Feds Give Flu Shots to States

Last Editorial Review: 11/10/2004

November 9, 2004 -- The Centers for Disease Control and Prevention (CDC) has just announced its plan for when and how the remaining doses of the 2004-05 flu vaccine will be distributed. This action was necessitated by the critical shortage of flu vaccine that hit the US this year. The shortfall occurred after one of two flu vaccine suppliers (Chiron Corp.) was shut down in October for reasons of contamination.

This year, a second vaccine manufacturer (Aventis Pasteur) had committed a total of 58 million vaccine doses for the US. This number includes the 33 million doses already shipped prior to the Chiron shutdown and the 14 million additional doses which were subsequently shipped.

Doing some simple arithmetic means that the flu vaccine distribution plan just announced by CDC will apply to the 10.3 million doses which are left. It is the CDC's intention to turn over this remaining vaccine to the state health departments which will then decide how they are going to distribute the vaccine within their own states.

Comment: A Nebraska health official was quoted as saying, "While all of the nation's vaccine needs will not be met, this system is fair and will assure that remaining doses of vaccine get to those most in need."

Perhaps "maximize the chances" would be a better choice of words than "assure." But we can always hope that the federal-state health "system" in the US will get the vaccine to everyone at highest risk from the flu.

Our other concern is that the CDC plan calls for distributing the remaining flu vaccine "over several weeks through December and into January." For many people, especially if the flu strikes over the holidays, this timeframe may be too little and too late.

Barbara K. Hecht, Ph.D.
Frederick Hecht, M.D.
Medical Editors, MedicineNet.com

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CDC and States Announce Plan to Distribute 10.3 Million Flu Shots Nationwide; Public Health Officials Call Allocation Fair and Aimed at Most Vulnerable Americans

Working closely with public health officials nationwide, the Centers for Disease Control and Prevention (CDC) today announced plans to distribute the remaining 10.3 million doses of Aventis Pasteur influenza vaccine to state health departments, which will then help ensure the doses reach those people at highest risk for complications from influenza. The vaccine will be distributed over several weeks through December and into January.

"The work by our colleagues in state and local health departments across the country that has gone into developing this plan has been absolutely extraordinary," said CDC Director Dr. Julie Gerberding. "We're doing everything possible to ensure that vaccine is distributed in a fair way and that it goes to those who need it most."

Under the plan outlined today, states and territories will be receiving 100 percent of any orders they had originally placed under federal, state, and multi-state contracts. Overall, this accounts for 3.1 million doses of vaccine. The distribution plan for the 7.2 million doses takes into account three things: 1) the number of high-priority individuals in the state, 2) the number of doses the state has already received and 3) the state's unmet needs. In the coming weeks, another 1.2 million doses of pediatric will be allocated to states using the same approach.

"The allocation plan announced today, designed to get vaccine to those individuals in greatest need of protection, demonstrates once again the critical role the federal, state, and local governmental public health system, working with the nation's health care providers, can play in protecting the public," said Richard A. Raymond, MD, president of the Association of State and Territorial Health Officials (ASTHO) and Chief Medical Officer, Nebraska Health and Human Services System. "While all of the nation's vaccine needs will not be met, this system is fair and will assure that remaining doses of vaccine get to those most in need."

"We support the influenza vaccine allocation method outlined today. It is the best available solution for getting the remaining vaccine to the persons who need it most," said Patrick M. Libbey, Executive Director, National Association of County and City Health Officials (NACCHO). "The nation's local public health departments will continue to assist their communities and their state health departments in every way possible to protect the public's health during this period of flu vaccine shortage."

Vaccine manufacturer Aventis Pasteur had already shipped 33 million of its expected total 58 million vaccine doses prior to Chiron Corporation's Oct. 5 announcement. The remaining 25 million doses have been allocated at a rate of about 3 million doses per week - or about 14 million doses - since Oct. 11, under a joint distribution plan developed by CDC and Aventis. The vaccine has gone to state public health departments, the Department of Veterans Affairs, long-term care facilities/acute care hospitals, Vaccines for Children program providers, private physicians who care for young children, HMOs and private providers serving high-priority groups. The plan announced Tuesday will allocate the remaining 7.2 million influenza vaccine doses.

This year's expected vaccine supply also includes 3 million doses of FluMist, which is approved for use by healthy people between the ages of 5 and 49. In addition, CDC is continuing to work with HHS and the Food and Drug Administration (FDA) on the possibility of obtaining several million doses of foreign-produced influenza vaccine for use in the United States this influenza season. These vaccines are not currently licensed for use in the U.S., but if deemed safe by the FDA, could be used under an "investigational new drug" protocol that meets FDA requirements. To ensure the safety of this flu vaccine, FDA inspectors are visiting the overseas plants of these manufacturers.


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In addition, a supply of antiviral drugs to treat influenza will be available this flu season. Supplies of antiviral drugs are available through private health providers and the federal government has purchased a stockpile of antiviral drugs to treat more than 7 million people. FDA has estimated that approximately 40 million people could be treated this flu season with the antiviral drugs available.

To provide more information to health care professionals and the public about influenza and influenza vaccine, CDC has launched 1-800-CDC-INFO, a new 24/7 central telephone hotline available in English and Spanish. This number will enable people to obtain information from CDC. The number for the hearing impaired is 1-800-243-7889 (TTY/TDD).

"We are excited to be able to provide a new information hotline that will help people, including health care providers, to get answers about the influenza vaccine and at a later time, a wide range of health and disease-related questions," said Dr. Gerberding. "We encourage people to call this number for information about the flu and this year's flu season or to report when they cannot find vaccine in their communities."

Any information CDC receives about problems in finding influenza vaccine will be shared with state health officials to help them direct the available vaccine to people and places where it's needed most.

Callers to the hotline can choose to hear voice messages on a variety of flu-related topics. Every caller has the option to transfer to a live person who can provide more information.

Health care providers can also call the number to report cases of influenza or flu-like illness in their community.

Source: Centers for Disease Control and Prevention press release, November 9, 2004

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