Dec 6, 2005 (CIDRAP News) – State health officials at a Washington, DC, meeting yesterday expressed frustration over problems with supplies of seasonal flu vaccine, while federal officials promised that the government's pandemic influenza preparedness plan will help clear up those problems.
A Michigan health official said physicians recently had requested a total of 90,000 doses of annual flu vaccine, but the state was able to release only 36,000 doses. "We need to address distribution—we need to not disadvantage physicians in the markets. The physicians are getting pretty frustrated with us, frankly," she said.
Texas State Health Commissioner Eduardo J. Sanchez commented, "We're in an awkward position trying to explain what's going on with flu vaccine. . . . The very people we want to help in a pandemic are confused when they can get vaccine at the local supermarket, but at their doctor's office they can't."
Dr. Julie Gerberding, director of the Centers for Disease Control and Prevention, empathized with those concerns, saying her mother's physician had trouble getting flu vaccine this year. "Small purchasers are at a disadvantage," she said.
The Bush administration's pandemic plan, released last month, calls for reinvigorating the nation's depleted vaccine industry so that it can produce enough flu vaccine for all Americans within 6 months after the start of a pandemic. That would also help eliminate the annual flu vaccine supply problems that have frustrated the public and health agencies the past several years, the administration asserts.
Health and Human Services Secretary Michael Leavitt told officials at the meeting, which was broadcast over the Web, "The president's plan calls for nothing short of revitalizing an entire industry. We must be able to create as much as 300 million courses of vaccine in a relatively short period. In a pandemic, vaccine must be produced here, not in another country, because it'll be hard to get it out of another country."
When the plan was released, President Bush proposed spending $2.8 billion to improve cell-culture technology for flu vaccine production. The administration also wants to expand existing egg-based vaccine production and develop adjuvant, or dose-sparing, technology.
To clear the way, the administration wants Congress to pass laws protecting vaccine makers from lawsuits over vaccine-related injuries. "Liability concerns have to be taken off the table," Leavitt said. "Legislation is currently before Congress and we have optimism that will occur. Some compensation arrangement [for people harmed by vaccines] will have to be made as part of that."
But health officials also said that expanding US production capacity depends on having a dependable market for the vaccine, the demand for which has been unpredictable.
"We've got to build the demand for the annual flu vaccine," said Leavitt. "So the annual flu vaccine is a very important part of the strategy to have pandemic preparedness."
Gerberding said that having a "reliable large supply" of annual vaccine will help iron out kinks in distribution, but a steady demand is necessary to drive production. She added, "This timing [of vaccine distribution] will also continue to be a problem, and we don't want to promise that will completely go away. Ultimately these investments should result in a large supply of vaccine and hopefully a faster supply, but they won't solve everything."
In his opening speech at the meeting, Leavitt voiced hope that Congress will act soon on Bush's request for $7.1 billion for pandemic preparedness, which includes the $2.8 billion for cell-culture vaccine technology. Calling the request "the most robust proposal made for public health at one time," he said, "Every day without Congress acting is a day that creates a lag in our ability to deliver a vaccine."
Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, said the government will have about 6.5 million doses of the experimental "prepandemic" vaccine for the H5N1 avian flu virus by January. It will take two doses to provide protection, he said.
Leavitt raised the question of what will happen if no flu pandemic erupts anytime soon. "My guess is that people will in fact say, 'They overreacted, they cried wolf,'" he said. "The truth is that a pandemic influenza of some sort will ultimately be our lot to handle. But what I believe to be an opportunity is that we can become the first society in history to do something about it."
Dec 5 CIDRAP News story on other discussions at the Washington meeting