Big managed care companies are stepping up to stop an epidemic.[@@]

Aetna Inc., Hartford, and WellChoice Inc., New York, the parent of Empire Blue Cross Blue Shield, have announced plans to cover the FluMist nasal-spray influenza vaccine to help cope with a shortage of the cheaper injectable version of the vaccine.

Production problems at a major British flu vaccine supplier have raised the possibility that the world might suffer a vaccine shortage during the 2004-2005 flu season.

Consumers often see the flu as a minor nuisance, but historians say a worldwide 1918 flu epidemic killed more than 20 million people. The 1918 epidemic killed many of the life insurance industry workers who were responsible for helping to handle the rush of flu-related death claims.

Aetna and WellChoice say they will follow government recommendations to cover use of the nasal spray for health plan members ages 5 to 49 who participate in plans that offer preventive services benefits.

The nasal-spray vaccine has not been approved for use by infants, toddlers and older adults.

Covering the FluMist vaccine for eligible individuals should help make more of the injectable vaccine for children under 2 and adults over age 49.