Those trying to avoid chills, fever and aching muscles this winter have run into difficulties getting a flu shot.

Across the country, certain clinics, hospitals and doctor’s offices have been waiting all month for vaccine they ordered last year in preparation for the coming flu season. Consequently, some high-risk patients, such as residents in nursing homes, have not received protection from what could potentially be a life-threatening virus.

“We normally would have had all our vaccines administered by this time,” said Phil Dubois, administrator of Market Square Health Care Center, a nursing home in Paris. Of the 120 vaccine doses the nursing home was approved for, only about 50 had been received and administered to long-term patients by Tuesday morning.

The remainder of the vaccines arrived later in the day on Tuesday, and nurses there will give shots to the remaining 32 residents Wednesday.

Although the scarcity of vaccinations panicked some, especially those more vulnerable to the influenza virus, there has not been a flu epidemic in Maine, New Hampshire and Vermont, decreasing the severity of what could have been more of a crisis. And although it’s advisable to receive a flu shot during November, flu often strikes later in the winter.

The holdup this year had to do with glitches in the production and distribution of the roughly 110 million doses of the vaccine, according to Curtis Allen at the national Centers for Disease Control and Prevention in Atlanta. So far, 83.5 million doses have been shipped out around the country.

“Part of the problem is they … can’t produce vaccines any quicker than they are now,” Allen said of the five private manufacturers of flu vaccine. The companies began cultivating the vaccines six to seven months ago after scientists identified which flu strains would hit North America this season.

“The vaccine is still being produced as it was a few years ago, with an egg-based production. Things can go wrong,” Allen said, pointing out that one vaccine strain in particular was slow to grow.

As the vaccine becomes available, or comes “off the production line,” the manufacturers ship it. “The vaccine is being distributed equitably across the United States,” Allen said.

But with many people still without flu shots in Maine by the third week of November, Maine Public Health Director Dr. Dora Anne Mills says it is clear that the production and distribution of flu vaccines needs to be nationalized.

The flu kills about 36,000 people in this country every year, according to the CDC, and about 200,000 more are hospitalized. Countless others lose work days.

Private distributors that can buy the vaccine in bulk generally receive the vaccine more quickly than health care systems that cannot afford the same quantities, Mills said.

“Vaccines come through in private channels, for for-profit companies, like Maxim Health that runs clinics up and down the East Coast,” Mills said. “They tend to get theirs early.”

Maxim Health Systems did not return phone calls for comment Tuesday.

Hannaford Supermarkets, which is supplied with flu vaccines by Maxim Health Systems, offered 50 flu clinics and more than 3,900 shots this fall with no delays, according to spokeswoman Liz Dallara.

Mills continued, “It gets frustrating for people. They see flu vaccines available in supermarkets and department stores,” but at the same time their doctor or health clinic can’t supply them with a shot.

The Maine Center for Disease Control and Prevention purchased 145,000 doses of the flu vaccine this year, which it supplies first to nursing homes, homeless clinics and rural health centers – the high-risk populations. This is down from a high of 250,000 doses in 2000, a result of increasing vaccine prices and a flat-line state budget for the vaccines, Mill said. Maine’s government provides about one-fifth of the state’s stock of flu vaccines.

Mills said Tuesday that she had received the final one-third or so of the state’s shipment in the last two days, enabling the state to send out vaccines to places like Market Square nursing home and hospitals.

Sharon Proctor, the infection control nurse for Stephens Memorial Hospital in Norway, said she had heard the good news that she would receive the remainder of the hospital’s doses early next week, letting her vaccinate emergency room nurses and more elderly patients.

Of the 1,700 doses the hospital was slated to receive, Proctor said that by Nov. 21, only 300 had arrived so far.

“The first time I got something, I got a whole 10 doses,” Proctor said. “It was probably early November. They’ve been giving everybody a piece of the pie.”

She said in the past when she had ordered from manufacturing companies to circumvent the state, the hospital was put on a waiting list, which ended up being an even longer lag.

If any vaccines are left over, Proctor said she would offer a flu clinic to dispense the vaccines to the public.

“People are clamoring for it,” she said.