What vaccine shortage says about us
I'll remember it well. My husband had just had serious surgery, and I was asked to leave the hospital to write about congressional hearings on the flu vaccine shortage.
Grumbling, I was informed by an editor that a national flu vaccine shortage was nothing to sneeze at and getting to the whys and wherefores was essential.
So I listened to endless excuses by frustrated government officials, vaccine manufacturers, public health doctors and other experts about why large numbers of people were unprotected during the great flu epidemic of 2003-2004 because of vaccine shortages. This followed the great flu epidemic of 2001 with calls for congressional investigation into vaccine shortages. And, of course, there was a worldwide flu epidemic 30 years ago and the worst one of all time in 1918, both of which Congress dutifully probed.
Today we are learning that there is not only a vast shortage of vaccine to protect against the swine flu pandemic but also that a shortage of seasonal flu vaccine is expected to develop. And yes, congressional hearings and investigation are underway.
This tells us a great deal about the national mood right now: We are finally, actually listening to the medical people who tell us we must get flu shots; capitalism doesn't always work; we do not like standing in line; and despite our propensity to blame Washington for everything, from canker sores to kindergarten test scores, we are not blaming President Obama for flu shortages. Not yet.
Every year about 36,000 people in the United States die from ordinary seasonal flu and 200,000 are hospitalized. Swine flu already has killed about 1,000, including children and young adults who have no immunity. And while we haven't even gotten into the height of the flu season yet, only about 114 million doses of seasonal flu vaccine are expected to be available.
Doctors, pharmacies and clinics are running out of seasonal flu vaccine, let alone the huge demand for swine flu or H1N1 vaccine, which is being parsimoniously parceled out only to those in society at highest risk such as children and hedge fund managers on Wall Street.
Every year's flu is different, so vaccines must be grown to anticipate what the current year's strain will be, which makes stockpiling difficult.
And because only a few private companies that have a low profit margin and sometimes have to throw away millions of doses of unused vaccine in years of little demand control vaccine production, the government has little control, except to regulate quality. (The 2004 shortage was caused largely because a California firm's British plant had quality control problems and about 47 million doses were not available to the U.S. market. Not surprisingly, there were accounts of price gouging.)
The Centers for Disease Control and Prevention and the Food and Drug Administration track vaccines, stockpile a little, set guidelines on who is at high risk and sometimes buy doses from other countries. But that is about all they can do. The National Institutes of Health researches basic vaccine development. States have some authority over distribution and rationing but not much.
This being a free-market nation, the government is not about to get into the unpredictable vaccine business and probably won't provide incentives such as tax relief so more companies will enter the risky business. Thus the annual erratic supply-and-demand dilemma and long lines at clinics will continue.
The government does, however, have admonitions for us: Be obsessive about washing our hands, using sanitizers and coughing and sneezing into sleeves, preferably our own. Children are conscientiously being taught these practices, the modern version of duck-and-cover exercises during the dawn of the nuclear age. Unfortunately, adults on crowded subway trains and airplanes are not as well trained.
Despite all the lessons-learned seminars, finger pointing and pledges for better research and incentives for private companies, I am convinced there will be many congressional investigations into flu vaccine shortages for journalists to cover in the future.
-- Scripps Howard columnist McFeatters has covered the White House and national politics since 1986. E-mail her at firstname.lastname@example.org.