As public clinics begin H1N1 shots, state says private provider shouldn't have 10,000 doses

The Farmers Branch flu clinic that has been selling its 10,000 doses of H1N1 vaccine to anybody with $20 should never have received a single one, state health officials said Friday.The company, known as Flu Shots of America and Star Medical Group, misrepresented itself when it registered for the swine flu vaccine, Texas health department spokeswoman Carrie Williams said. The company identified itself as a private medical practice rather than a company in the vaccine business.

Because the vaccine is still scarce, the state is sending it only to private practices, public health departments and hospitals. But the huge amount shipped to the company should have tipped state officials that something was wrong, Williams said. No other private provider in the county has gotten as much as half that amount"It should have raised a red flag," she said. "This is a lesson learned."

Meanwhile, public health departments began mass vaccinations.Dallas County, people with appointments steadily visited the health department to vaccinate their children with chronic illness. And Tarrant County held its first walk-in clinic, using up almost all of the more than 1,600 doses it had on hand for pregnant women and children with chronic illnesses.

Officials from both counties said their first clinics had gone smoothly.

"We started our clinics as a test run because children are a high-risk population," said Zachary Thompson, director of the Dallas County health department.

The Tarrant County clinic may offer a warning about crowd control for the Dallas County clinic, scheduled for Wednesday and open to county residents in the H1N1 risk category without health insurance.

On Friday, about 1,000 people came out to W.G. Thomas Coliseum in Haltom City for a clinic aimed at a much smaller target population. The available parking was filled long before the doors opened Friday morning.

High-visibility clinic

Like the two public clinics, traffic at Flu Shots of America was steady again Friday. Owner Jeff Vitt said he expected to give out 800 doses, a bit less than on Thursday.

Flu vaccine is finding its way to more private providers each day, but this clinic – labeled on building signage as Flu Shots of Texas – is the only high-visibility source in North Texas placing no restrictions on who got vaccinated.

State officials had two problems with that:

Because the national supply of the vaccine is limited, Texas is distributing it only to practitioners who serve the most patients at the highest risk of getting very ill with the H1N1 virus. The state defines that category as pregnant women, children ages 6-24 months, youths with chronic illness, health care providers and household contacts of infants younger than six months old.

Any provider who wants to give out H1N1 vaccine is required to register with the federal Centers for Disease Control and Prevention and identify what kind of practice it is and the types of high-risk patients it serves.

Williams said the state is investigating why Flu Shots of America misrepresented itself on the registration. The state will not ship any more vaccine to the company while it investigates.

The other concern, Williams said, is that the company offered the vaccine to people not in the high-risk groups.

'Missing the point'

Vitt could not be reached to respond to Williams' remarks, made late Friday afternoon, but he said Thursday that he has done nothing wrong.

Public records show that Vitt has registered several business names in recent years, often listing the Farmers Branch clinic address, 2300 Valley View Lane. Some are health-related, including Texas Family & Occupational Health Services, which does business as Star Medical Group, and Excel Occupational Clinics.

He also has formed a debt-collection business called Recovery Services of America, which describes itself as "a results-oriented recovery resource for companies and physician practices."

On Thursday, Vitt said that he believes that everyone is at risk and that many of those who visited his clinic are in the official risk groups.

Vitt broke no law in selling the shots, Williams said. But that doesn't mean state officials are happy about it.

"It is missing the point of what we are trying to do," she said.

Officials at one local medical company, Home Health Services of Dallas, said they had alerted the state to what Flu Shots of America was doing days before the clinic came to public attention.

When told by a client that their competitor was offering unrestricted H1N1 vaccine, the company complained to the state, said Dr. Robert Kramer, the company's flu program medical director. They were told the state was relying on the honesty of the providers.

"There is no due diligence or accountability there," said Kramer, a pediatric pulmonologist who practiced at UT Southwestern for 30 years. "I am just furious there are people around who are doing something they know is unconscionable."

In line with the rules

On the other hand, some people who are in the high-risk groups got their vaccines Friday from the two county free clinics.

People started arriving for the Tarrant County clinic in the chill drizzle long before dawn. By the time screeners emerged to check for eligibility, the line snaked around the building and along an adjacent road.

The third group in line was turned away by the screeners. Lauro Euribe said he came at 5 a.m. with friends and family. He seemed bewildered at being told none of them were eligible for that day's clinic. But none of the women were pregnant and the kids were all healthy.

"We came here for nothing?" asked Ramon Jimenez, 11. "And we missed a test!"

But Kathleen Jenkins of Arlington got her vaccines for her children. She and daughter Charlotte, 15, and son Kelly, 16, were the first in line and had camped out overnight with a tent. Jenkins said that her two children were asthmatic and that she has suffered from serious bouts of pneumonia.

"We have been hypervigilant since they first announced two weeks ago that the swine flu vaccine would be coming," Jenkins said.

In Dallas, the scene was more orderly. There were few walk-ups and those who did were turned away and told to make an appointment or wait for next week's clinic.

By the time Fatima Rangel and her 7-year-old son reached the lobby at 9:30 a.m., there was no line. She was relieved to get the vaccine for her son, Zion, who has spina bifida and uses a wheelchair. Last year, he was hospitalized with breathing problems.

"Unfortunately, his pediatrician didn't get the shots," she said. "So we had to come here."

Dallas only

Dallas County administered about 150 flu shots Friday and plans to do 200 more each on Monday and Tuesday for children, ages 6 months to 18 years old, who meet the department's criteria.

On Wednesday, the health department will begin offering 10,000 free flu shots to anyone in the highest-risk groups, including children, pregnant women, caregivers of children under 6 months old, people aged 25 to 62 years old who have medical conditions and health care and emergency workers who might have contact with flu carriers.

The doses will go only to those who can prove they are Dallas County residents. The intent is to serve only people who have no medical insurance.

On Friday afternoon, staffers were unloading traffic cones that will be used to corral the onslaught of vehicles. Thompson said he hoped the public will understand that the county's vaccine is not for everybody.

"We are the safety net," he stressed. "When everyone has their vaccine, it's a non-issue."