10 million doses of flu shot to be thrown away

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After the 2002-03 season, Wyeth Pharmaceuticals had to destroy a third of the 20 million doses it produced because of low sales. The company lost about $35 million and then dropped out of the flu shot business. A national shortage followed in October 2004, when Chiron Corp. lost a manufacturing license that deprived the nation of half of its flu shot supply during the height of vaccination season.

Although there are more suppliers now than then, brewing vaccine takes six months at best and remains vulnerable to the vagaries of millions of chicken eggs and a fragile production system.

Stockpiling leftover vaccine until new vaccine is available “doesn’t sound like an unreasonable thing to be doing,” said another vaccine scientist, Dr. Robert Belshe at St. Louis University. After all, usually only one of the three vaccine strains changes — often, only slightly. Twice in the last decade, the recipe didn’t change at all, said Alexander Klimov, a CDC flu strain expert.

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And three times in the last decade, the vaccine strains recommended for the United States in one winter were identical to what was recommended for the Southern hemisphere the following summer, he said.

Also, several recent studies showed that even poorly matched vaccine can still be highly effective — something to consider amid worries about bird flu and efforts to stockpile vaccine to protect in a pandemic.

Demand down
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Dr. Stuart Brown, Georgia’s director of public health, suggested a second wave of flu shots every spring and availability of one season’s shot into the following summer.

“That would allow us to purchase just as much vaccine as we need and maybe a little more,” he said, without worrying as much about losing money and tossing vaccine if deliveries don’t arrive until November or later.

Georgia got less than half of its flu shot orders by Nov. 1 last year, and expects to have thousands of doses left this spring.

Despite a big ‘Flu Shots Available’ banner outside his Atlanta pharmacy, Ira Katz says few customers are interested this time of year and he’s left with about 40 doses. “We’re not at all hurting for vaccine, that’s for sure,” he said.

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“This past year, the demand definitely was down,” said Jean Ellis of the Visiting Nurse Associations of America. Many late-season orders were canceled, and lots of vaccine remains on shelves. Doctors and VNA clinics will get a refund of taxes paid but will still lose about $10 per dose. Losses of up to $20,000 a season have caused some clinics to quit offering shots.

As long as public demand falls short of supply and manufacturers can make enough fresh vaccine, “there doesn’t appear to be any reason to hang on to it,” said Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases.

Even better, Fauci said, would be a universal, permanent flu vaccine effective for all strains of the virus, something his office has been researching.

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