At Vanderbilt University Medical Center in Nashville, Tenn., doctors and nurses treat a baby for heart problems. His father worries about the flu, but there are no shots available for the infant.
"I think if he's exposed to it, he could still have the potential of getting it and it could be catastrophic for him," says Paul Thompson.
In addition, there are no shots available for the baby's health-care providers.
"You're exposed to a lot of kids who have cold symptoms and things like that," says Alicia Barnett, a registered nurse at the hospital. "(It's) not only that I could get the flu, but that I could pass it to other patients and that's scary."
It's not just hospitals. Many nursing homes have no vaccine, while places ranging from the U.S. Capitol to many prisons have plenty — although doctors insist it is going only to those at high risk.
"Nothing ticks people off more than finding out that prisoners get better access to any health care, including a flu shot, than an ordinary, upstanding citizen," says Dr. Arthur Caplan, a bioethicist at the University of Pennsylvania.
Across the country, people who are eligible for flu shots wait for hours for a supply of vaccine that is arbitrary and unpredictable. The immediate question: how best to get what vaccine there is to those at highest risk of death from complications. Some say the government should declare a public health emergency.
"We should have taken over the supply of flu vaccine some time ago," says Caplan. "It shouldn't be left up to who happens to have the supply to decide who to give it out to."
But Health and Human Services Secretary Tommy Thompson said Tuesday that it is best to rely on voluntary compliance to guidelines.
"Calling it a public health emergency would cause too much confusion and nothing good would be established by it," he said.
Regardless of what happens this flu season, the question for the long term is how to fix a vaccine manufacturing and distribution system that is clearly broken.