Vaccine preparedness, or not

October 14, 2004

An editorial in this week's issue discusses the impact of the temporary removal of Chiron's licence to provide influenza vaccines. It comments that the main lesson to be learnt is the future avoidance of relying on only two manufacturers (in the case of the USA) for vaccine supply.

'Influenza remains a killer disease. Each year around the world, about a fifth of children and about 5% of adults develop influenza, and half a million people die as a result. The vaccine is highly effective (it protects about 80% of recipients) and serious side-effects are rare. So, in developed countries, various groups at high risk for serious complications of influenza or in contact with people at such high risk are recommended to be vaccinated. These groups include, in the USA for instance: children aged 6-23 months (the new group this year), adults aged 65 years and older, people aged 2-64 years with chronic conditions, women who will be pregnant during the influenza season, residents of nursing homes, health-care workers directly involved with patients, and out-of-home caregivers and household contacts of children aged under 6 months.'

'So, how bad are Chiron's manufacturing troubles for potential recipients of influenza vaccine? The company was to have supplied about 2 million doses to the UK (about a fifth of the doses needed), and MHRA [Medicines and Healthcare products Regulatory Agency] has arranged for the shortfall to be made up by other manufacturers, with shipping of the first lots by the end of this month. In the USA, Chiron was to have supplied half the 100 million doses required there, a figure itself increased (from 87 million) by the inclusion of the new at-risk group. What is certain is that the available supplies will be strictly saved for the groups who qualify for vaccination. Somewhat disingenuously, the US Centers for Disease Control and Prevention says all those who do qualify will get the vaccine, because take-up is never 100% anyway.'

The editorial concludes: 'There is a lesson here, about vaccine supply. It is not sensible to restrict manufacturing licences, in the case of influenza vaccine and especially in the USA, to two suppliers. At a blow, half this year's stocks were impounded. The risk (of faulty batches) should be spread across several manufacturers. The UK hedged its bets and thus secured supplies. It will not look good if US campaigns for influenza vaccination have to overwrite their adverts this year with the addition of ". . . If you can get hold of a dose".'
-end-


Lancet

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