Flu shot scramble highlights vaccine woes

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The current run on influenza vaccine in United States highlights the neglected status of vaccines in general, health experts said -- but efforts are under way to improve vaccine technology and supply.

The current run on influenza vaccine in United States highlights the neglected status of vaccines in general, health experts said on Tuesday -- but efforts are under way to improve vaccine technology and supply.

They said sporadic shortages of vaccines routinely given to children for mumps, measles, diphtheria and other diseases are likely to continue unless some changes are made.

And regular shortages of influenza vaccine can also be expected unless some changes are made.

In a report published in Wednesday’s issue of the Journal of the American Medical Association, the National Vaccine Advisory Committee recommended increased government funding for vaccine stockpiles.

The group also advised stronger liability protections for manufacturers; a requirement that manufacturers give advance notice if they are leaving the marketplace; and a national campaign to emphasize the safety and benefits of vaccines.

The U.S. government has bought 625,000 doses of flu vaccine from two makers -- Emeryville, California-based Chiron Corp. and a U.S. subsidiary of French-based Aventis -- to try and cover the demand.

It has also negotiated a discount price for states to buy up to 3 million doses of Wyeth and MedImmune’s FluMist vaccine, which can be given nasally.

Health experts say the demand -- brought on by media coverage of an unusually early flu season in the United States -- illustrates the dilemma over vaccines.

Prevention not valued
“We don’t value prevention in this country,” said Dr. Paul Offit of Children’s Hospital of Philadelphia and a leading vaccine expert.

The current shortage only affects some areas and some doctors’ offices, but it is only the latest in a series of flu vaccine shortages. The most recent was in 2000.

And in 2001-2002 there were serious shortages of childhood vaccinations, including immunizations for measles, pneumococcal disease and tetanus.

Despite the huge amount of publicity surrounding the shortages, people still do not get their influenza vaccines, said Dr. Julie Gerberding, head of the U.S. Centers for Disease Control and Prevention.

“We believe that about 185 million people in this country are at risk from influenza and we never get anywhere near that number vaccinated,” Gerberding to a news conference last week.

One reason the influenza vaccine is in short supply this year is that last year Aventis and Chiron made 95 million doses, but had to throw 12 million away because people didn’t get immunized. This year, they made 83 million doses.

No way to hurry up
There was no way for them to hurry up and make more when this year’s flu season started early.

“To scale it up we would have to change the whole approach,” Gerberding said. Now flu vaccines are grown in eggs and it is a time-consuming process.

“We know we need more research to be able to use tissue culture based vaccine,” Gerberding said.

Another way to quickly change the vaccine would rely on genetic engineering to precisely tailor the vaccine to keep up with the quickly mutating virus.

Offit said another problem is that there are so few vaccine makers.

“The measles, mumps and rubella vaccine -- there one vaccine maker,” he said. “Varicella (chickenpox) -- one maker. The result is we don’t have a very nimble system. When shortages occur we don’t have stockpiles we can go to.”

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