Flu Shot Fiasco, Critical Incident Report

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Medical Authors and Editors: Barbara K. Hecht, Ph.D. and Frederick Hecht, M.D.

October 13, 2004 -- Now that the flu shot fiasco is upon us, the CDC (US Centers for Disease Control & Prevention) is doing quite a job. It is taking charge of the situation.

The List of Eight

Upon learning of the shortage, CDC promptly recited the List of Eight -- the eight groups of people who had already been granted high priority to receive the flu vaccine.

The List of Eight is made up of two geriatric groups, a chronic disease contingent, two groups of kids, women heavy with child, and two groups of caregivers. The List of Eight, as set forth by the CDC, consisted of:

• adults aged 65 years and older,
• residents of nursing homes and long-term care facilities,
• persons aged 2-64 years with underlying chronic medical conditions,
• all children aged 6-23 months,
• children 6 months-18 years of age on chronic aspirin therapy,
• all women who will be pregnant during influenza season,
• healthcare workers with direct patient care, and
• out-of-home caregivers and household contacts of children aged <6 months.

We would add at least one other group, namely people who are immunosuppressed. Anyone who is immunocompromised by chemotherapy or extensive radiation therapy or by a disease should clearly receive priority for the killed-virus flu vaccine.

So the List of Eight should be the List of Nine (or more).

CDC Allocating Remaining Vaccine

Now the CDC has announced that the remaining 22 million doses of flu vaccine that have not yet been shipped will go specifically to the geographic areas and to the people who need them most. The Aventis Pasteur vaccine will go to hospitals, long-term care facilities, nursing homes, and pediatricians and other doctors who care for young children. High-risk children, seniors over the age of 65, and VA facilities are also on the CDC's list of high-priority groups to receive the "first wave" of vaccine.

The remaining 8 million doses will be left to the CDC to "move around in ways that serve those at the highest risk."

Thanks to the CDC

We have often been critics of the CDC. However, when it comes to the current flu vaccine situation, we congratulate the CDC on its superb service to the nation.

The CDC's response has been rapid, right on target, and pioneering. Dr. Julie Gerberding and her many, many colleagues at the CDC deserve all our thanks for a thankless job well done.

The Health World is One

Incidentally, why is Fluarix, the flu vaccine made by GlaxoSmithKline not available in the US? As we understand it, Fluarix is licensed in some 70 countries. Why not in the US?

And finally, while we were in line for flu shots yesterday, we discovered that none of our new friends standing there realized the vaccine they were about to receive was made in France! The health world is one.

Related Links

• Flu Season 2004-2005: Questions & Answers
• Flu Vaccination
• Influenza (Flu)
• Flu Shot Locator (Find the locations in your area offering the flu vaccination)
• Cold and Flu Center