BALTIMORE (AP) – At the Walgreens flu shot clinic, the honor system is in place.

If you tell nurses there you have a chronic heart problem, you can get a shot. Pharmacies and grocery stores doling out shots in the midst of a major shortage are depending on customers’ good citizenship.

“We don’t want to be the flu-shot police,” said Michael Polzin, spokesman for Illinois-based Walgreens. “But we’re letting people know the situation.”

The drugstore chain contracts with Maxim Healthcare of Maryland to administer shots at 4,000 stores nationwide. Maxim also dispenses flu shots at Giant Foods, Costco and Rite-Aids across the country.

The healthcare group pledges to follow the pleadings of federal health officials. Nurses are requiring those seeking a shot to sign a form saying they are at high risk of developing complications from the flu.

Earlier this week the Centers for Disease Control and Prevention urged private vendors to withhold shots voluntarily from young, healthy patients after the government learned that the United States will get only half its expected vaccines.

“I think we’re all trying to do the right thing,” said Steve Wright, Maxim’s national director of wellness services.

His firm received less than half of the 2 million shots it expected and has announced on its Web site that it will close its clinics on Oct. 16.

Health care providers are turning away healthy adults, but “it’s more problematic” at places like Wal-Mart, said Dr. Anthony Fauci, infectious diseases chief at the National Institutes of Health.

If someone claims to have a heart condition or diabetes, “It’s difficult for the Wal-Mart person to say, ‘No you don’t.’ They have no way of knowing that,” he said. “It’s not going to be a perfect situation.”

Waiting in line at a Baltimore Walgreens on Thursday night, 62-year-old Ellwood Beale said he suffers from a heart condition and his doctor quickly ran out of vaccine.

While acknowledging “it’s human nature” for people to protect themselves, he said, “I think most of them are going to be honest.”

Store officials agree. Even in past years, they estimate two-thirds to three-quarters of those who lined up for vaccines were high-risk.

“That’s our target group,” said Barry Scher, spokesman for Landover, Md.-based Giant Foods, which offers shots at most of its 150 stores in Maryland, Virginia, New Jersey and Delaware. “We’re hoping the other 25 percent will not be upset, because this is what we have to do. We just can’t give shots to everybody.”

Federal health officials say the shots should be given only to children 6-23 months old, people 65 and older, people with underlying or chronic medical problems, pregnant women, nursing home residents, health care workers who directly care high-risk patients, caregivers of children under age 2, and children who regularly take aspirin.

The form distributed to patients at Maxim clinics says people not in those high-risk categories should forego flu vaccination.

Wright says Maxim has received few complaints, although some people are disappointed when they’re turned away.

“We’re asking people when they look at the questionnaire, if they’re not in that (high-risk) category, then they know someone who is,” Wright said. “And if they get a shot, they’re taking the vaccine away from that person.”

The United States expected 100 million vaccine doses, but British health authorities suspended the license of vaccine producer Chiron Corp. at the company’s Liverpool, England, factory because of contamination.

EDS: Medical writer Lauran Neergaard in Washington contributed to this report.

AP-ES-10-08-04 1758EDT

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