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    "When many cures are offered for a disease, it means the disease is not curable" -Anton Chekhov

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    Sunday, September 26, 2004

    Flu Shot Season Approaches: The CDC and infectious disease experts are urging just about everyone to get flu shots this year:

    A record 100 million doses of flu vaccine will be available this year, the vast majority of it shipped to doctors' offices by the end of October, said Dr. Keiji Fukuda of the Centers for Disease Control and Prevention.

    That assurance comes several months after one major supplier, Chiron Corp., delayed its shipments because a small amount of vaccine failed sterility testing, suggesting contamination. That was "a precautionary move," and close monitoring so far suggests the rest of Chiron's supply is fine, Fukuda said.

    ..."When you are vaccinated, you not only protect yourself, you protect your loved ones," stressed Dr. Walter Orenstein, the associate director of Emory Vaccine Center.

    That's especially important advice for parents, who should double-check that day care providers, baby sitters and grandparents anyone in close contact with their young children are vaccinated, said Dr. Carol Baker of the American Academy of Pediatrics.

    Meanwhile, here in the real world, there's no word from suppliers when the vaccine will be shipped. I pre-ordered about 150 doses this past winter, yet my inquiries about when it will be available have gone unanswered so far. Yet, my patients tell me that their employers ( large companies like Ford, GM, etc.) and drug stores are already announcing that they'll have their vaccines in the next couple of weeks. They, of course, buy much more than 150 doses.

    That means the vaccine will be distributed without regard to medical need. Young, healthy adults can line up at work or the local drug store and get the shot. So can the elderly and those with chronic illnesses, but when it's distributed on a first come, first serve basis like that, the supply doesn't get distribute to where it's needed the most. And that's a big deal because even if it were only given to those who need it the most, there wouldn't be enough to go around:

    CDC's list of those in most need of vaccination includes about 185 million Americans, far more than the vaccine supply.

    But supply depends on consumer demand and since so many Americans skip their shots, the 100 million doses on tap this year should be plenty, Fukuda said. Temporary shortages did occur last year when an early start to the flu season sparked a run to doctors' offices. But ultimately, a little of last year's 87 million doses went unused.

    Those who need the shot the most are:

    -Those who are 65 years and older. (The CDC has broadened that to include those 50 years or older, but many private insurance companies won't cover the shot for those age groups unless they have a chronic lung condition.)

    -Anyone with a chronic disease such as diabetes, heart disease, asthma, emphysema, or a suppressed immune system, or who takes medication that suppresses the immune system

    -Children ages 6 to 23 months old. (Again, insurance companies often won't cover this unless the child has some respiratory disease. Also, most of the vaccines contain thimerosal. Studies have found it to be safe, but there are still websites out there devoted to litigating it. As a result, few physicians are eager to use it. And the supply of the thimerosal-free version of the vaccine is limited.)

    -Healthcare workers or those who work or live closely with someone in a high risk category.

    As much as I believe in free markets, vaccines like this is one area where it just doesn't work. If the CDC is going to urge everyone to get the vaccine, then they should make sure that 1) there's enough of it and 2) that it gets sent to where it's needed. The CDC doesn't have that power, but maybe they should be given it. Either that, or stop being so complacent about supply and demand.


    posted by Sydney on 9/26/2004 10:27:00 AM 0 comments


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