As recently as three weeks ago health experts projected that 100 million Americans would have access to flu shots this fall, according to the Department of Health and Human Services. The same was true of the staff at the Brandeis health center, until they did not receive all of the vaccine doses they had initially ordered. The national shortage is the result of British authorities shutting down a Liverpool production plant operated by the American company Chiron because of contaminated flu vaccine cultures. Brandeis initially ordered the flu vaccine from Aventis, the only other drug manufacturer that sells to the United States. Because of this, the University still received some doses, while major hospitals that ordered exclusively from Chiron, were left with no supply.

"The situation has been very difficult and has made many people in the U.S. fearful, anxious and angry," said Kathleen Maloney, a nurse practitioner and the administrator of the health center.

It has also become an ethical issue, she said. "If you have one vaccine left and two students stating they should be in the 'priority group,' how do you decide who should get it?"

Each year, the Brandeis nurses review the health forms of incoming students and a list of students who are at high risk, using guidelines from the Center for Disease Control (C.D.C). The health center contacted just over 150 high-risk students-most with asthma-and nearly all took advantage of the offer. The few students who did not said that their stated medical condition had been stable for a few years, and thus their risk was low.

Maloney reported that once the list of students is completed, there will probably be a very limited supply left. If shots remain, the Health Center will contact staff and faculty via e-mail and offer it to those who fit the C.D.C. guidelines. At-risk staff and faculty were not offered the shot in the first round because it is assumed that they have better access to private healthcare providers and clinics than students living on a college campus.

The definition of "high-risk" applies to those for whom there is the possibility of life-threatening complications if they contract the flu. Among these are children under six months of age, pregnant women, the elderly and anyone with a history of serious health issues. For most Brandeis students, this includes cases of severe asthma or a history of disease-such as cancer-that weakens the immune system significantly.

Failure to follow the guidelines during a crisis such as this one can result in a $250 fine per violation and the possibility of imprisonment.

Due to the shortage of vaccines, Varun Saluja '08 said he thinks there is a prospect of widespread illness on campus this flu season. He said has never gotten a flu shot because he believes that he has a good immune system, yet in the face of the shortage, Saluja said that circumstances now are different.

"With public restrooms and eating facilitates, as one person gets sick, others will follow quickly," he said. "There is the potential for people to get sick, to be less likely to do work and for things around campus to get bad."

Josh Raffel '06 was among those identified as high risk to get a flu shot this year. He said he did not want to leave anything to chance.

"After I found out that there was going to be a shortage of flu shots I contacted the health center to make sure that I received one," Raffel said. He receives the shot because of a serious illness he contracted during high school.

Similarly, Stephanie Shelan '05 took the opportunity presented to her by the Health Center.

"I have really bad asthma and the flu is extremely dangerous for me; it could easily lead to pneumonia and serious related problems," she said.

Even when the flu vaccine is plentiful, an average of 36,000 Americans die of influenza or its complications in a given season. Due to the vaccine shortage this year, there could be a 25 percent surge in flu-related deaths, according to an infectious-disease expert quoted in the Nov. 1 issue of Newsweek. And economists see up to a $20 billion loss in productivity, double the amount in a normal flu season.

The lack of such a potentially vital vaccine has resulted in ethical and legal breaches across the nation. Six-hundred-and-twenty doses were stolen from a Colorado clinic, leaving only 120 behind. Montgomery County, Md. entered 14,000 names in a lottery for 800 shots.

Also, because the United States doesn't purchase left-over flu shots-like other countries do-hospitals and clinics tend to be conservative in the number of vaccines they order, not wanting to be left with a surplus.

Brandeis sells the flu shot for the amount that it pays the distributor: $10. Yet, in this shortage, some economists are turning toward the classical supply-demand paradigm to push for higher cost to consumers of the shots in a quest to cut down demand. Newsweek quoted U.S. Secretary of Health Tommy G. Thompson urging state attorneys to "thoroughly investigate reports of price gouging and prosecute those engaging in this immoral and illegal activity."

The majority of Brandeis students that do not make the cut for the Center for Disease Control's high-risk B find themselves with old fashioned methods of prevention and cure this year.

Maloney suggested that washing hands is the easiest defense against the flu.

"Singing the ABC's is a good way to make sure you are washing your hands long enough," she said. Preventing an epidemic could come down to following those rules we learned in elementary school.

And for those who do succumb to the flu, first-year student Saluja said, "I do make a mean homemade stew.