AKRON, Ohio – The influenza vaccine has always been a shot-in-the-arm proposition -until this year, when a quick, painless spritz up the nose was offered as an alternative.

But as the peak flu season draws nearer, consumers are ignoring the nasal vaccine known as FluMist.

Not even a nine-week, $25 million advertising campaign has overcome the vaccine’s obstacles: storage difficulties, a different target audience, the use of a live virus, problems training pharmacists to administer the drug and, most obviously, cost.

“We had a lot of phone calls (asking about FluMist),” said Tom Nameth, Discount Drug Mart’s director of pharmacy operations, “but once they found out the price, that was the big turnoff.”

Most doctors aren’t surprised.

“None of us expected it to catch on,” said Dr. Ellen Kempf, medical director of Children’s Hospital Physician Associates. “The company kept telling us what a great influx this would be and we said, “Huh? We don’t think so.’

“It’s, what, five times the cost? As soon as you tell a family this … they say, “Forget that.’ “

Out of literally thousands of flu vaccinations given at the offices of Children’s Hospital Physician Associates in the past two months, only one used FluMist.

Some people have shown interest, Kempf said, either because of needle phobias or because they were intrigued by the TV commercials. But the interest was generally quickly snuffed out by the price.

FluMist retails for about $56, while flu shots cost less than $20 at most drugstores and can be found for as little as $8 to $12 at local health departments.

Steve Tomasko was willing to deal with the price – and the hassle – to find FluMist for his 7-year-old daughter, Alex.

“My daughter, like most of us, does not particularly like needles,” he said. “Trying to be a good dad, I try to avoid unpleasantness for her whenever possible. Also, the first time you get the flu vaccine, you are supposed to get it twice that year. I knew getting her to the first shot would be tough – to a second, nearly impossible.”

Nearly as impossible was finding someone willing to administer FluMist.

Tomasko first called his doctor’s office, but he was told they weren’t administering FluMist because of the cost and the fact that most insurance companies don’t cover it. When Tomasko learned that his insurance company covered it, he called back, only to learn that the office didn’t have any FluMist on hand because it didn’t have the non-defrosting freezer required to store it.

So he suggested that he could pick up the vaccine at a nearby pharmacy and bring it to the office with his daughter for the vaccination.

“They responded that they could still not give it because they could not guarantee that the vaccine had been handled properly,” Tomasko said. “I told them that I was not importing anything from Mexico – that it was just going to be coming from the Sand Run Pharmacy down the road.”

After another consultation, the doctor finally agreed to administer the FluMist to Alex.

Trained pharmacists can administer the vaccine to children 12 and older. But there have been snags for pharmacists, too.

The Discount Drug Mart chain sent pharmacists to training sessions sponsored by FluMist maker MedImmune and then learned that the course wasn’t approved by the Ohio State Pharmacy Board. So the pharmacists couldn’t administer the vaccine without taking another board-approved course, an investment the drug chain wasn’t willing to make again this year for a product that had generated little consumer interest.

Another key problem, Kempf said, is that FluMist is approved by the U.S. Food and Drug Administration only for healthy individuals between the ages of 5 and 49. Pediatricians target all children between the ages of 6 months and 2 years, in addition to children battling chronic illnesses, such as asthma, heart disease or kidney disease – none of whom can be vaccinated with FluMist.

The problem is the same in the adult population, where those over 50 and those with chronic illnesses are encouraged to be vaccinated.

Unlike flu shots, which contain a dead, inactive version of the influenza virus, FluMist uses a live virus, which can be dangerous to those who have compromised immune systems because of chemotherapy or corticosteroid use.

MedImmune had predicted sales of between 4 million and 6 million doses this season – a small percentage of the 60 million to 90 million flu vaccinations given this year. The company told analysts and investors in a conference call last week that just 400,000 doses had been sold.

According to the FluMist Web site, only two doctors’ offices in Akron – and fewer than two dozen in Summit, Stark, Medina, Portage and Wayne counties – are offering the vaccine.

“If it takes off and becomes the standard,” Tomasko said, “I’m sure that in future years we will retell our story of how we were some of the first, and just how hard it was to get it back when.”

(c) 2003, Akron Beacon Journal (Akron, Ohio).

Visit Akron Beacon Journal Online at http://www.ohio.com/.

Distributed by Knight Ridder/Tribune Information Services.

AP-NY-12-01-03 0627EST

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