By Elizabeth M. Whelan, Sc.D., M.P.H.
Posted: Friday, September 28, 2007

EDITORIAL
Publication Date: September 28, 2007

This piece first appeared in the September 28, 2007 New York Post:

It's flu-shot season again. The good news is that we've got plenty of vaccine this year; the bad news is that far too many Americans will skip their shots.

One health problem is that even high-risk people have been skipping in recent years. Another is that shots that go to waste endanger the nation's future supply of vaccine.

We'll have a record number of vaccine doses on hand - more than 130 million (mainly in the form of shots, but also as nasal spray). These offer substantial protection against a severely debilitating illness -- influenza leads to 36,000 U.S. deaths a year.

But it's not cheap. The virus mutates constantly, so each year's vaccines must be designed from scratch. And with many people skipping their shots, manufacturers face ever-lower incentives to produce the vaccine. That is, the pharmaceutical companies take a huge loss if their products are discarded, rather than sold.

Very few drug-makers remain in the flu-vaccine business these days -- most have been driven out by years of financial losses (the result of market uncertainty, government actions and lawsuits).

Remember late 2004, when contamination at a plant in England devastated our flu-vaccine supply? With only about half the expected 120 million doses on hand, near-panic conditions prevailed. Media reports told of elderly people waiting in line in blistering Miami heat to get shots -- and fainting by the scores.

Yet even in that year of shortage and angst, the flu season's end saw nearly 5 million doses tossed out. Last year, a far more normal one, discards were some 18 million doses (out of 121 million).

Flu-vaccine development is a very complex process. Production begins as early as nine months before the flu season, with substantial research to determine the strains most likely to be in circulation. After the vaccine strains are selected and distributed to manufacturers, actual production requires millions of fertilized hen eggs. The incubation, purification, testing and packaging process goes on between June and October -- and then distribution, complex in itself, begins.

Public-health guidelines recommend that 75% of U.S. citizens get a flu shot -- everyone over age 65, babies, children and pregnant women, plus anyone who's immune-compromised. But all of us -- even those not at high risk -- should get immunized, if only to avoid a week of aches, pains, fever, etc.

A little-known fact: Immunizing the young, who are themselves unlikely to die from flu, can help prevent the flu from spreading among the elderly, who are far more vulnerable.

In producing an abundant vaccine supply, pharmaceutical firms are going out on a financial limb to promote public health. Do yourself and others a favor: Get a flu shot this fall, and encourage your family members to do the same. In so doing, you not only protect your health (and loved ones'), you help ensure that these life-saving preparations will be available in the future.


Dr. Elizabeth M. Whelan is president of the American Council on Science and Health (ACSH.org).

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