Number 93 |

Number 93

For many people, fall is harvest time – time to bring in the fruits and vegetables. For me, it is the time for my annual round of physical examinations. I have said that the nice thing about getting older is you get to meet a new doctor every year. I now have two eye doctors, a dermatologist, a cardiologist, a proctologist and my internist of many years who has sent me to his colleagues when the occasion warrants. I don’t know what I will have next year, but I am looking forward to it.In any event, it is my internist who has traditionally given me my flu shot. This always occurs at the end of the physical when he says, “Oh, by the way.” This year there was no “Oh, by the way,” but rather the suggestion that I call in from time to time to see if the vaccine had arrived. In the meanwhile, there was the news about Chiron. Chiron, as you probably know, is a California-based American biotechnology company. It bought a company based in Liverpool that makes flu vaccines. This year these vaccines were contaminated, wiping out half the expected American supply. This caught my attention.After several calls to my internist, I was told they did not have the vaccine and would not get the vaccine. I asked what they suggested and was told there were drugstore chains giving out the shots. A few calls to these made it clear that they had no vaccine either, but one of them suggested that I call the hospitals. I called the nearest one and they suggested that I call a senior center named Caring Community, and they also supplied the telephone number of the nearest one.

The term “senior center” curdles my blood. I imagine a building filled with the halt, the lame and the blind, singing folk songs. Anything, however, is better than getting the flu.The man at the center I called could not have been nicer. He told me that each of the centers in New York was given 100 doses, which they were trying to distribute in an orderly way. His center was not yet signing people up, but he gave me the number of another nearby one that was. “Ask for Hazel,” he said.I phoned and got a machine message that said they were registering people until 4 p.m. I looked at my clock. It was 20 minutes to four. I literally ran to the center and arrived at about five minutes to four. Hazel and her colleagues were packing up but I pleaded for them to sign one more person up – me. I was given a number – 93 – and told to return in two days for the actual vaccination.The vaccination site was in a Presbyterian church – one that I pass often as I walk up Fifth Avenue from my house. There is an iron fence around its yard. On the sidewalk, when I arrived, was a mob of very angry people – seniors by the look of them. They did not have numbers and were trying to break through the guards and the fence. It was the same sort of scene you find when people are evacuating a burning building.

My conjecture is that most of these people had never had a flu shot before, but that the prospect of not being able to get one had put them into a panic. I was able to show my No. 93 and get into the church. A large room had been set aside where we were to wait our turn. Everyone looked pretty old. I remembered the scene near the end of “Remembrances” when Marcel goes to a reception at the Duchesse de Guermantes. He remarks how old everyone has become and then catches sight of himself in a mirror. I found a chair near the back of the room. A very pleasant woman – No. 38, I think – told me that Caring Community is partly financed by the city and partly by donations. They offer meals at nominal cost. She said they used to have nice entertainment until the entertainment director got another job. Some of the people in the room were being assisted by younger people – I suppose relatives.There seemed to be two stages to actually getting the vaccination – three if you count having your number called. The first stage was going to a long table where Hazel and her colleagues had people fill out some forms. This, as a city-run program, has the usual red tape. The vaccinations were free, being paid by Medicare, the much-maligned federal health insurance program. Behind the table were three nurses doing the vaccinations. It was a bit like an assembly line. Between the forms and the vaccinations, I think each person took about 10 minutes. I had arrived at 10 in the morning and by the time I got to the table it was about 12:30 in the afternoon. Much of the room had cleared out, but there were new arrivals since a few extra doses had turned up. They had no numbers and were trying to shove their way to the tables. As I tried to take my place, I was shoved out of the way by a curious-looking woman, surely only 5 feet tall, with red hair and long red eyelashes. She had no number and was restrained. I have no idea if she ever got a shot.We are now in a soul-searching mode. How did we ever get into this mess?

It is clearly a failure of both the manufacturer and of the federal government. This shortage was known in August, although the British regulators failed to notify their American counterparts. But it has been known for several years that the American supply of vaccine is very fragile. Companies don’t want to make the stuff because they can’t make enough money at it.Only two companies worldwide are licensed to sell flu vaccine in the United States. In Britain there are several, so there is no crisis and the same thing seems to be the case in Canada. Because of the failures in the supply here, many people, perhaps thousands, are going to die of the flu this winter. Healthy people over 2 years old and under 65 are being asked to go without. The president is going without, but the Senate majority leader, Bill Frist, who is a doctor and does not fall into the age categories, is joining the other Congress people who are being vaccinated. He’s not stupid.Jeremy Bernstein has recently been vaccinated against pneumonia. His arm still hurts and he needs sympathy.

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