At military bases already strained by the demands of war in Iraq and Afghanistan, the men and women who defend the nation aren't being defended against the flu.
Soldiers who deploy are getting shots once they receive their orders, as are young children and others in at-risk groups, according to base spokesmen from around the state. But for many others in the military, flu shots are as scarce as they are for civilians.
Normally, the Navy hospital at Camp Lejeune - one of the state's two largest installations - would be getting 50,000 to 60,000 doses of flu vaccine for more than 40,000 active duty Marines, dependents and retirees.
"There are none aboard the base at this time," said George Reynolds, director of community health at Lejeune's hospital, which also covers needs at the New River air station. "We have not received the first dose."
Deploying troops are exceptions to the federal rules that suggest only at-risk groups such as young children, the elderly and the chronically ill should receive the vaccine.
Marines who get deployment orders as well as special operations soldiers and aviators also classified as highly deployable - meaning they might be called to leave the country at any time - will get vaccinated only once the Department of Defense decides how to dole out the military's vaccine supply.
"If they get exposed to an area where the flu is epidemic, there is a readiness problem," Reynolds said.
But Marines who are staying at the base and normally would get flu shots will not this year. Anyone who comes down with the flu will be quarantined and treated by medical personnel, Reynolds said.
"We don't normally find high-risk people on active duty," Reynolds said. "They're all healthy individuals."
Vaccine supplies have been short since British regulators shut down shipments from Chiron Corp., which had made millions of flu shots in a British factory. That has cut the U.S. supply of vaccine almost in half.
North Carolina's other large military installation - Fort Bragg - also is grappling with how to handle a limited supply of vaccine. Army hospital spokeswoman Shannon Lynch said soldiers deploying with the 18th Airborne Corps will receive the vaccine, but those who stay behind will not.
High-risk dependents will be vaccinated as shots become available.
"Then it's pretty much take care of yourself, for the rest of us," Lynch said. "If you're sick, don't go to work. If you sneeze, cover your mouth. Wash your hands frequently. If you use someone else's telephone, wipe it down."
Officials reported 76 cases of flu at Bragg during last winter's flu season.
At the 82nd Airborne Division, whose 15,000 paratroopers make up one of Bragg's major units, spokeswoman Maj. Amy Hannah said officials plan to have enough vaccine on hand for 3,000 to 5,000 paratroopers, should deployment orders come during flu season.
"The majority of the division is between 18 and 40 and in the low-risk category," Hannah said, adding there may be a few paratroopers with a chronic disease or a few who are pregnant.
By Estes Thompson