ATLANTA — Georgia pharmacists are struggling to find influenza vaccines for Georgians who need it the most.

Public officials have stressed the need for every Georgian to get an influenza vaccination this year to avoid potentially dire outcomes of a “twindemic” — COVID-19 coinciding with a bad flu season. But the high-dose vaccines for elderly Georgians are few and far between for pharmacists trying to find them for their communities.

The elderly population is at particular risk of severe outcomes for both the coronavirus as well as the seasonal flu.

According to the Atlanta-based Centers for Disease Control and Prevention, the recommended high-dose annual flu vaccine contains four times the amount of antigen — the part of the vaccine that stimulates immune response — than the standard flu shot, prompting a stronger immune response for people who need it.

During a press conference earlier this month, Gov. Brian Kemp and Department of Public Health Commissioner Dr. Kathleen Toomey urged all Georgians to get vaccinated.

“Never has it been more important to get a flu shot than this year,” Toomey said. “We realize that people sometimes don't think a flu shot is effective, or are afraid to get it or just don't bother. This is particularly important this year. We're trying to prevent twindemics of COVID plus influenza, which could be devastating.”

But pharmacists across Georgia say they are struggling to source influenza vaccinations — particularly the high dose.

Nikki Bryant, owner of Adams Family Pharmacy which has two locations in southwest Georgia, said she ordered 600 flu vaccines back in March and has only received about 170. Only 20 were high-dose vaccines, which were gone in a couple of days.

"I've had a horrible, horrible time getting flu shots this year,” she told CNHI. "It's just been a struggle to try to keep enough flu shots to cover my patients.”

Bryant said it’s gotten to the point where a network of about 10 independent pharmacy owners, herself included, are shifting supply between their stores to take care of patients.

“It's very frustrating when you have a patient come in and want a flu shot and you don't have one to give,” she said.

But a shortage in supply isn’t the only issue. Shipping delays are being reported across industries and pharmaceuticals are no exception. Influenza immunizations must be shipped overnight, Bryant said, so if it takes any longer, they’re no longer usable and have to be destroyed.

Nancy Nydam, spokeswoman for the Department of Public Health, said the agency has heard reports that smaller providers have run out of high-dose vaccines completely, with no additional shipments available. Larger providers like the department and stores such as CVS or Walgreens, she said, may be out temporarily and waiting on additional shipments.

"However, DPH has been told that when we get all the vaccine we pre-ordered, it’s done; the manufacturers are not making more," she said.

In a typical year, Nydam said, the department orders between 400,000 and 500,000 influenza vaccinations, both regular and high dose. This year, it added 200,000 doses to its pre-order.

Health officials also worry the possible combination of coronavirus and influenza could take up much-needed hospital bed capacity across the state.

Nydam said there are two steps people needing high-dose vaccines should take: call around ahead of time to make sure pharmacies have doses in stock and if they cannot find a high dose, get vaccinated with a regular flu shot regardless.

Dhara Patel, who owns the Medicine Stop pharmacy in Warner Robins and Unadilla Drug Company in Unadilla, said high-dose vaccines are nearly impossible to find. When she does find batches from companies she’s not used to using, she said she’s paying premium price.

“It's been tough finding flu vaccines — all the regular people I usually order from, nobody has,” she said. "And the high dose is completely out — you can’t find it anywhere.”

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