The flu and you
With shortages everywhere, authorities are trying to quell panic and reassure the public that the vaccines are coming
The CDC is reallocating some of the Aventis vaccine to state health departments that have none. State officials are charged with getting the vaccine to their most vulnerable populations. In Oregon, for example, with a population of over 1 million high-risk residents, using 9,300 surplus doses the state recovered and the more than 224,000 doses received from Aventis to date, health authorities there have been able to vaccinate only about 22 percent of the state's high-risk residents this winter, instead of the usual 50 percent in an average flu season.
What this will almost certainly mean on a national level is higher healthcare costs related to flu, more hospitalizations, and more deaths. There are no official estimates yet on how much the flu vaccine shortage may cost, but David Cutler, a professor of economics at Harvard University, estimates it may go as high as $20 billion in doctor and hospital payments and productivity losses. Compared with the $13 billion to $15 billion a typical season costs, the increase is significant.
"Land rush." Report after report from the Institute of Medicine, the National Vaccine Advisory Committee, the Government Accountability Office, and other bodies have warned of a coming flu vaccine shortage. The GAO has consistently urged the CDC to come up with a plan for quickly distributing flu vaccine to high-risk groups. In fact, says the CDC's Cohen, such a plan can be developed only on a case-by-case basis, as he and other CDC officials are doing now. This seat-of-the-pants approach, however, is sowing lots of confusion. "The current system is like a land rush," says Jeffrey Koplan, a vice president at Emory University and former director of the CDC. Koplan's 83-year-old aunt waited for two hours at one Long Island, N.Y., supermarket and three hours at another to get a flu shot last week. "It's one thing to say here are the folks who should get the vaccine, and it's another thing to make it more practical and easy to take place."
Ultimately, says Koplan, the government is going to have to guarantee that a certain number of doses will be purchased. "Guaranteed purchase of vaccine is the one thing we could do that would make an immediate difference," says Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases. Most experts agree that this is an investment worth making. Vaccines "dwarf every other medical advance that has been achieved," says Koplan. "To not support them adequately is a grave error."
Late last week, Ralph Loschiavo's luck changed. His doctor called to say the practice had received a few doses of flu vaccine. They'd selected Loschiavo and seven other patients to get flu shots. He was pleased. "But," he says, "something has to change."
Priority groups to receive the flu vaccine
(2002-03 population in millions)
Pregnant women 4
Children 6 to 23 months 5.9
People in contact with babies less than 6 months 6.3
Healthcare workers 7.0
People over 64 35.6
People with chronic illness 39.4
Source: Centers for Disease Control and Prevention
USN&WR
With Nancy Shute
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