The state health department is significantly changing the way it distributes swine flu vaccine, giving more control of vaccine supplies to local health departments under a plan announced Wednesday.

Starting this week, 20 percent of Texas' supply of vaccine will be set aside for use by local health departments.

The bump-up for health departments probably means a drop in the percentage sent to private providers in many counties because the total number of doses offered to each county – based on population – will not change. But the change may also create an opportunity for the general public to get access to the vaccine.

Wednesday's announcement came as a surprise to health departments across Texas, and they must now decide how to use the increased supply of vaccine.

It followed complaints that too little vaccine has been made to meet demand, a problem the federal government blames on manufacturing issues. Federal statistics indicate that Texas may not be getting its vaccine as fast as some other states, although CDC officials say the difference is not as large as the numbers indicate.

And last week, Texas officials were embarrassed by the discovery that they had sent more than 11,000 doses to a mass vaccination company in Farmers Branch that officials say should not have been sent any.

None of that is related to Wednesday's announcement, said Carrie Williams, spokeswoman for the Texas Department of State Health Services.

The state's decision followed conference calls in which several county health representatives discussed possible changes in vaccine distribution with state officials, said Dallas County health department director Zachary Thompson.

If the Dallas County health department had received 20 percent of the total vaccine sent to the county since distribution started last month, it would have received about twice as many doses as the 10,700 that actually arrived.

Thompson said that his department would figure out how to use the additional doses.

"I think anything is workable, but they should have come to us with this early on," he said. "They are now coming to us after the fact."

Thompson's day started before 4 a.m., preparing for the opening of the county's first large-scale vaccination clinic. The county vaccinated about 3,600 people – all Dallas County residents who identified themselves as uninsured and as members of groups considered at high risk for a bad case of swine flu. The clinic will reopen this morning.

Thompson said he learned about the state's new distribution policy late Wednesday afternoon and had not come up with a specific plan yet. The county may team with private pharmacies to get the vaccine out to the general public, as well as hold other walk-in clinics aimed at its traditional client base, he said.

"We are just starting to try to look at this," he said.

The change in state policy is a response to complaints by local health departments that they were not getting enough vaccine and never knew when the next shipment would arrive or how much would be in it, Williams said.

As of Friday, more than 1.4 million doses had been shipped to Texas, with more than 500,000 added to the state's allocation already this week.

Under the updated system, the state will start with the total allocation set aside for Texas by the federal Centers for Disease Control and Prevention and take 20 percent off the top for health departments before dividing the rest among private providers.

Local departments have the option to turn down all or part of their allocation – a flexibility welcomed by county officials who are unsure whether they will have adequate storage space or demand for all the offered doses.

Harris County started offering the H1N1 vaccine in its health clinics last week.

"The demand has already started to wane," said Rita Obey, spokeswoman for the Harris County health department.

Health departments have been advised to target high-risk groups, including pregnant women, children, and young adults with chronic illnesses. But the departments are free to distribute their vaccine based on local needs, Williams said. For instance, although Dallas County has aimed its clinics at the uninsured, that's not a state requirement, she said.

Also Wednesday, state officials released an accounting of H1N1 vaccine that has shipped to nonpublic health agency providers in each county. The records showed that as of Friday, at 199,419 doses shipped, Dallas County ranked among the state's larger vaccine recipients, both in sheer number and per capita. The records showed Dallas County has received 8.3 doses for every 100 residents.

With the promise of increased supplies, county officials will probably shift to pandemic vaccination plans that had been put on hold because so little of the vaccine had arrived.

Tarrant County may be able to put the vaccine in its seven public health clinics and open vaccination centers in several strip shopping centers, said county spokesman Marc Flake.

Harris County may team with local school districts that are interested in on-site vaccinations, Obey said.

And Dallas County may be able to offer several vaccination sites for its usual clients – plus create a new system offering some of its doses to the insured who can't easily find the vaccine elsewhere, Thompson said.

But Thompson said he was not satisfied with the way the state came up with this new plan – or the old plan, for that matter. Local health departments had too little input too late in the process, he said.

"They came up with this decision on their own," he said. "That's one of their problems."

More than 400,000 doses of H1N1 vaccine have been shipped to nonpublic health providers in the Dallas area. Here's how much they have received and how many doses they have:

SOURCE: Texas Department of State Health Services