People are lining up at pharmacies and supermarkets in the middle of the night: old folks with oxygen tanks, sleeping children bundled up in strollers, people in wheelchairs.
Some collapsed in exhaustion. In the San Francisco area, a 79-year-old woman died Thursday from head injuries after collapsing from exhaustion. She had waited four hours in a flu shot line with hundreds of other seniors. Two elderly women in Concord, Calif., were hospitalized after collapsing in a vaccine line.
Federal health officials don't want long lines, said Centers for Disease Control director Julie Gerberding.
"It's important for people to understand we've got 20 million doses of flu vaccine coming on the way. It's coming out of the factory in an orderly manner and we're doing everything to get it to the people who need it most in an orderly manner," she said Monday on CBS News' The Early Show.
The shortage developed after British health authorities shut down one of the two makers of vaccine sold in the U.S., because of contamination. Gerberding said the other is working as fast as it can.
"Aventis is trying to allocate what is coming out to the people who need it most and we're focusing on the people 65 years and older because they are the most vulnerable to the complications," The other priority group is 6- to 23-month-old children.
Some economists expect losses in productivity, not just in terms of sick employees but lost workdays to tend to sick family members, reports The Wall Street Journal. One expert tells the paper twice as many people could get the flu this year because of the lack of vaccine.
In a normal year, the flu is the leading cause of Americans calling in sick to work.
David Cutler, a professor of economics at Harvard University, estimates that the flu's effects on the economy could approach $20 billion this year.
The shortage of flu shots is also a fairly simple lesson in economics, reports CBS Newsman Tony Guida: Flu vaccine is complex and costly to produce, profits are thin and it has to be re-invented every year.
"In the United States, the manufacturers have been dying a slow death," said Dean Manson, head of the Sabin Vaccine Institute.
Twenty years ago, there were two dozen manufacturers. Now there are just two, and one, Chiron Corp., is out of the running this year. Public health experts warned about that trend 14 months ago, in a National Academies of Science report which recommended changing the government's role from buying vaccines to assuring immunization.
"Public and private insurers would be required to cover certain vaccines and the government would pay a certain amount per dose," said Dr. Frank Sloan of Duke University, who chaired the committee.
That would offer sufficient incentive, Sloan said, for manufacturers to get back in the business of making flu vaccine. It would also insure, he said, that every American who needs a flu shot could get one.
"We were worried that a lot of people are not covered for vaccines," he said.
Whether the lack of flu shots this year will cause an epidemic isn't known yet.
"Flu is unpredictable," Gerberding told Early Show co-anchor Julie Chen. "Right now, we can't say whether this is going to be a mild flu season or a serious flu season."
Health and Human Services Secretary Tommy Thompson has said it's not really that much of a crisis.
"Just a few years ago, we went through the whole flu season with the same number of doses that we're dealing with this year," Gerberding said.
Democratic presidential contender John Kerry took issue with that, making the vaccine shortage a campaign issue.
"The Bush administration simply does not get it," Kerry said in a statement. "They didn't take action to avert this shortage, despite the fact they had been warned for years. Yet again the Bush health care policy sends a clear message to Americans: don't get sick."
The Massachusetts senator also reiterated the charges on the stump this weekend. A Bush spokesman accused Kerry of hypocrisy for criticizing the president after voting against a measure that would protect vaccine manufactures from punitive damages.