Maine is experiencing a surge in H1N1. The virus has killed five people, and in the last week hospitalized 50 and shut down at least a couple of schools. But Maine's top health official, Dr. Dora Anne Mills, says there isn't enough vaccine to protect even the top-priority groups -- children and pregnant women -- let alone other high-risk populations, such as health care workers and people with chronic conditions.

"This is not a place where we should be as the richest country in the world," Mills said at an Augusta news conference. "I just find it shameful that we are in this place where are having say, "OK, do pre-school age and babies get the vaccine? Or do EMS workers get it? Or do people with diabetes and bad asthma who are adults?"

As of Friday the state will have received about 210,000 doses of the H1N1 vaccine, when it expected more than 500,000 by this time. Basically, there's one dose for every three people in the high-priority groups.

Mills says the vaccine shortage is especially galling when considering that some states have enough vaccine for everyone. State officials in Oklahoma opened vaccinations to all groups Tuesday, saying that demand from priority groups had decreased, as had H1N1-related hospitalizations.

"And that's great for Oklahoma but what's it do for us?" Mills said. "We have a surge on our hands. I'd would like to see if we could get some vaccine here to help us."

"If there are states that need vaccine and other states want to share their vaccine, then that is something we're leaving up to the states to work out," says Tom Skinner, a spokesman for the federal Centers for Disease Control and Prevention, which is overseeing the distribution of vaccine around the country.

Skinner says that states are allocated a certain amount of vaccine according to population. In states where supply is low and demand is high, Skinner has this advice: "Officials really need to continue to emphasize to people the other steps that they can take to protect themselves absent the vaccine, and that is making sure we keep hands washed and keep ourselves away from individuals who are sick, keep our children home when they're sick."

He says shipments were delayed, in part, because manufacturers had difficulty growing the virus. "They also had some difficulties in having the facilties needed to finish and fill the amount of vaccine that was coming off the production lines, so we had a hiccup there."

Skinner says that he expects that vaccines will become more plentiful by the end of this month or December. Laurie Brown of Falmouth says she can't get a vaccination soon enough. "I'm disabled, I have asthma, I have emphsyema."

Brown, who is 47, says she asked her primary care doctor for H1N1 vaccine a week ago but was told there was nothing available to her, even though she is in the high-risk category. She's worried about catching something from her two sons, who are both in their 20s and sick with flu-like symptoms. "With the upper respiratory stuff, when I get the regular flu, I'm down for a month. So if I get the H1N1 flu, I don't know --- I'd probably end up in the hospital."

The state reports that adults with chronic conditions account for the 200 or so calls it gets each day from people looking for the H1N1 vaccine. Callers are also contacting doctors' offices and hospitals.

"There is definitely pent-up demand for the vaccine, and a lot of anxious people wanting to receive it," says Sue Hadiaris, Vice President of Southern Maine Medical Center in Biddeford, where only certain health care workers have received the vaccine.
"And that is the Emergency Department staff, the front line staff on the inpatient units, the individuals working on our physician's offices who see pregnant women and pediatric paitents. Everybody else is waiting for the H1N1 vaccine."

Some hospitals, however, are beginning to open vaccinations to all their employees.

"Yesterday's clinic was for anybody who wanted to come and get it," says nurse Cokie Giles, who works at Eastern Maine Medical Center in Bangor and is President of the Maine State Nurses' Association. But Giles says that supplies ran out before those in line could get vaccinated. "That's what happening, is they're doing the best job they can, but if they're not getting enough, or they're getting doses later than they planned on, they have had to cancel some of the immunization clinics."

While the state waits for more vaccine, health officials are hoping that the surge in H1N1 activity will wane, as it has in nearby states such as Massachusetts and Rhode Island.

In the meantime, if people get sick, health officials urge them to talk to their doctor about getting an anti-viral medication such as Tamiflu, which can lessen flu symptoms. They also recommend staying away from big crowds during Thanksgiving break.