With doctors and clinics running out of flu vaccine here, some people are turning to Canada for a shot.
But supplies across the border are limited, and Americans in search of a shot will have to hunt around for a physician who is offering vaccine to non-residents.
"We have some vaccine, and while supplies last, we're happy to help," said Dr. Artaj Singh, medical director of Urgent Care Niagara's Fort Erie clinic, one of a handful of medical offices in Ontario selling vaccinations to Americans.
Meanwhile, health officials in the United States are encouraging calm. More vaccine, about 24 million doses, has yet to be shipped, they say.
"More doses of vaccine will be going out over the next six to seven weeks, so there will be more opportunity for those who need the vaccine to get it in time for this year's influenza season," Dr. Julie Gerberding, director of the Centers for Disease Control and Prevention, said in a statement.
Most of the vaccine available in Canada -- about 90 percent of 10 million doses -- is purchased by provincial governments and provided free to residents. The government-purchased supply that physicians receive is not to be sold to nonresidents, according to Canadian authorities.
But physicians, clinics and others can sell the remaining supply, a little more than 1 million doses, that they buy from suppliers themselves. Two companies sell flu vaccine in Canada -- Aventis and ID Biomedical.
Singh said his office, a walk-in clinic, had a "few hundred doses" that it is selling to high-risk nonresidents at around $40 American and may receive additional supplies in the future.
"Our desire is to maintain the integrity of the Canadian system and to help our neighbors to the south if we can," he said. "The flu doesn't respect borders."
Another Fort Erie provider, Dr. Michael Csanadi, is trying to obtain vaccine to sell to nonresidents.
"We don't have serum now, but perhaps later in the week," said Joni Carpenter, a nurse in the practice that has a large American clientele that buys cheaper prescription drugs in Canada.
"We're getting a lot of calls from Americans," she said. "If vaccine is available, we will provide it."
There may be other Ontario physicians with doses to sell, but there's no way to know who except by calling around to pharmacies and border city medical offices.
Physicians in Canada are being warned not to sell their government-purchased vaccine to Americans.
"The stuff in my fridge didn't just magically appear. It's part of predetermined plan to immunize every high-risk person in Canada," said Dr. Albert Schumacher, president of the Canadian Medical Association.
Schumacher, based in Windsor, predicted that because of increasing numbers of patients with chronic conditions, there would be fewer than expected flu vaccine doses available for sale to nonresidents.
He also warned that Canadian physicians who vaccinate a nonresident are not insured against the rare but possible risk of an adverse outcome related to the shot.
The U.S. supply of vaccine was cut in half Oct. 5 when British regulators shut down production of the vaccine at the Liverpool, England, plant of Chiron Corp., an American company, because of contamination problems.
As is the case nationwide, Buffalo-area providers of flu shots have canceled public clinics and rationed supplies for individuals most at risk of influenza.
The latest casualty came Monday when the Catholic Health System canceled all of its scheduled flu shot offerings.
Federal officials had planned to have 100 million vaccine doses available this winter, up from 87 million last winter. Instead, they expect 54 million doses from the other major manufacturer, Aventis Pasteur, and 1 million to 2 million doses of a nasal spray FluMist vaccine from MedImmune.
Priority groups include children ages 6 to 23 months, adults 65 and older, individuals with underlying chronic medical conditions, pregnant women, residents of long-term care facilities and health care workers involved in direct patient care.
The loss has left many Americans, especially those at high risk of such flu complications as pneumonia, anxious about the approaching influenza season.
Mary Buffamonti of the Town of Tonawanda, a senior citizen who also gets a flu shot every year, got one Monday in Fort Erie after learning the Urgent Care Center was offering flu shots. She said she called the clinic first to find out about office hours and the cost.
"It makes me feel safer," she said Monday evening. "My husband got a shot earlier in the morning at the (Veterans Affairs Medical Center), but I called my doctor and couldn't get one."
News Staff Reporter Dale Anderson assisted with this report.