Swine Flu and the Vaccine

Swine Flu and the Vaccine

Reasons for the H1N1 Vaccine Shortage

Although many people are aware of the importance of being vaccinated for H1N1, there's little they can currently do to obtain the vaccine as early as needed. The article H1N1 running rampant amid shortage of vaccine (Fiore, 2009) reveals the implications for a shortage of the H1N1 vaccine and a high-level reason supply lags demand as this paper summarizes. but, the devil is in the details of explaining underlying policies and actions that have led to poor preparation and response.

As of middle of October 2009, more than 5,000 cases of H1N1 flu have been reported in 2009 resulting in more than 800 deaths. Only 25% of the vaccine that was expected by the end of October will actually be available. This is a large problem because, typically, flu spikes happen in January, but the H1N1 virus is already spiking in October. Unfortunately, there will not be widespread availability of the vaccine until the middle of November. In addition to the lack of H1N1 vaccine, there is not enough pediatric Tamiflu available, an issue that is causing concern because children are a high-risk group for complications and death from the H1N1 flu virus.

Health and Human Services Secretary Kathleen Sebelius attributes the vaccine shortage on lower than predicted yields from vaccine manufacturers and on manufacturing glitches. The country is only working with five manufacturers to produce the vaccine. She expects the situation to be resolved moving forward into November and the vaccine will both be safe and effective. In the interim, there are concerns that hospitals are ill equipped to deal with widespread outbreaks where as many as 300,000 flu patients could require ICU treatment this year. The only action appears to be updated guidance to schools, governments and the private sector on how to handle outbreaks.

Although, the article assigns no blame for the shortage of the H1N1 vaccination, it certainly raises red flags and questions about our government's competence in dealing with the H1N1 outbreak. Certainly, the public was informed in early 2009 that there was a new flu occurring in Mexico with far different epidemiologic characteristics and clinical profiles than traditional flu strains. Yet, our healthcare officials seem to be caught off guard by H1N1 spiking months earlier than other flu strains. Given a new flu strain, it seems reasonable that there should have been expectations that it could have different seasonal patterns.

The fact that there are only five manufacturers is another issue that needs to be understood. Why so few, given the many warnings of the potential for a wide-spread pandemic? One has to wonder if our government should have done more to encourage additional manufacturers, perhaps even subsidizing or offering other financial incentives for production. The article doesn't discuss the percentages of the H1N1 vaccine that the manufacturers are producing and which ones are experiencing glitches. Perhaps a larger number of producers and better diversification would have helped to alleviate the production bottlenecks.