Concern Grows Over Vaccine Supplies
WASHINGTON, Sept. 28-For Sen. Larry Craig, R.-Idaho, the image from last year’s flu scare still rings clear: hundreds of people lined up outside grocery stores and local clinics, waiting for hours in order to get the prick in the arm that translates to good health. The vision speaks clearly to last year’s -and in all probability, this year’s-demand for vaccinations, Sen. Craig said on Tuesday, speaking in front of the Senate Special Committee on Aging, which he chairs. Yet as the nation’s cry for immunization increases, questions linger over whether the three U.S.-licensed influenza vaccine manufacturers can supply what is needed, he said.
“Many of us questioned for the first time [last year], whether we can assume that everyone who needs a vaccine can obtain one,” Sen. Craig explained.
Last year, almost 36,000 Americans died from exposure to the flu and another 200,000 were hospitalized. Of note, Sen. Craig said, is the fact that almost 90 percent of those who died were over age 65.
“This is a killer of elderly Americans and it ought to be viewed that way,” Sen. Craig said. “The statistics are just black and white when it comes to that issue.”
Influenza, more commonly known as the flu, is a respiratory disease that typically occurs during the winter months and can cause disease among all age groups. Rates of infection are highest among children, but as occurred last year, rates of serious illness and death are typically highest among persons over 65.
Because the strains of the virus mutate so rapidly, vaccines must also be continually updated. And with a shelf life of roughly one year for each vaccine, it is difficult for the government and state agencies to maintain the necessary stockpiles.
This is one of the difficulties that Sen. Craig and experts in disease control and prevention discussed on Tuesday.
Dr. Stephen Ostroff, who is deputy director for the National Center for Infectious Diseases of the Centers for Disease Control and Prevention, said local preparation is the key to making it through flu season unscathed. With approximately 100 million doses of the influenza vaccine available for the upcoming season, the question is not whether there will be enough vaccines available, but whether they will be distributed evenly and provided to those individuals who are most in need.
Failure to do the latter, he said, is what caused many of the problems during the 2003 flu season, even though a record number of 83 million Americans were immunized last year.
“Last year, unfortunately, was one of the anomalies,” he said. “The demand for influenza vaccine in the United States exceeded what had been experienced in previous influenza seasons. We believe this shortage resulted from the early onset of the influenza season, which occurred during the months that the vaccination usually takes place, and the widespread media reports of influenza-caused deaths among children.”
That is why, Ostroff said, CDC officials have encouraged health centers and vaccine distribution sites to start promoting the vaccine now. The goal is to prevent a last minute surge of requests like the one that occurred last year. CDC officials also have urged states to develop a contingency plan in the case that a rush for vaccines occurs nonetheless. In its recommendations, the CDC cites the importance of a tiered vaccination approach in which high-risk individuals like seniors would be allowed the immunization first. In Massachusetts, the Department of Public Health has ordered influenza vaccine from two different manufacturers: 168,000 doses of FluZone® manufactured by Aventis and licensed for use in persons over 6 months of age, and 462,000 doses of Fluvirin®, manufactured by Chiron and licensed for persons over 4 years of age.
While officials are not required by law to do so, they try to direct these vaccines to high-risk populations first, said Alfred DeMaria, the department’s director of communicable diseases. But community health centers are reluctant to turn people away, he said, so instead they will try to send the message out ahead of time, explaining the need to give priority to high-risk individuals.
“And most people cooperate, because those high-risk people are their grandparents and children,” De Maria said.
There is no practical way to try and screen those coming in for vaccinations, he said. Furthermore, a large portion of the vaccinations are distributed by private medical professionals, over which the state has no control.
There are still some, however, who believe the federal government should be playing a larger role. Janet Heinrich, of the Government Accountability Office, Congress’ investigative arm, believes there should be set guidelines, and not just recommendations, that ensure distribution to high-risk individuals.
“The situation is no different today [than from last year],” she said. “The CDC plan describes federal responsibilities, but leaves important questions on deliverance unresolved.”
