Norman Cooper has been unable to find a flu shot for his wife who takes daily oxygen treatments for asthma, emphysema and bronchitis.
So he was incensed to learn that some inmates in the state prison 30 miles down the road were getting flu shots (search).
"This deal with the prisons has got me so upset," said Cooper, who also hoped to help an 80-year-old friend who was on oxygen for a chronic lung illness. "I don't think they should get flu shots over citizens who are at high risk. They're being treated like first-class citizens, and we are second-class citizens."
Federal and state prison officials say the inmates getting the shots are also high-risk — either 65 and over or suffering from a chronic medical condition. They say it's the surest way to fend off a flu epidemic inside the prisons that could be costly to taxpayers.
But Cooper's distress over the situation is just one example of the difficulty of fairly distributing the nation's short supply of flu vaccine.
The government estimates there are 98 million people at high risk of flu complications, and expects to have a little more than half of that number of flu shots.
The Missouri prison system's medical services contractor, Correctional Medical Services (search), got 8,780 of the 9,460 doses it had requested, said spokesman Ken Fields. And he said all of those shots have already been given to high-risk inmates as well as some high-risk staffers who have direct contact with them.
"By being proactive about this, we hope to keep inmates from having to be housed in outside hospitals," said John Fougere, corrections spokesman.
Meanwhile, Cooper and thousands of others have spent countless hours calling doctors and health departments seeking flu shots. Cooper, who lives in Scott City in southeast Missouri, says his 64-year-old wife was hospitalized in June and was warned that a cold or the flu could be fatal.
But prison officials argue that inmates also need protection. Even though they are confined, they are susceptible to flu through contact with staff, visitors and turnover among inmates, said Joe Weedon, spokesman for American Correctional Association (search), a trade group that accredits jails and prisons. A large number of inmates also suffer from alcohol and drug addictions, which can compromise their immunity.
"You've got an environment where inmates are living in close quarters, coming into contact with each other and not necessarily in the most sanitary conditions because they don't wash their hands," Weedon said. "The inmates throw fecal matter at other inmates or at officers, things like that do happen, and they lead to the spread of disease."
Even so, while prison populations often have infectious outbreaks like staph infections or hepatitis, no corrections officials could recall a serious outbreak of flu among an inmates.
Like the rest of the country, prison officials have been told not to expect all of the vaccine they ordered.
While Missouri had enough vaccine for nearly a third of its inmates, Texas, with one of the nation's largest prison populations, is mapping plans for doling out 1,100 flu shots among 150,000 inmates — or less than 1 percent.
"Our infection control policy is to give a flu vaccine to chronic disease patients, HIV/AIDS patients, offenders 65 years of age and older and pregnant females," said Texas prisons spokesman Mike Viesca.
As part of its infection control policy, health officials with the Texas corrections system also vaccinate to protect against pneumococcal bacteria, a common flu complication, and Hepatitis B, measles-mumps-rubella and tetanus and diphtheria.
In Kansas, the Department of Corrections doesn't have any flu vaccine for its 9,000-plus inmates. Officials hoped to learn later this week whether it would get some, spokesman Bill Miskell said. Last year, 5,500 flu shots were given to inmates and employees, he said.
Dan Dunne, a spokesman for the Federal Bureau of Prisons, which has 152,811 inmates across the country, said the system didn't expect to use a disproportionate amount of vaccine.
He said he didn't know how many flu shots were available for federal prisoners. Shots to employees will be limited to those at greatest risk of getting the flu and spreading it to prisoners, he said.