Vaccine Poker

By Dr. Marc Siegel

This article appeared in the November 1, 2004 edition of The Nation.

October 14, 2004

With the announcement that 50 million influenza vaccines from the British manufacturer Chiron won't be available in the United States this year because of possible contamination, the Centers for Disease Control (CDC) has been put in a quandary, its credibility once again damaged. From pushing the yearly flu vaccine accelerator pedal, urging everyone to get a shot, it suddenly has had to slam on the brakes. "Take a deep breath, this is not an emergency," Dr. Julie Gerberding, the agency's director, said, trying to ward off a stampede of shot-seekers. But such attempts are bound to fall flat, especially with the elderly, who need the vaccine to protect them from serious illness and death.

One of the main reasons a shortage like this can occur is because drug manufacturers are not eager to produce vaccines in the first place. This is why there are only two major flu vaccine makers--Chiron and Aventis--worldwide. Without a patent to insure high prices, the profit margins for "generic" vaccines is narrow. Plus, proper sterilization methods are quite expensive and cut further into the profit margin. Forget altruism, or concern for patients; drug companies are not eager to make a product they can't make a lot of money on. The only way to insure adequate supplies and reserves is for the government to step in and subsidize the manufacturing of vaccines. Yet last year Congress approved only half the $100 million requested to develop better flu vaccines and improve the distribution system.

Instead of worrying about the flu, our government has been busy spending millions stockpiling over a million doses of anthrax vaccine (with no use for it in the foreseeable future), and more than 200,000 doses of smallpox vaccine (without a single case occurring here since 1949). These actions were taken so that the Department of Homeland Security can look like it takes the threat of biological agents seriously. A bioterror attack would likely affect only hundreds, or at the worst thousands, yet the expensive preparations are for millions of potential victims. BioPort makes the only anthrax vaccine, an unwieldy six-dose process that many military recruits have complained gives them a flu-like syndrome. But fearing an anthrax attack since 2001, Congress has contracted with this company for millions of dollars in vaccine production. Since the vaccine is perishable, and there is no anthrax, most of what is produced is thrown away. Similarly, panicked over smallpox in 2002 and 2003, the government purchased 291,400 doses of the antiquated live virus vaccine, which was found to have significant side-effects, including heart problems. Ultimately, only 38,549 people were vaccinated and more than 250,000 doses were discarded. Meanwhile, influenza kills approximately 40,000 people in the United States every year and hospitalizes more than 200,000.

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About Dr. Marc Siegel

Dr. Marc Siegel is a practicing internist and an associate professor of medicine and a fellow in the Master Scholars Society at New York University School of Medicine. He is a weekly columnist for the New York Daily News, a frequent contributor to the Los Angeles Times, the Washington Post and The Nation. He is a member of the board of contributors at USA Today. He appears frequently on CNN, the Fox News Channel, and the NBC Today Show. He is the author of False Alarm: the Truth About the Epidemic of Fear and most recently, Bird Flu: Everything You Need to Know about the Next Pandemic (Wiley). more...
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