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The H1N1 influenza (a.k.a. swine flu) vaccine is in short supply. Is it possible to buy yourself one?
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That is the question right now as Americans wrestle with class divides in health care and Senate leaders lock horns over insurance coverage. Already last week, Wall Street was jeered when Goldman Sachs and Citigroup obtained hundreds of doses of the coveted vaccine for their employees, while pregnant women and children (groups considered at high-risk for the disease) around the country were left without.

With average consumers worried there might not be enough vaccine to go around, the unavoidable subtext here was clear: Those with more resources could get better care.

Of course, money almost always makes a difference in getting what you want. But the conditions here are a little different. For one, the government has cornered the H1N1 vaccine supply, so free market rules should (at least in theory) not apply. Another wrinkle: Where the vaccine is available, it’s free and most insurers are waiving or reimbursing any co-pay a doctor might charge. With so much focus on government-run health care and the treatment afforded wealthier Americans, we decided to create a test. Putting ourselves in the position of a hypothetical rich person, we set out to see if there were strategies (other than a job at Goldman) that would give an edge to someone with a lot of money.

The success rate among the options was mixed -- but with some surprisingly available avenues. Our first stop was concierge medical services. Figuring that the wealthy use their wealth for access, we checked in with the doctors -- a la cable TV’s “Royal Pains” -- who charge high annual fees in exchange for a promise of 24/7 access. Then we searched abroad. What if we had the financial freedom to buy a last-minute airline ticket or even access to private jet -- would a vaccine seeker be able to set off to France or England or Canada? Looking closer to home, we hunted for sale and auction listings online. Lastly, we chose the path most taken by the rich with a staff of minions at their disposal: We hired a team of virtual assistants (at roughly $7 an hour) to scour the phone books in three cities -- New York, Highland Park, Ill., and Tillamook, Ore. -- to locate a doctor who would give us the vaccine.

Our hunt put off the medical experts we contacted, who were disturbed at the idea that vaccines could go to the patients with the biggest wallets, and not those with the most risk. “Right now, when the vaccine supply is so severely limited that places that need 1,000 doses are getting 200, there’s a real possibility that someone who skips the line is getting a vaccine that would have gone to someone who truly needed it,” says Dr. Margaret McLean, the director of bioethics and the associate director of the Markkula Center for Applied Ethics at Santa Clara University in California.

Others said that paying for a vaccine would also likely be a waste of money. Supply should surge within two weeks, as manufacturers ship enough vaccine for clinics and physicians to welcome all comers, says Hedwig Kresse, a senior analyst of infectious diseases for market researcher Datamonitor, which recently released a report on public apathy’s effect on H1N1 vaccination rates. In that time, more supply may free up as people decide they don’t want the vaccine. “All the ads have been geared to ‘Get it as soon as possible,’” Kresse says. That was when the government expected to have the bulk of their supply by mid-October. “How many of these people will come back four weeks later? Not many.” An October survey from the Harvard School of Public Health found just 40% of U.S. adults planned to get the vaccine.

If you’re set on getting an early vaccination (legitimately or otherwise), these four options may offer some leads:
Craigslist, eBay and other marketplace options

Verdict: Not available -- though worth checking for free leads.

A search for “swine flu” or “H1N1” turns up plenty of listings on eBay (EBAY: 23.30*, -0.21, -0.89%) and Craigslist, including purported herbal preventatives, filtration masks and a band searching for a drummer to replace one who came down with the disease. The one relevant post: On the Washington, D.C., Craigslist page, the Manassas Clinical Research Center wrote that its offices in Manassas and Burke, Va., have the H1N1 vaccine available for the general public. (A receptionist confirmed that it still has vaccine available.)

What you won’t find on either eBay or Craigslist are listings to sell the vaccine itself, or access to it (say, a clinic reservation). Such offerings are prohibited by site policies. “EBay does not allow the listing of any substance that requires a prescription from a licensed medical practitioner or must be administered by a licensed practitioner,” says a spokeswoman for the auction giant. That includes listings that offer access to substances that must be administered by a licensed medical practitioner.
Visit a concierge doctor

Verdict: Potential source, but primarily for patients in an at-risk group.

In so-called concierge or direct medicine, patients pay an annual fee -- often more than $1,000 -- in exchange for 24-hour access and care beyond what a typical primary care physician might provide, such as house calls and in-office diagnostic tests (CAT scans, X-rays). But wealthy patients don’t necessarily equate to more pull in obtaining vaccine supply. “We’re on the list like everyone else,” says Dr. Raphael Darvish, the medical director of Concierge Medicine/LA, who anticipates the order for his at-risk patients will arrive within two weeks.

Even if a doctor does have the vaccine available, signing up won’t necessarily get you a shot, says Dr. Thomas LaGrelius, a Torrence, Calif.-based concierge physician and the board chair of the Society for Innovative Medical Practice Design, a professional group for concierge doctors. “Most of us as physicians would look askance at that thought process,” LaGrelius says. “The H1N1 vaccine should go to people at risk, not to people who have an extra $1,500 to spend on a concierge doctor. To me, that would be the height of hypocrisy.” (He has 200 doses on hand for his at-risk patients only, and has already pledged any left over to other local doctors with high-risk cases.)
Hire a virtual assistant

Verdict: An option, if you absolutely can’t wait.

Unless you have an inside connection at the local health department, tracking down which physicians and clinics have the H1N1 vaccine on hand is a time-consuming project. If you have more money than time -- and a desperate need for the vaccine -- a virtual assistant might be the way to go.

SmartMoney.com hired TaskUs.com, a virtual assistant service based in Santa Monica, Calif., to track down availability in three cities: New York, Highland Park, Ill., and Tillamook, Ore. We paid $139.50 for 20 hours of work (thanks to a monthly special, a 50% discount off the regular rate of $279), with assistants generating a list of targets and calling 70 doctors in each area. Two days later, TaskUs delivered the results. In New York, just three doctors called had the vaccine available; one offered it for children only. In Tillamook, seven have it on hand for anyone who wants it. The only Highland Park, Ill., physician to have the vaccine on hand just offered it to pregnant women.
Travel

Verdict: Both supply and safety are iffy.

The United States isn’t the only country prioritizing shots for at-risk groups. “Most countries are handling it strictly via public health system at the moment and focusing on those who have highest probability of being killed by infection,” says Laura Hilton, the director of provider relations for HTH Worldwide, an international health-care provider that offers policies for travelers. Travelers would have a difficult time gaining access.

In Canada, most provinces are asking clinic visitors to present their government-issued health-care card as proof of residence. But people who don’t show a card won’t be turned away, which would violate the Canada Health Act, Nova Scotia Health Minister Maureen MacDonald told the Canadian Broadcasting Corporation Wednesday. MacDonald also said she would investigate complaints that New Brunswick residents were crossing into the province for the vaccine.

Travelers hunting for an H1N1 vaccination abroad also face additional safety concerns. “In the U.S., all approved vaccines are based on established technologies that have been used for years,” Kresse says. All three of the vaccines approved for Europe, on the other hand, were made using new technologies. For example, two of the three vaccines are adjuvanted, meaning they contain an added compound that stimulates an immune response with a smaller dose of the vaccine. Such vaccines have a higher record of injection site reactions, dizziness, fatigue and fever, she says. “People are worried about the long-term safety profile,” Kresse says.

Of course, you might not have to voyage abroad for the vaccine. If the supply lasts, you can always hop a flight to Tillamook.

Read more: Can You Buy Your Way Into a Flu Shot? (Page all of 2) at SmartMoney.com http://www.smartmoney.com/personal-finance/health-care/can-you-buy-...