BOSTON - A $2 million budget shortfall is forcing Massachusetts to reduce by 19 percent the number of free flu shots available to the elderly and others at high risk, health officials said yesterday.

The state Public Health Department had originally ordered 700,000 doses of the influenza vaccine, but only has enough money to buy about 568,000 doses.

"It's the first time we've had to cut an order for an influenza vaccine," said Dr. Alfred DeMaria, the department's director of communicable disease control. "Now more than ever, people over 65 and people with underlying medical conditions that put them at risk should get vaccinated first."

The state is also reducing orders for pneumonia, hepatitis A and B vaccinations. Vaccines for childhood immunizations will not be reduced.

Health officials had estimated the total cost of vaccines for the state at about $22 million, $2 million more than was approved by the Legislature.

A spokesman for House Speaker Thomas Finneran, D-Boston, refused to comment.

The state's budget crisis has forced cuts to many state agencies. Lawmakers also approved about $1 billion in new taxes.

The state buys the vaccine, then distributes the doses to clinics run by towns and cities around the state. The state is urging those clinics to carefully manage the shots to make sure they are available to those most at risk - people over 65, pregnant women and children with chronic medical conditions.

The $2 million cut in the program is made worse by the rising cost of the vaccine. A single dose has risen from $1.53 in 1998 to $5.90 this year.

The 132,000 flu vaccines canceled by the state will go back on the market, and there is no guarantee the shots will be available to Massachusetts residents, DeMaria said.

The state buys flu shots from Aventis Pasteur, the nation's largest producer of influenza vaccines.

The higher price reflects the cost of improvements, government regulations and expanded production and shipping, a company spokesman said.

In addition, the prices in 1998 were artificially low due to overproduction, spokesman Len Lavenda said.

Lavenda said he hasn't heard of any other states reducing their flu vaccine order because of budget cuts.

Influenza and pneumonia are the leading causes of deaths that can be prevented by vaccines. Health officials estimate that up to 750 Massachusetts residents die each year from flu complications.

Flu shots should be given to those at high risk in October and November, but can be given through February. Peak flu activity typically occurs late in the winter.

All the vaccines purchased by the state will be available by early November.