Flu shots will be late again this year, although health officials believe the delay will not be as long as last fall.

Also, the price that public clinics pay for the vaccine has more than doubled, rising from $1.79 a dose last year to $4.49 this year.

"I don't think the higher prices are going to dissuade physicians from recommending flu shots," said Karen Resner, program director for Merced County Public Health Services. "I think physicians who have recommended them in the past are going to stay committed to the shots, even with the higher prices."

Many state and nonprofit health-care providers in the Northern San Joaquin Valley and foothills expect to receive most of their vaccine in late October or early November. Some of those providers have raised their prices, as well.

The Stanislaus County public health division, which ordered about 7,580 doses, is scheduled to receive half the shipment in September, half in October, said Nancy Bancroft, public health nurse.

The county will charge $10 a shot at its public clinics, up from $8 last year. The first clinic is scheduled at the Modesto Senior Citizens Center in mid-October.

Merced County Public Health Services does not know when it will receive its order of about 6,400 doses, Resner said.

"We don't have a date yet, but I think it may be late October," she said. "We haven't scheduled any of our clinics until November."

San Joaquin County Public Health Services also does not know when it will receive its vaccine, said Ginger Wick, the county's immunization coordinator. The county ordered about 17,000 doses.

"We're told it will be a divided shipment, but we don't know exactly when we'll get the vaccine," she said.

Wick said the county will hold most of its clinics in November, not October, this year.

Tuolumne County will receive its 2,570 doses in mid-August and will start holding its clinics in mid-October, said Kathy Amos, a manager with the county's public health division.

The Modesto-based Visiting Nurse Association of the Central Valley, a nonprofit organization that provides flu shots at area Longs drugstores, is expecting to receive 75 percent of its shipment in November. Danette Stoddard, a manager for the organization, said the group ordered 11,000 doses.

"We normally start our clinics Oct. 1," she said. "However, we're going to have most of them in December."

Stoddard said the association will raise its price from $12 a shot to $15.

Nationwide, manufacturers expect to produce 77.1 million doses this year, according to the Centers for Disease Control and Prevention.

Manufacturers produced 70.4 million doses in 2000 and 76.8 million in 1999.

However, the CDC expects only 49.8 million doses to be available by the end of October.

Because of this delay, the CDC is recommending that vaccine providers immunize senior citizens and those with weakened immune systems first.

Younger, healthier people should receive shots in December and early January. CDC officials say that vaccines given later in the flu season are still effective.

"Hopefully, if we can do this phased-in approach, it won't cause too many problems," said Dr. Natalie Smith, the chief of immunizations for the state.

"It seems like the situation will be much better than it was last year."

Last year, flu shots were given late because the federal Food and Drug Administration took action against two manufacturers and there were problems growing a strain of influenza.

Smith said this year's delay is being caused by a reduction in the number of vaccine makers. There used to be four manufacturers; this year there are three.

"Our understanding, the long and short of it, is that this year will be better than last year," Wick said, "but worse than a normal year."

Bee staff writer Brian Joseph can be reached at 578-2330 or bjoseph@modbee.com.

Reprinted by permission of Modesto Bee.