Flu shot shortage shows symptoms fast

CDC urges long-term fix as people flock to clinics

System shows `signs of erosion'

October 07, 2004|By Erika Niedowski, Julie Bell and Frank D. Roylance | Erika Niedowski, Julie Bell and Frank D. Roylance,SUN STAFF

As patients and physicians began grappling with the unexpected shortage of influenza vaccine, the country's public health chief declared yesterday the need for a long-term solution for a national vaccine supply system that critics say is inherently flawed.

Dr. Julie L. Gerberding, director of the Centers for Disease Control and Prevention in Atlanta, said that federal health officials were pursuing all avenues to amass more vaccine before the impending flu season -- including contacting manufacturers that supply other countries.

But even if they succeed in rounding up additional shots -- which might not be possible at the 11th hour -- a much more significant problem remains.

"We have a very fragile vaccine production system," Gerberding told CBS News' The Early Show. "We really need a long-term solution so that we don't end up in this year-to-year situation where we have an unreliable supply."

California-based Chiron Corp. announced Tuesday that it would be unable to provide any of the 46 million to 48 million doses that it was expected to supply after a British regulatory agency suspended its production license and blocked it from releasing the vaccine.

In Maryland, repercussions from the shortage were widespread. A grocery store in Potomac offering shots was so crowded Tuesday night that police were called to direct traffic. Evidence of possible price gouging -- vaccine going for many times its usual cost -- was surfacing.

Johns Hopkins Hospital, which had been counting on receiving 25,000 vaccine doses from Chiron, found itself without a single adult vaccine and scrambled to regroup. Doctors lucky enough to have shots in stock struggled to determine whom to vaccinate, after federal health officials asked them to voluntarily ration the supply.

Several patients with serious health conditions -- who are among those officials say should get first priority for immunization -- couldn't get the shots from their doctors. So they waited at the Cockeysville Giant in a line that stretched from the front of the store near checkout station 12 to the back near the meat section.

"I had a kidney transplant, and the shot is something I need," said Kam Finckel of White Hall. "My doctor did not have it. So here I am, two hours and counting."

Delicate programs

The shortage the country faces is only the latest illustration of the delicate state of national programs designed to prevent the spread of common but virulent diseases. Many manufacturers have left the field, preferring to spend resources on developing higher-profit medicines rather than engage in the complex business of making vaccines in large part for sale to the government -- at deeply discounted prices.

More than 25 companies used to produce all the routinely recommended adult and pediatric vaccines; now there are five. Not surprisingly, the dwindling number of suppliers has repeatedly resulted in product shortages in recent years. Demand for the flu vaccine outpaced supply in the 2000-2001 season, while health officials didn't have enough Prevnar, a vaccine against pneumococcal disease, last winter.

A little more than a year ago, the government's adviser on health matters, the Institute of Medicine, warned in a report that the system for purchasing and distributing vaccines was showing "signs of erosion."

So it came as no surprise to Frank A. Sloan, chairman of the IOM committee that compiled the findings, that the country would find itself in the position it does now: without enough influenza vaccine to immunize even those at highest risk of complications from the virus.

"We just have these two major suppliers," he said, referring to Chiron and Aventis Pasteur, which is providing 54 million doses this year.

In its report, the IOM proposed that both public and private health insurance cover recommended immunizations and that the government subsidize the cost of that coverage. That way, said Sloan, a professor of health management and policy at Duke University, manufacturers of the vaccines would be ensured a market for their product.

"The companies might even stockpile it if this is a good deal for them financially," he said.

Dr. James King, a pediatrician and vaccine researcher at the University of Maryland School of Medicine's Center for Vaccine Development, was of a similar mind. Though it may sound counterintuitive in the face of a shortage, he thinks the CDC's Advisory Committee for Immunization Practices should recommend, for future years, that all children and adults get vaccinated.

"This is the perfect time for ACIP to consider universal vaccination that would stimulate all kinds of markets for the flu vaccine because it would be guaranteed that it would be paid by insurance," he said.

What's more, routinely having more doses on hand would help public health officials prepare for the worldwide outbreak they have warned is overdue.

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