Syndicated columnist and Fox News contributor  Susan Estrich describes how difficult it is to get a seasonal flu shot -- not the H1N1 flu shot, mind you, which has been delayed and will not be widely distributed for several weeks yet:

I was all set to get it at the one-day clinic in the lobby of the building where I work, but it turned out that I had to go to something ridiculous like a hearing that day and missed the morning hours. Imagine, work getting in the way. There were no afternoon hours.

Of course, I've tried all the drug stores. I know I should have started there, and if I had, I would have been flu-ready a long time ago. ... How stupid of me to think that if my local mega-branch of a national drugstore chain had flu vaccine, my internist and rheumatologist definitely would...

My secretary made it to the clinic at work, but they weren't vaccinating pregnant women -- their insurance didn't cover pregnant women.

So, since her obstetrician didn't have any vaccine and her son's pediatrician didn't have any vaccine, instead of coming to work the next morning, she drove 25 miles in the wrong direction to be one of the first in line at the county clinic, putting her among those numbers I hear at the end of the day.

Estrich notes that since the government is very obviously running the show when it comes to the distribution of vaccine, it's not exactly a reassuring introduction to some kind of "public option."

The unavailability of the H1N1 "swine flu") vaccine during a period when President Obama has declared "a national emergency" is an even better illustration of Estrich's point about government run health care.

Health and Human Services Secretary Kathleen Sebelius is suggesting that vaccine manufacturers were not forthcoming about the amount of vaccine they could produce by mid-October, while the pharmaceutical companies insist they kept administration officials in the loop every step of the way, reports The Washington Post:

Caught in the middle are parents who have heard contradictory messages and remain unable to get their children immunized.

"I don't know if all departments are communicating within the government," Silver Spring mother Robyn Dixon said Monday [October 27]. She left a long line in Rockville last week when it was clear that her 18-month-old son would not receive the vaccine. "I think it's them trying to get information out too quickly without really doing their research into how involved it is to make the vaccine.

"I want them to get it right," she added. Still, "I'm at their mercy." [Emphasis, The Stiletto.]

The result? Instead of "every American" being inoculated, "doctors and clinics are forced to turn away many people," according to The Post, and swine flu vaccine is being rationed. "[Local ]government officials, hospital workers and doctors in private practice are being conscripted as ad hoc swine flu police," reports The New York Times:

The goal is to make sure that those Americans with the highest risk for contracting the virus -- and experiencing the more dangerous complications that can ensue -- get injected first. But the somewhat willy-nilly nature of the vaccine's distribution in some areas, publicity surrounding President Obama's declaration of a national emergency and the rather large population legitimately considered high risk have brought hundreds of thousands of people to vaccine distribution points.

Some people beg. Some reduce themselves to lying about a pregnancy, or an underlying medical condition, that would move them ahead of the pack. In any case, officials say it is virtually impossible to verify most of the claims. ...

[G]overnment officials have set unambiguous priorities based on who is most vulnerable: pregnant women, people who live with or take care of infants under 6 months old, health care workers, anyone 6 months to 24 years of age and people who are older than that but have underlying health problems that make them susceptible to influenza-related complications.

But the vaccination priorities The Times cites assume that H1N1 vaccine would be available at the start of flu season, that high-risk groups would be at the head of the line, and that as more vaccine was distributed a wider swath of the population would get the shot.

But that's not what happened -- only 16 million doses of the vaccine are currently available, and as many as 159 million Americans fall into one of the high risk groups who could develop life-threatening complications -- so the priorities tighten further to preferentially protect those at highest risk, according to the Centers for Disease Control and Prevention:

When vaccine is first available, ACIP recommends that programs and providers administer vaccine to people in the following five target groups (order of target groups does not indicate priority):

- pregnant women,
- people who live with or provide care for infants younger than 6 months (e.g., parents, siblings, and day care providers),
- health care and emergency medical services personnel,
- people 6 months through 24 years of age, and,
- people 25 years through 64 years of age who have certain medical conditions that put them at higher risk for influenza-related complications.

Because the amount of vaccine available at first will be small, the ACIP also made recommendations regarding which people within the groups listed above should be prioritized if the vaccine is initially available in extremely limited quantities. [Emphasis, The Stiletto.]

Even when swine flu has swept through schools, parents have been unable to get their kids vaccinated -- so their kids got vaccinated by Mother Nature (that is, they got sick). One can only hope that kids who are already battling serious illnesses are getting vaccinated.

But, trust me on this, if there is one thing you can count on it's that no matter how much a needed or desired treatment is rationed, the privileged will be at the head of the line. It's the rest of us hoi polloi -- and our children - who must wait or go without.

The Stiletto blogs at TheStilettoblog.com.