LUMBERTON — A line at the Robeson County Health Department on Thursday morning snaked along yellow tape demarcating the flu shot area. It was 9:30 a.m.; just more than an hour later, the 200 available doses of H1N1 vaccine were gone.

The line was dotted with the very young and very old, all hoping for a vaccine against the flu virus that can be fatal for high-risk groups, and unpleasant for anyone who contracts it.

As weekly shipments of 2009 H1N1 vaccine trickle in, the Health Department is courting high-risk groups — but with a very limited supply of vaccine in the refrigerator. November is in the heart of flu season, and national reports of school closings and flu deaths are stirring a demand that vaccine manufacturers cannot meet.

The county Health Department has received 1,400 vaccines in four shipments since Oct. 6, and is expecting a cumulative 31,600 in weekly shipments by the end of the year.

William Howell left the Health Department after his two children, Luke, 2, and Bailey, 7, received shots. They waited for 1 hour, 30 minutes.

“(Luke) has upper respiratory weakness, so we want to make sure he doesn’t get H1N1,” Howell said.

Children under 10 years old are supposed to receive a second shot after three weeks, but with limited vaccine, the follow-up shot isn’t always possible.

The vaccine clinic opened at 8:30 a.m., and 86 people had been seen by 9:30 a.m., with 60 more in line.

“This is the largest group we’ve had at one time,” said Kit Dial, a nurse at the Health Department who has worked vaccine clinics for almost three weeks. “It’s a great response.”

“We’re trying to reach (high-risk) groups,” she said. “We’ve seen quite a few pregnant women come through.”

The Centers for Disease Control has identified high-risk groups based on incidences of hospitalization and death: pregnant women; people who live with or care for infants younger than 6 months old; health care workers; children and young adults 6 months to 24 years old; and people with chronic medical conditions.

In a Centers for Disease Control study of 1,400 adults hospitalized with H1N1, 26 percent had asthma, 10 percent had diabetes, 8 percent had chronic lung disease, 7.6 percent had weakened immune systems, and 6.1 percent were pregnant.

Sonia Collins and Tony Williams took their sons out of school to get shots Thursday morning.

“It would have been better if it was tomorrow because they have the day off (for a teacher work day), but they all have asthma,” Collins said.

The boys — Anthony Williams, 9, Callarri Williams, “11 and three-quarters,” and Dorian Collins, 15 — were among 60 people in line at 9:40 a.m.; by 10:10 a.m., 124 vaccines had been administered, with 40 people in line.

“I didn’t want them to get the flu,” Williams said. “Since they all have asthma, they’re at risk for secondary infections, like pneumonia.”

“Their doctors aren’t offering H1N1, only seasonal flu shots,” Collins said.

Health Director Bill Smith said pregnant women and children have received doses through local obstetricians and the children’s clinic, but most of the H1N1 vaccine recipients have been elderly — not a high-risk group for H1N1 — because they come to the clinics.

“We’re not going to hold out a vaccine for someone who’s not here when there’s someone here,” Smith said. “And what’s the difference between 66 or 59 if you have a chronic disease, like obesity or diabetes.”

Every Friday afternoon, the state tells Health Department when the Centers for Disease Control will send another shipment and how many vaccines will be included. The county Health Department has chosen to administer vaccines as they come in.

“Some counties are not doing anything with their shipments. They’re waiting to do mass vaccinations,” Smith said. “We went the other way with smaller clinics. We prefer to get it out of the refrigerator.”

Nationally, the Centers for Disease Control has fallen behind its promised vaccine shipments. At the beginning of October, the government announced that 28 million doses of H1N1 vaccine would be available by the end of the month, short of the 40 million it had predicted, and not even close to the 160 million vaccines that it promised in July.

Smith said every year the government misjudges its production and delivery capabilities. This year, the Health Department was supposed to get the seasonal flu vaccine in July and received it in September, and the H1N1 vaccine was promised by August and arrived in October.

Vaccine delays start at the manufacturers. H1N1 vaccine is produced the same way seasonal flu vaccine is: in chicken eggs. The virus is injected into a chicken egg, and the eggs are incubated so the virus can grow.

After a few days, they are harvested: A machine slices of the top of each inoculated egg and drains the fluid. The virus, in the fluid, is then killed, split and purified to make an injectable vaccine.

Manufacturers say the viruses in the eggs are not growing fast enough to keep up with the vaccine demands, and with this year’s extended flu season, seasonal flu vaccines that normally have to be discarded are also in demand. The Health Department has administered all but a few hundred doses of children’s seasonal flu vaccine.

Along with another 2009 H1N1 vaccine shipment, Smith said the Health Department is expecting mask and Tamiflu shipments this week. Tamiflu is an anti-viral drug used to treat influenza, usually in high-risk groups like very young children or pregnant women.

The masks are for everyone who comes into contact with patients, Smith said.

To keep the community posted on vaccine availability, the Health Department now has a dedicated phone line for flu vaccine updates. A recorded message answers the number, (910) 671-6274, after five rings. Right now it says that only nasal mist vaccines are left, but more injectable vaccines are on the way.

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The Robeson County Health Department now has a dedicated phone line for flu vaccine updates. Call (910) 671-6274 to learn current vaccine availability.