Flu vaccine suddenly in short supply

By Seattle Times staff and news services

AP Syringes are loaded with flu vaccine at a Chiron Corp. facility in Liverpool, England, in an undated company photo. British authorities yesterday blocked flu-vaccine shipments by Chiron, a major U.S. supplier.

E-mail this article Print this article Search archive Most read articles Most e-mailed articles

Related stories Chiron slashes profit outlook after vaccine license pulled Other links Influenza: Protect yourself and your loved ones

The surprise shutdown of the maker of half the U.S. flu-shot supplies means tens of millions of people will be urged to skip the vaccine this year so babies, the elderly and other at-risk populations can have dibs on scant doses.

As U.S. health officials rushed to revise flu-shot guidelines yesterday, Washington's state and local health departments scrambled to overhaul their vaccination plans with flu season around the corner.

Dr. Alonzo Plough, director of Public Health-Seattle & King County, said the news turned local policy "almost on its head." Now, instead of encouraging the broader public to get the shot, "healthy people will be urged to forgo their vaccine this season," he said.

The agency, along with the Washington State Department of Health and Snohomish Health District, said it will follow the new federal recommendations for rationing the vaccine this season.

That means the vaccine is reserved for children ages 6-23 months, people 65 or older, those with chronic health conditions such as heart disease or HIV, pregnant women, residents of nursing homes, kids on long-term aspirin therapy, health-care workers and people who live with babies less than 6 months old, according to the Centers for Disease Control and Prevention.

For everyone else, "it's important to take a deep breath and put this into some kind of perspective," Dr. Julie Gerberding, head of the CDC, said at a news conference yesterday.

While a loss of half the flu-shot supply is unprecedented, there will still be more vaccine available than in all but the most recent years. "Ten years ago, we were only making 20 million doses," said Secretary of Health and Human Services Tommy Thompson.

Who should get a flu shot Children ages 6-23 months Adults 65 or older People with chronic medical conditions Women who will be pregnant this fall and winter Residents of nursing homes and long-term-care facilities Children more than 6 months of age on long-term aspirin therapy Health-care workers with direct patient contact Caregivers and people who live with children less than 6 months old Centers for Disease Control and Prevention

He said the government cannot enforce the recommendations on providers who have already purchased the vaccine; it must rely on voluntary rationing by health departments, doctors and the public.

In other words, "If you are not in one of those groups, please step aside and let those who need it most get their vaccine," urged Tim Church, spokesman for the state health department.

Authorities can't say how the shortage will affect the flu season.

"One thing we know about the flu is we can't predict it," Gerberding said. "We haven't been able to get the crystal ball to work. It's very difficult to know at the beginning of the season how bad it will be."

Supply cut in half

The vaccine supply for this year's flu season was cut roughly in half, from around 100 million to 54 million doses, when British regulators abruptly suspended the license of California-based Chiron Corp. after they found problems at the company's factory in Liverpool, England. The company said it will ship no flu vaccine this year, including some 46 million to 48 million doses meant for the United States.

The rest of the U.S. supply is coming from a different manufacturer, Aventis Pasteur, which already has begun shipping. The shortage doesn't affect the shots available for children 6-23 months because Aventis is solely responsible for making those doses.

Last year, an early flu bug drove demand for the shot to an all-time high and the supplies had to be rationed midseason. Nearly 90 million people received the shot.

Trying to avoid another crunch, the state health department doubled the number of vaccines it purchased for at-risk children this year to 200,000, Church said. But about 70,000 of that was ordered from Chiron. So far, they've already distributed 30,000 shots from Aventis to local health departments. "We hope to receive the rest of the shots we're expecting, but we can't be sure we'll get them," he said.

The state doesn't keep track of vaccine orders from private providers, who dole out the majority of shots, so the extent of the shortage across Washington is not yet known.

The King County health department gets its children's vaccines through the state, but it ordered 21,000 adult shots from Chiron for public-health clinics. For now, it has none to offer adults at its nine clinics. Plough said the department will meet with major providers of the shot next week to get a picture of the area's total supply.

Snohomish Health District has only a little more than 5,000 doses, including 3,300 designated for at-risk kids, said Dr. Ward Hinds, director of the district. It had planned to start providing the shots Oct. 18 but is still deciding how to ration the limited supply.

Group Health Cooperative is one of the lucky outfits that ordered primarily from Aventis. Only about 10 percent of its more than 100,000 doses was to come from Chiron, said Walter Sidles, manager of pharmacy materials. It has about 40 percent of its supply on hand and hasn't announced who will get shots.

About 20 Bartell drug stores in Western Washington have a limited amount of vaccine that will be available to customers who fall into the CDC priority groups, said Dan Connolly, vice president of pharmacy. He added that even physicians have been calling Bartell trying to secure doses.

Exploring all avenues

Chiron discovered about 4 million doses were tainted back in August. But late last month, the CDC announced that close monitoring of the rest of the supply showed it was fine.

British inspectors visited the Liverpool factory last weekend, then abruptly pulled Chiron's license, taking U.S. officials by surprise. Food and Drug Administration officials were headed to England yesterday to investigate whether some of the vaccine might be salvageable.

"We are exploring all avenues for obtaining more vaccine this season," Thompson said, including asking Aventis to produce additional doses and exploring whether existing doses can be diluted. The vaccine, which is made using chicken eggs, takes months to produce, so manufacturers can't quickly whip out extra.

Flu-shot campaigns usually start in October, a month before the flu season typically strikes the United States. In an average year, the virus kills 36,000 people, mostly the elderly.

Healthy people ages 5 to 49 have another option: 1 million to 2 million doses of the inhaled flu vaccine, MedImmune's Flu Mist, will be available. It's made from weakened rather than a dead virus, so it's not recommended for high-risk patients.

Healthy people also are encouraged to wash their hands often, and to steer clear of people clutching tissues.

The Associated Press and Seattle Times reporter Warren King contributed to this report.

Julia Sommerfeld: 206-464-2708 or jsommerfeld@seattletimes.com

Copyright © 2004 The Seattle Times Company

E-mail this article

Print this article

Search archive

More nation & world headlines...