Vaccine availability opens up as doses approach 100 million

Dec 17, 2009 (CIDRAP News) – The nation is reaching a new milestone in its fight against pandemic flu, with the number of vaccine doses expected to reach 100 million by the end of the week and nearly half of states opening up immunization to anyone who wants it, federal officials said today.

Kathleen Sebelius, secretary of the US Department of Health and Human Services (HHS), said today at a media briefing that the achievement marks the next phase in government's response, encouraging the public to get vaccinated as soon as possible to soften the impact of a third wave of infections, should one occur. As of today, the number of vaccine doses available to states for ordering stands at 99.5 million, she said.

Several other top federal officials were on hand today to acknowledge the vaccine developments and to offer their perspectives on what has worked well during flu response, what didn't, and what the next challenges will be.

"I got my shot yesterday," Sebelius said, warning that holiday travel and gatherings are conditions that can contribute to the spread of the virus.

Nicole Lurie, MD, HHS assistant secretary for preparedness and response, said pandemic response is a shared responsibility, and the public can now play a greater role by resolving to protect themselves and the people around them by receiving the pandemic vaccine. "It's finally your turn. It's everybody's turn," she said.

Sebelius credited the Bush administration for the steps it took to prepare the nation for a possible pandemic, and she said the government's planning and responses have always been dictated by science. Federal officials have taken pain to share everything they know as soon as they know it, she added. "But sometimes that meant having to change our estimates."

Partnerships that government departments have built with state and local public health officials during the pandemic response so far will have lasting benefits that will help the nation respond to future threats, she said. "One of the key lessons we learned is you can't mount a public health response only from the beltway."

Anthony Fauci, MD, director of the National Institute of Allergy and Infectious Diseases, said a disappointing aspect was how slow the virus grew, which shrunk the vaccine supply at the time when demand was great.

He said, however, that a plan to modernize vaccine production has been under way since well before the pandemic emerged. Though cell-based vaccines might be a reality in the next few years, "more important as an end game is to get it to be 21st-century technology, such as recombinant DNA production techniques that are rapid and consistent—something to rely on."

Adjuvants have great potential to boost vaccine supply and efficacy in the future, he said, and the federal government is pursuing more study on them. A universal vaccine that fights a wide range of influenza subtypes would be ideal, but is still several years away, Fauci added.

Tom Frieden, MD, director of the Centers for Disease Control and Prevention (CDC), said that pandemic events have yielded some positive new developments. For example, he said 34 states conducted school-based immunization clinics, a practice that could help tamp down the yearly impact of seasonal flu.

Obstetricians have had some success boosting flu vaccination among pregnant women, and hospital tracking reports suggest more children are receiving treatment for pandemic H1N1, as suggested by federal guidelines, Frieden said.

"But clearly we need to get better at managing expectations," he said, referring to summer federal estimates that the nation would have plenty of vaccine by about the middle of October.

Looking ahead, Frieden said the nation needs to continue work in three key areas:

  • Perseverance in pushing vaccination, despite not knowing what will happen with the virus in the months ahead
  • Fine-tuning preparedness
  • Investing in science

Margaret Hamburg, MD, commissioner of the Food and Drug Administration (FDA), said the pandemic has been a good test of the agency's ability to be flexible and respond quickly to developments. She called the 6-month interval between the identification of the virus and the launch of the vaccine "quite notable" and said federal officials stockpiled adjuvant in case the nation needed a stronger vaccine or urgently needed more doses.

She also credited the FDA for its quick work in approving diagnostic tests and issuing emergency use authorizations for tests and the experimental intravenous antiviral peramivir, as well as its aggressive strategy of identifying fraudulent pandemic flu products.

Federal officials said today that its contracts with vaccine manufacturers stipulate that production capacity not needed to make vaccine for the US market can be used to fill orders for other countries. They added that the government will only need to pay for the amount of vaccine needed for the US market.

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