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Health Officials Say Flu
Shots Should Go to Most Vulnerable Betsy Mc Kay, the Wall Street
Journal
In light of a rapidly dwindling supply of flu vaccine that may run out in a week or two, the U.S. Centers for Disease Control and Prevention is urging health-care providers to focus on giving shots to those considered most vulnerable. Those at risk include people over age 50, particularly nursing-home residents; children and adults with chronic conditions such as heart disease, diabetes and asthma; and pregnant women. The CDC says it also encourages children between the ages of six months and 23 months to be vaccinated. The Atlanta-based agency hasn't made a blanket recommendation about parceling out the remaining vaccines, leaving the final decision up to local health officials and individual providers. Health officials and clinics said they are figuring out how to ration the shots they have left. Pediatricians, for example, are wrestling with whether to reserve shots for children who are being vaccinated for the first time and need a booster 30 days after their first shot, or use those shots to inoculate more kids now. Remaining vaccine supplies may cost both doctors and their patients more. One pediatrician said he was charged 50% more per dose for shots he ordered late last week. A doctor typically will pay $8 or $9 to purchase a single vaccine from a distributor. Ed Thompson, the CDC's deputy director for public-health services, cautioned that the estimate that supplies may last just a week or two is a "very imprecise prediction." The CDC is still trying to determine exactly how much vaccine remains in the pipeline after the country's two manufacturers of the medicine disclosed Friday that they have shipped their entire inventory. About 83 million doses of flu vaccine were produced for this season, including 4.1 million doses of a new vaccine in nasal-spray form. State health departments polled last week by the CDC had no more than a total of 200,000 shots left. The agency is now trying to locate extra supplies in the marketplace that it can redirect to needed areas. Demand for flu shots has been brisk since October, thanks to an especially early start to the flu season, heightened fears of respiratory diseases in the wake of the SARS epidemic last spring and an active government-education campaign. New wording by the government encouraging vaccination for children ages six months to 23 months also boosted demand, vaccine manufacturers say. Reports of deaths of children in Colorado and elsewhere caused this year's post-Thanksgiving demand to jump about 50% above its usual level for this time of year, according to Michael Racioppi, president of the medical group for Henry Schein Inc., a large distributor of vaccines. The shortage of shots could also prove a boon for the manufacturer of a new nasal-spray vaccine whose sales have been tepid so far this season. Shares of MedImmune Inc. were up $1.64, or 6.5%, at $27.04 as of 4 p.m. in Nasdaq Stock Market trading on Friday, on the apparent hope that its remaining 3.7 million doses of FluMist vaccine could help partly fill the void, although the vaccine isn't approved for use for high-risk groups, and it costs as much as five times the price of a shot. Influenza kills an average of 36,000 people a year and some experts are predicting that this year's toll could be double that. Deaths most often are among the elderly or those with underlying health problems. Each year vaccine makers have to make educated guesses about how heavy demand will be for flu shots the next year, based on factors such as orders from doctors and distributors and predictions from epidemiologists. Flu vaccine must be reformulated for each flu season and thrown out at the end of winter if it isn't used. Health officials estimate somewhere between 10 million and 14 million doses were discarded after the 2002-2003 flu season. About 150 million people in the U.S. should get the shot annually to protect themselves from a disease that could threaten their lives, according to the CDC. But no more than 80 million usually do. But comes a bad year -- like this one -- and suddenly droves of people want the shot. "Erratic rather than consistent demand makes it impossible" to know exactly how much to produce, says Michael Decker, vice president of scientific and medical affairs for Aventis Pasteur U.S., the vaccine unit of Aventis SA and the largest manufacturer of flu shots for the U.S. market. "If demand spikes after you've made it all, what can you do?" When the supply does run out, Dr. Thompson says basic measures, such as frequent hand-washing, can help protect those who aren't immunized. For most people, "the flu is uncomfortable and inconvenient, but typically not more than that," he says. Copyright
© 2002 Global Action on Aging |
