Caught off guard

October 19, 2004

DOESN'T IT always seem that unanticipated disasters are the ones most likely to strike?

While the nation's public health officials were all in a dither to guard against an outbreak of smallpox -- which hasn't been seen in the United States since 1977 -- or SARS -- which hasn't been seen here at all --they failed to prepare adequately for an infectious disease that arrives every fall without fail and kills up to 36,000: the flu.

Now that a contamination incident has cut the supply of flu vaccine in half, small children and the frail elderly are standing for hours in long lines around the nation, fearing they will miss out on an inoculation that could be vital to their health.

This fiasco didn't catch everyone by surprise, though. In fact, corrective legislation was introduced in Congress when vaccine ran short during last year's unusually heavy flu season. But it has been largely ignored as Washington's notoriously short attention span turned to other topics.

Lawmakers will have to dust that bill off and pass it when they come back to the Capitol for a lame duck session if they are to have any hope of alleviating the vaccine shortage before next year's flu season.

Federal auditors have been warning since 2001 that the flu vaccine supply was fragile because it relied on a shrinking pool of manufacturers. So many uncertainties surround the supply and demand for the vaccine that many companies see it as too risky a venture.

Thus, when a factory used by Chiron Corp, one of the two remaining U.S. suppliers, was found to have been contaminated, that left only one source -- and too late to increase the supply above about half of the 100 million doses needed.

A bill offered by Sen. Evan Bayh seeks to boost vaccine production by guaranteeing the sale of at least 100 million doses, so that even in years when demand for the shot is low, manufacturers won't have to take a loss on unused supplies.

Health and Human Services Secretary Tommy G. Thompson floated a similar proposal last week, after allowing the Bayh bill to languish without his support since last season.

President Bush argues flu vaccine suppliers are dwindling because drug manufacturers fear lawsuits from adverse reactions. He proposes to free them from legal liability.

But fear of lawsuits didn't seem to affect Chiron, a small California company which has been rapidly expanding its flu vaccine production. Nor is it dampening the enthusiasm of two other pharmaceutical companies now entering the $300-million-a-year business.

It makes sense, though, for the government to quickly take steps to ensure the flu vaccine supply is not left entirely to the whims of the marketplace.

Of all the potential national security threats the government could have been preparing for since Sept. 11, 2001, an influenza outbreak was the most realistic. And yet, it seems to have gotten the least attention.

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