Out of nearly 120 million A/ H1N1 vaccine doses distributed in the United States, only about 70 million have been used, it was reported on Saturday.

An additional 35 million doses have been produced but not shipped and instead may be donated overseas, the Los Angeles Times said, quoting federal officials.

Of the total doses, four million were distributed to the Los Angeles County alone last month, according to the paper.

New orders had come to a near halt for the California Department of Public Health (CDPH) which were holding back 1.5 million doses to begin building a stockpile for the next flu season, said the paper.

Just months ago, the vaccine was so scarce that people camped out at free clinics for the chance to get it. But now the surplus raised the question: what should happen to the unused doses, the paper asked.

In L.A. County, it remains unclear how many of the four million doses distributed have been used. Also unknown: a full accounting of which providers got the vaccine, when they got it and how much they received.

The Los Angeles County Depart of Public Health, along with state and federal health officials, has so far refused to release a list of doctors, clinics and other private healthcare providers who ordered the vaccine, citing privacy concerns, according to the paper.

Some providers report confusion about what to do and frustration with a distribution system that has made it difficult to know whether their unused doses, some of which are about to expire, are needed by another doctor to vaccinate patients, the paper said.

State public health officials say that although doctors may now refuse to accept previously ordered shipments of H1N1 vaccine, once they sign for the doses the state will not take them back. At that point, it is up to the provider to consult with local health officials, said Mike Sicilia, a spokesman for CDPH.

In some cases, doctors said they have been rebuffed by county health officials when they attempted to give back surplus vaccine so it could be redistributed.

But many doctors report that demand is simply no longer there, in some cases leaving them with thousands of doses of the once-hot vaccine, according to the paper.

(Xinhua News Agency February 7, 2010)