For years, the Allentown Health Bureau would take anyone at its flu clinics — insured, uninsured, city resident, out-of-towner — because the overriding goal was to get as many people as possible vaccinated.
As the 2013-14 flu season looms, the goal of mass vaccination remains unchanged, but new rules imposed by the Affordable Care Act limit who can get free vaccinations from the bureau.
Obamacare now will restrict the free distribution of public supplies of the flu vaccine to the uninsured and seriously under-insured, driving insured patients to their primary care providers, where the cost will be covered by their insurance, or to other places where they may have to pick up part of the bill.
"We will not have open flu clinics," Allentown Health Bureau Director Vicky Kistler said.
People on Medicare, Medicaid and the Children's Health Insurance Program and those with private insurance will no longer qualify for free vaccines at the bureau, Kistler said, noting that the bureau is not set up for third-party billing. The exceptions to that policy, she said, are if the individual's insurance does not cover vaccinations or if the government determines the region is affected by a flu outbreak, at which time the old policy would apply.
The Obamacare regulations will not affect Lehigh Valley Health Network's free drive-through clinics at Coca-Cola Park and Dorney Park, spokesman Brian Downs said. LVH gets the vaccine and distributes it to the public as part of its community benefit, a requirement that nonprofit hospitals have to keep their tax-exempt status. This year, for the first time, the drive-through clinics also will offer high potency doses for adults 65 and older, Downs said.
The Bethlehem Health Bureau gets some government-provided vaccine and also buys some directly from manufacturers, bureau Director Kristen Wenrich said. The government supply will go to the uninsured, and anyone with insurance will be able to receive a vaccination for $10, she said.
Both health bureaus are working on their schedules for clinics beginning later in the year.
Officials at the U.S. Department of Health and Human Services did not respond to questions about Obamacare's impact on the distribution of the public supply of vaccines.
People will have to check their health coverage to understand where their benefits apply, Kistler said, noting that a pharmacy or retail clinic may not accept the insurance that someone's family doctor does. Since 2010, Obamacare has prohibited new group or individual health plans from charging beneficiaries all or part of the cost of preventive care, including flu vaccines.
The public should have plenty of vaccine available. According to the U.S. Centers for Disease Control and Prevention, manufacturers will produce up to 139 million doses of flu vaccine, including intramuscular, intradermal and nasal spray forms. Most of the injectable doses will cover three types of flu expected to comprise the biggest threat in the coming flu season, although all of the mist types and some injectables will protect against four strains of the virus, CDC said.
Vaccine-maker Sanofi Pasteur of Swiftwater, Monroe County, began delivering supplies in late July, spokeswoman Donna Cary said. The company has been providing flu vaccines in mid-summer for the last several years, she said.
Cary said Sanofi Pasteur's vaccine covering two strains of influenza A and two of influenza B is in limited supply and is of most benefit to young children. She recommended that parents ask their pediatricians about the availability of the "quadrivalent" vaccine for their children.
Some providers already are advertising the availability of flu vaccines. Rite Aid, for example, last week announced that its 4,600 pharmacies were ready to deliver the vaccines.
While the vaccine's strength diminishes over time, Kistler and Wenrich said getting the vaccine is more important than when you get it. Immunized people will stand a better chance of avoiding illness or at least having a milder case of illness than people who are not vaccinated, Kistler said.
People with the flu can experience fever, runny nose, aches, chills, nausea, cough or fatigue. The elderly and those with underdeveloped or compromised immune systems are particularly susceptible to the flu, and in those cases, flu can result in more serious illness and death.
The state Department of Health estimates that 5 percent to 20 percent of Pennsylvania residents — up to 1.2 million people — get the flu each year. It also estimates that 200 to 2,000 Pennsylvanians die each year from the flu.
For that reason, health officials urge healthy people, especially those who regularly come into contact with the very young and very old, to get vaccinated.
The CDC says people older than 6 months should get vaccinated. Earlier this year, the Food and Drug Administration approved Flubok, a vaccination for people 18-49 years old not made using the influenza virus or chicken eggs — an allergen to some people.
Lehigh Valley Health Network's free drive-through clinics will be Nov. 9 at Dorney Park in South Whitehall Township and Nov. 10 at Coca-Cola Park in Allentown. Children, adults and seniors will be eligible. Online registration will be available closer to the date.