Even in ordinary times, the meningitis vaccine is pretty pricey -- it wholesales for $60 a pop.
But the outbreak of the disease has brought on an anti-meningitis bull market in the Houston area. The Houston Press phoned most of the pediatricians listed in the yellow pages and found a few physicians who marked up the shot by only $10, but most had doubled the price.
Dr. Haroon Siddiqui's office, for example, charges a lean $80 for uninsured patients to get the vaccine. "He's trying to be reasonable," the pediatrician's receptionist says. "Some facilities are charging way too much for it."
Another doctor's staff gave a quote of $90, whether people are insured or not. At the top of the scale was an office charging $160 a shot, plus the price of an office visit.
"People who have money can access this vaccine, and people who don't can't," says Dr. Jeff Starke, chief of pediatrics at Ben Taub General Hospital and director of infection control at Texas Children's Hospital. "There is a disparity on who will get this vaccine -- I don't know if that's right or wrong, but it's a problem created by this whole situation."
However, high prices -- and even the appearance of possible profiteering spiced by social Darwinism -- haven't dampened the demand. Panicked parents are packing pediatricians' offices seeking the vaccines. They don't want their children to die.
"It's one of the infections we least like to see," Starke says. "It's one of the very few infections that can get you really, really sick, really, really fast."
But parents might want to save their money, he says. The expensive vaccine stays active only about three years. There's evidence that if kids are vaccinated now, it won't be as effective if they're vaccinated later, say, if there's an outbreak in their college dorm.
Less than 1 percent of kids who get the meningococcal germ in their throats actually get meningitis, Starke says. "They don't know they have it; they're perfectly fine."
Despite the extensive everyone's-gonna-die news coverage, there really aren't many more cases of meningitis than usual. This year it's reached "outbreak" levels in Conroe, New Caney and Humble. This sounds far scarier than it actually is; since October, there have been 12 confirmed cases and two deaths in Montgomery County, with a population of 300,000.
Houston and Harris County have more confirmed cases (18), but with almost four million people here, there would have to be at least 190 cases to qualify as an outbreak. That probably isn't going to happen, says Kathy Barton, chief of public affairs for the Houston Department of Health and Human Services.
"It is a very serious disease, but it is also very rare," Barton says. "Everybody should be alarmed, but in Houston, Harris County, we don't have a reason to panic."
Since most of the world hates shots, she doesn't think giving them out en masse is the best idea. "It is not the disease-control method of choice," Barton says.
For the mass immunizations in Montgomery County, Texas Health Department officials bought 65,000 injections, and they're still haggling over the price, says department spokesman Doug McBride. They're asking for only a $10 donation (from people who can afford it), but the vaccine maker is charging them $52.22 a dose. The company says it will knock off about 30 percent for such a big order, but that still leaves close to $3 million that taxpayers are going to have to swallow.
The drug, Menomune, is expensive for many reasons. First off, as the only maker of the vaccine, Aventis-Pasteur has cornered the market. Len Lavenea, company spokesman, says the vaccine is really hard to make. It protects against four strains of meningococcal bacteria (if you get the fifth kind, you're screwed), so they essentially have to make four different vaccines.
Most doctors recommend it only for children who are at risk of getting slobbered on or sneezed on by sick children.
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"The main message we're trying to get out is not to panic -- not to panic about the meningitis or about the vaccine," says Gayden Cooper of Texas Children's Hospital. McBride also tried to reassure the public: "It's time for everyone to calm down. This is not something that's sweeping the countryside."
But the fear is sweeping through doctors' offices, where there has been a run on the vaccine.
Many physicians said they didn't have it in stock (once a vial is opened, it's good for only five days). Quite a few didn't want their names published because they were giving shots to only their regular patients. Publicity, they feared, would create a deluge that would clean out their supply cabinets.
"I'm a big believer in peace of mind," Starke says. "If this vaccine helps people sleep better at night, why not get it?" He's got three school-age kids; he hasn't vaccinated any of them.