Officials See a Shortage in Vaccine for Swine Flu

Officials See a Shortage in Vaccine for Swine Flu
By DENISE GRADY
Copyright by The New York Times
Published: October 16, 2009
http://www.nytimes.com/2009/10/17/health/17flu.html?th&emc=th


Health officials on Friday predicted a shortfall in the supply of swine flu vaccine, as the numbers of cases, hospitalizations and deaths grow to levels unprecedented for this time of year.

Flu caused by the H1N1 virus is now widespread in 41 states, and flulike illnesses account for 6.1 percent of all doctor visits.

“That’s high for any time, particularly for October,” said Dr. Anne Schuchat, the director of the National Center for Immunization and Respiratory Diseases at the Centers for Disease Control and Prevention.

Forty-three children have died from swine flu since Aug. 30 — about the same number that usually die in an entire flu season. Nineteen of the 43 who died were teenagers, and 16 were ages 5 to 11 years old; the rest were under 5.

“These are very sobering statistics,” Dr. Schuchat said in a news briefing, “and unfortunately they are likely to increase.”

Fifteen percent to 20 percent of the patients who were hospitalized for the flu wound up in the intensive care unit, a rate comparable with that for seasonal flu. Although the disease continues to spread, its severity is not increasing.

Projections of the supply of swine flu vaccine have widely varied. During the summer, health officials said 120 million doses would be ready in October. They later dropped the estimate to 40 million doses by the end of the month.

Now, Dr. Schuchat said, they expect only 28 million to 30 million doses, adding that the exact numbers were impossible to predict and could change daily. She said vaccine manufacturers were reporting that production was behind schedule.

“I wish we could be more predictable, but this is how influenza vaccine goes,” Dr. Schuchat said.

“Vaccine production for influenza is pretty complex,” she said in explaining the delay, “and the complex process this year is taking a bit longer than we had hoped. The yield of antigen is lower than they had hoped for.”

The antigen is the part of a virus included in vaccine to stimulate the body’s protective response. It is crucial; a vaccine will not work without it.

Dr. Schuchat also said that once batches of vaccine were prepared, they had to be tested for potency and purity.

“We are not cutting any corners,” she said. “It’s important to us that this process be done carefully and safely.”

She acknowledged that some people were having trouble obtaining vaccinations, saying, “I’m sorry it’s a difficult time in terms of looking for vaccine.”

As of Wednesday, Dr. Schuchat said, 11.4 million doses of the H1N1 vaccine were available, with more being shipped. She predicted that by early November, there would be widespread vaccine availability and information on where people should go for it.

Explaining how just 30 million doses could translate into widespread availability, a spokesman for the disease centers, Tom Skinner, said: “ ‘Widespread’ means it’s going to be in a lot of places. It doesn’t mean that a lot is going to be in a lot of places. It just means it’s going to be out there.”

Dr. Schuchat acknowledged that some people had fears about the H1N1 vaccine, but she emphasized that it was safe and urged pregnant women to be vaccinated because they were especially prone to severe complications and had accounted for a disproportionate number of deaths.

Studies of the swine flu vaccine are being conducted in pregnant women. But, Dr. Schuchat said, “if I were pregnant, I would not wait for the results of those trials; the risk in pregnancy has been very striking.”

On the seasonal flu, Dr. Schuchat said 82 million doses of vaccine had been distributed, out of an expected total of 114 million.

But the vaccine has been running low in some areas. Dr. Schuchat urged the public to “keep looking” and emphasized that there was time because seasonal flu did not usually take hold until December. Virtually all cases now are the H1N1 swine flu, she said.