The shortage sent hundreds of people to Costco's Waipi'o store on O'ahu yesterday because it was one of the few places offering flu shots this week. Most of those who showed up had heard about the shots from their doctors or had seen a sign in Costco.

Thomas Giltner, 56, drove from Kailua and wore a medical mask to Costco and to get the shot. He said he had a heart transplant in late June that left him very vulnerable to illness so his doctor recommended that he wear the mask in public to reduce the risk of infection.

"So far, I've been lucky," he said.

Giltner said his doctor advised him to get a shot. "When I found out my doctor didn't have any, I started calling around," he said.

Thomas Giltner, who wears a breathing mask to avoid infections after his recent heart transplant, sought out a flu shot at Costco yesterday. Richard Ambo • The Honolulu Advertiser

Waipi'o Costco Pharmacy manager Gary Vita said more than 100 people were standing in line when the store opened at 10 a.m., including one woman who said she arrived at 4:30 a.m. to make sure she got a shot. The store followed federal guidelines in offering the $15 shots to members in one of the high-risk groups.

Vita said Costco vaccinated 429 people by 3:45 p.m. when it ran out of vaccine. He said most people there were patient and understanding about the shortage.

State health director Dr. Chiyome Fukino said medical officials agreed that elderly in nursing homes and other long-term care facilities are of greatest concern. "They are our most vulnerable to complications from the flu and should be protected," she said.

Those involved expect to work out just how to distribute the vaccine in the next two weeks as well as to determine the actual supply of vaccine available statewide.

Some residents of long-term care facilities have already received their vaccine.

Hawai'i Health Systems Corp. on O'ahu has begun vaccinating 178 residents of Leahi Hospital and 158 at Maluhia Hospital, according to spokesman Miles Takaaze.

He said officials there feel confident that the state Health Department will help with all patients.

"We are concerned about having a sufficient supply of vaccine for our employees who handle direct patient care," Takaaze said.

The Health Department meetings included representatives from HMSA and Kaiser Permanente (the state's largest and second-largest insurers), the Medical Corner, Longs Drugs, the Veterans Administration and the Department of Defense.

The state asked many community clinics to postpone scheduled clinics because of the shortage, which left many of those who usually get shots searching for a source of vaccine. But Hawai'i is better off than states that had ordered most of their vaccine from Chiron, the company that had been expected to distribute more than 46 million doses until British officials suspended its license last week.

At Costco yesterday, Pat Gallo, 66, of Westchester, N.Y., decided to get her shot here after hearing that supplies might be out by the time she and her husband return home from spending the month with their daughter at Schofield Barracks. Gallo's son-in-law is deployed in Iraq.

Gallo said she's prone to bronchitis and pneumonia, so her doctor recommends the annual shot.

A few states and Washington, D.C., are threatening healthcare workers with fines and even jail if they give shots to healthy low-risk people. But Janice Okubo, spokeswoman for the state Health Department, said there is no move here to penalize healthcare providers who don't follow the guidelines.