America’s current flu vaccine crisis, if it is a crisis, highlights many inadequacies of our health-care system and the fragile trust between government, the public and health-care professionals.
Perhaps because of the anthrax scare and other elements of the war on terror, the flu vaccine shortage combined with misinformation can lead to distrust. This manifests itself in heightened anxiety and even, perhaps, hysteria. Internet rumors and ineffective media cooperation by government agencies like the Centers for Disease Control and Prevention may well exacerbate the problem.
Here’s what we know:
• On Oct. 5, British regulators suspended the Chiron Corp.’s license to produce the flu vaccine due to bacterial contamination in filling vials. Chiron planned to produce almost half of America’s 100 million flu vaccine doses this winter.
• The flu changes year to year in potency and makeup. Consequently, the flu vaccine has to be tailor-made for the specific form of flu each season. Most medical professionals believe that in some years, like last year, the vaccine is almost completely useless in fighting the current strain of flu.
• On Oct. 14, on NBC’s “Today” show, Katie Couric mentioned that her parents had to wait almost six hours to receive their flu shots. The Courics live in Arlington, Va.
• On Oct. 16, a Giant supermarket manager in Arlington had to turn away more than 100 elderly people eager to receive the vaccine. Many had waited all night in the store’s parking lot. The store only had 100 shots of the vaccine. This scenario is being repeated in Silver Spring, La Plata and across our region.
All over the country, people are angry that their flu shots are unavailable, hard to find or too costly. Elderly people even say, “Without my flu shot, I might die.” Local media outlets rabidly report the complaints but seldom give a complete picture.
We don’t yet know the severity or virulence of this year’s flu strain. We don’t know if this year’s vaccine might have been effective at knocking down the flu. And we don’t yet know if there is time to locate or manufacture additional shots.
All we really know is we have a 100-million-shot vaccine shortage and a large, growing number of dismayed people.
How did this happen?
First, American pharmaceutical companies feel little or no incentive to produce the flu vaccine. A large pharmaceutical corporation executive said on condition of anonymity: “A small percentage of flu vaccine recipients react badly to the shot. In our litigious society, some small portion of these people sue the pharmaceutical companies. By producing the vaccine, we take on an inordinate risk.”
He continued: “Because the vaccine is primarily targeted for the very young and very old, the so-called high-risk recipients, we face the likelihood of a very low margin [profit] for producing the vaccine.”
Sad to say, some unprincipled profit-seekers increased the flu shot price tenfold as soon as the shortage emerged this year.
The flu vaccine shortage also reveals the following complexities:
(1) Panic and fear may cause even the slightly ill to overreact. This could quickly overwhelm an overcrowded, busy emergency health-care system. Medical professionals fear that patients with the common cold could overreact and fill emergency rooms in a month or two. Think what might happen in a real anthrax or chemical weapon emergency.
(2) There is no centrally managed federal system to ensure equitable distribution of the vaccine to the targeted “high risk” population. Thus, the Feds asked the states to ensure the elderly and very young get the first of the scarce flu shots. Maryland and D.C. advised providers to give the flu shots only to those most at risk. Several states even threatened fines for violators. Virginia made compliance voluntary.
(3) In many areas, while a children’s health-care clinic may have no flu shots available, a veterans’ clinic a few blocks away may have more than enough. The voluntary, cooperative nature of our health system makes a response to a situation like this one haphazard, unpredictable and without central control.
(4) The potential for lawsuits has changed every facet of our health-care system. Large insurance premiums impact every doctor, convincing many to relocate, alter how they do business, or leave their chosen profession. Pharmaceutical companies cower at the word “lawsuit.”
The current flu vaccine situation deserves careful study and corrective action. This may be a clarion call to the CDC and other responsible government agencies.
From those standing in lines for hours, awaiting flu vaccine shots this year, the federal government and President Bush get most of the blame. Deserved or not, the criticism makes for angry, impassioned voters.
John E. Carey is a writer in Arlington.
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