Healthy seniors asked to forgo flu shots A plan for Southeastern Pa. asks all healthy adults to skip vaccines. It also prioritizes shots for health-care workers.

Just as the first cases of flu are reaching the Philadelphia region, health experts are encouraging all healthy adults - including those 65 and older - to skip the flu shot this year and give "highest priority to the elderly with significant health problems."

Scheduled to be announced today, the voluntary plan for Southeastern Pennsylvania goes a step further than the federal government's guidelines, because it suggests how to distribute scarce vaccine among the most vulnerable patients.

The plan, which offers a number of options to prevent and treat the flu, also sets up a priority system to immunize health-care workers most likely to transmit the influenza virus to patients.

"The simple arithmetic is such that there is no way we would have enough vaccine to cover all the people in the categories," said Andrew Wigglesworth, president of the Delaware Valley Healthcare Council, which spearheaded the plan. "The effort is to maximize the use of the vaccine" for people with the greatest needs.

Philadelphia health officials said yesterday they had confirmed two influenza cases, in a 15-year-old and a 7-year-old - apparently the virus' debut in the city this season. A 53-year-old man also tested positive for flu in Chester County this month, according to Betsy Walls, the county's bureau director for personal health services.

Six cases have been confirmed in Delaware, but none have been reported in New Jersey, according to officials.

Health officials are approaching this season with even more than the usual caution after the announcement last month that about half of the nation's flu-vaccine supply would not reach the market this year because of poor quality at Chiron Corp.'s British plant. The supply will consist largely of vaccine from Aventis Pasteur S.A., the other major flu-vaccine maker, which expects to provide 58 million doses this year.

Because of the shortage, the federal government advises that the vaccine be restricted to high-risk groups, such as people 65 and older, children from 6 to 23 months, and those in between with chronic diseases.

But the advice has not been specific enough to help nursing homes make tough decisions, said Alan Rosenbloom, president of the Pennsylvania Health Care Association, a group for nursing homes and other facilities.

"How do you make choices?" he asked. "Do you prioritize workers over the residents or the residents over the workers?"