If it feels a bit like the early days during the coronavirus pandemic, when people were scrambling to find doses of the COVID-19 vaccine, you’re not imagining things.

Federal regulators this month recommended the latest COVID-19 shots for everyone 6 months and older, but many pharmacies don’t have enough doses, especially for children. Though there appear to be appointments on several pharmacy websites in the Baltimore region, in some cases they cannot be booked or the pharmacies run out before the appointments.

“Our pharmacies are receiving the updated COVID-19 vaccine on a rolling basis, but we’re experiencing supplier delivery delays,” said Matt Blanchette, a spokesman for CVS Pharmacy. The chain advises checking its digital scheduler for real-time availability.

Harris Teeter pharmacies also aren’t promising doses everywhere. The pharmacy appointment portal comes with a disclaimer: “Availability may vary by location.”

At Walgreens, the website says: “As additional inventory arrives to our stores, appointments will be added. For patients under age 12, the vaccine is not available yet, please check back soon.”

The latest vaccine for children and adults includes a single strain that federal authorities say should protect people against currently circulating variants of the coronavirus. Officials were hoping the shot, which they no longer call a booster, would have better uptake than the last version. Less than 20% of Americans got that vaccine.

The latest version is the first since the federal public health emergency ended and available on the commercial market, rather than bought and supplied by the federal government.

There are two factors now at play, said Tinglong Dai, a medical supply chain expert and a professor in the Johns Hopkins Carey Business School. There is low demand and variability in that demand. If pharmacies don’t know if and when people want the vaccine, they could end up with significant wasted doses.

Dai said some of his Hopkins colleagues predict the vaccination rate for the updated shots could drop even below the last version, to single digits.

“So it’s logical for pharmacies to take a conservative approach by under-ordering vaccine supplies,” he said. “Manufacturers such as Pfizer face a similar dilemma; planning production based on low demand forecasts is a rational but unfortunate necessity.”

Dai said complicating distribution could be relatively high demand early on among vulnerable people, such as seniors and those with underlying conditions. Among the general population, there may be initial interest that quickly wanes.

“This could have serious implications, as limited availability could disproportionately affect those most in need,” he said. “It is essential for the federal and state governments to focus on addressing the demand of those in most need — prioritizing them if the supply situation is really bad.”

Pharmacies and doctor’s offices expect to get supplies. It may just take patience.

Dr. Michael Albert, who practices internal medicine at Johns Hopkins Community Physicians Odenton, said Hopkins offices will be offering the COVID-19 vaccine.

“We are two to three weeks behind the retail pharmacies,” said Albert, also chief of internal medicine and chief of primary care clinical innovation for Johns Hopkins Community Physicians.

The offices will also offer flu vaccine for everyone, but most seniors who now qualify for the new vaccine against the respiratory syncytial virus, or RSV, will likely need to turn to the pharmacies to avoid paying out of pocket. Medicare, the health plan for those age 65 and older, pays only for the vaccine and not the office visit.

“We are prioritizing our storage and staff bandwidth for COVID-19 and flu vaccines, which we can give to all ages,” Albert said.

Local health departments are also likely to rely on pharmacies for most RSV and COVID-19 vaccinations. Many still plan to hold flu clinics.

Baltimore County, for example, will hold flu clinics, including its annual “Super Saturday” clinic Oct. 14. The health department plans to offer COVID-19 vaccines only to those who are uninsured or underinsured. It has doses for children in hand and is waiting for doses for adults.

The Centers for Disease Control and Prevention has a COVID-19 and flu vaccine finder here.

Private insurers should cover the doses with no copays. Pharmacies can tap a federal bridge program for those without coverage.

CareFirst BlueCross BlueShield, Maryland’s largest insurer, said in a statement it was covering the COVID-19 vaccine, along with flu shots, with no cost at in-network pharmacies and doctor’s offices. It also is covering the new RSV vaccine approved for seniors and pregnant people.

meredith@thebaltimorebanner.com