expecting a baby and not a caregiver for one, Barrera would not fall under the priority group for the vaccine: pregnant women, caregivers of infants younger than 6 months, health-care and emergency-services personnel, people 6 months through 24 years of age, and those 25 to 64 who have underlying medical conditions that put them at risk for complications from the flu.
The problem is, no one is enforcing health officials' recommendations that the most vulnerable residents get vaccinated first.
"We are relying on the general public to do the right thing and let those who are among the priority groups to get vaccinated first," said Orange County spokesman Dain Weister. "If somebody lies about their health condition or their pregnancy, there's nothing we can really do about that. It's basically an honor system."
In Los Angeles last week, the director of the county's Health Department stood at a swine-flu-vaccination site gently turning elderly residents away because they are not among the priority group for the vaccine. There, local-government officials, hospital workers and private doctors were being drafted as ad-hoc swine-flu police.
'Do the right thing'
"We had a woman come in for the nasal mist who said she was a caregiver of a preterm baby," said Rey of Solantic. "We have to take their word for it. Besides, we cannot refuse the vaccine to anybody. We ask the public to use their discretion."
Nicole Vickey took her 4-year-old daughter, Elle, to Central Florida Urgent Care on North Orange Avenue in Orlando because it was one of a handful of clinics that had received the injectable vaccine last week.
Vickey, 32, said her daughter's pulmonologist recommended that she get a flu shot instead of the nasal mist because she has asthma.
"I went on the CDC Web site and county Health Department site to get as much information as I could," she said. "I learned that as an expectant mother and caring for a little one, that I was in the priority group. I want to do the right thing, and I want to protect my family."
Fernando Quintero can be reached at 407-650-6333 or fquintero@orlando sentinel.com.
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