AFTER BEING swamped with flu patients in October and early November, my office has seen a slowdown in the past three weeks in the number of children suffering from the H1N1 virus.

We're all breathing a sigh of relief and being cautiously optimistic that the worst has passed. Of course, if it's not one thing it's another! Now we're starting to see a rapid increase in RSV, a respiratory virus.

There were definitely more sick kids than usual this fall, but it was manageable. What was almost not manageable was the huge number of phone calls, e-mails and questions about H1N1, the huge number of complaints about the lack of the vaccine, the interoffice discussions about the H1N1 vaccine policy, and the frustration and confusion of having two completely different flu vaccines in one season--with several forms (mist, shot, preservative-free, etc.) of each.

If you're wondering why things were so maddening, here's a little background.

RINGING PHONES

I'm sure everyone reading this has experienced a situation where someone is yelling at you, and is right to be mad, but there was absolutely nothing you could do about the situation.

Well, imagine this: The Centers for Disease Control recommends that all children ages 6 months to 18 years receive the seasonal flu vaccine every year, and this year it added the H1N1 vaccine for all those patients--plus those up to age 24.

It was hard enough to convince parents last year that all kids need the flu vaccine, not just those with underlying medical conditions. But we did our best, and we ordered lots of flu vaccine for this year. (We have to order almost a year in advance.) We had our plan for extra flu clinic days, extra staffing, etc.

Then, H1N1 hit.

The number of flu vaccines we were supposed to be giving more than doubled! At the same time, supply of seasonal flu vaccine was interrupted by throwing the H1N1 vaccine into the mix.

Each state has control over the H1N1 vaccine, which is distributed through the health department. We had to sign up to be providers of the new vaccine. Many doctors chose not to sign up to avoid the hassle.