Flu vaccine without eggs is unavailable in Hawaii

Question: I have an egg allergy that prevents me from getting the normal flu vaccine, which is grown in eggs. A new vaccine that doesn’t use eggs, called Flublok, has been available for over a year, but I can’t find anyone who offers it, including my primary care physician, two infectious disease physicians, an allergist, Longs Drugs, Walgreens and the Hawaii Department of Health. The only rationale came from my doctor’s office, who said Flublok only comes in 10-dose packages and they didn’t have nine other people with egg allergies. I can’t believe that I’m the only person in Hawaii who’s allergic to eggs, but would like a flu shot! Any ideas?

Answer: It doesn’t appear that any health provider in Hawaii is offering the Flublok vaccine, for whatever reason.

On the Flublok website — flublok.com/FlublokFinder.pdf — Hawaii is not listed among the 39 states where the vaccine is available.

The state Department of Health has no control over what flu vaccines health providers in the community offer, said Ron Balajadia, chief of the Immunization Branch. No one reports to the department and no list of who provides what is available, he said.

Protein Services Corp., which produces the vaccine, says the availability of Flublok is based on providers ordering the product.

As your doctor’s office pointed out, Balajadia noted that the required minimum order for the vaccine is 10 doses, at $32 per dose or a total of $320.

That could be a big factor in health providers not ordering Flublok, Balajadia said.

The U.S. Food and Drug Administration approved the use of Flublok for people 18 years and older in 2013.

Neither the influenza virus nor chicken eggs are used to manufacture Flublok, but the FDA says it has a shorter shelf life — six months from the production date — than most other flu vaccines.

Question: Why did Super Bowl 49 use the convoluted Roman numerals XLIX instead of the logical, simpler and correct IL? The former subtracts 10 (X) from 50 (L), then adds 9 (IX), whereas the latter just subtracts 1 (I) from 50. That was how I learned to denote 49.

Answer: As convoluted as the letters may seem, the NFL got it right under the Roman numeral rules of counting.

We found various explanations about why XLIX is the correct representation of 49 and will try to boil it down as simply as possible. (It will still make your head spin.)

One rule: A numeral is counted positively unless there is a larger number to its right. In which case, it is counted negatively.

So XL is 40 and LX is 60. Similarly, IX is 9, while XI is 11. Hence, XLIX is 49.

However, there are restrictions about the "subtractive principle" — in which a subtrahend (number to be subtracted) precedes a minuend (number from which the subtrahend is subtracted) — used in Roman numerals.

Two restrictions: this principle applies only to a subtrahend that is a power of 10 — I, X or C (100) — and only when the minuend is no more than 10 times larger than the subtrahend.

So VL (V is 5) can’t represent 45 (it should be XLV) and IL can’t be 49.

Also, the subtractive principle applies only if any numeral preceding the subtrahend is at least 10 times larger.

So 8 should be VIII and not IIX.

Why use Roman numerals in the first place? Lamar Hunt, the late owner of the Kansas City Chiefs, is credited with coming up with the term "Super Bowl," then with using Roman numerals (beginning with Super Bowl V), ostensibly to beef up the importance of the game.

Next year, it will be Super Bowl 50. The NFL has decided to do away with the Roman numeral for one year, the 50th year of the title game.

CORRECTION: Next year’s Super Bowl will be Super Bowl 50. An earlier version of this story and the story in the print editions said it would be a simple Super Bowl L.

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