Last month, I concluded a PediaBlog post admonishing parents about the importance of getting an influenza vaccine:
There are no more excuses. Make sure that you, your children, and those who live and breath around you get a flu vaccine this and every year. Let your doctor or your child’s pediatrician give you one. Or go to your local pharmacy and get one. Insurance pays for it. (If you don’t have health insurance at the moment, the government will pay for it — just go!) It will only cost you a very short amount of time. If you don’t have that you probably have bigger problems to deal with.
Most years, influenza season peaks in January. But it begins much sooner than that. (As of last week, 23 cases of influenza A and B had been reported in Pennsylvania so far.) Pediatricians have become accustomed to begin immunizing our patients and families as early as August with FluMist, the intranasal vaccine. By early-to-mid September, we’re ready to give the injections of the influenza vaccine. Sometimes shipments of these vaccines might be delayed a week or two, and sometimes they are even split by the distributer into two or three smaller shipments over the Fall season. And most times, for reasons unfathomable, vaccines for patients with public Medicaid insurance or no insurance at all are distributed to primary care doctors and clinics (through the Vaccines For Children program) much later than for those with private insurance. Still, by mid-October, health care providers are into our “full-court press” to prevent influenza in our communities.
We should be, anyway. This season, the influenza vaccine’s production, distribution, and delivery have been significantly delayed. Maggie Fox tells us why for one company:
The vaccines that Glaxo makes are done the old-fashioned way, using virus injected into chicken eggs. It’s an inherently unreliable process, prone to delays. Sometimes the virus used as a seed to make the vaccines doesn’t grow well in the eggs.
It appears the influenza A Panama (H3N2) strain is particularly hard to cultivate this year. And some producers, reports Robin Eisner, are having quality control issues:
King Pharmaceuticals has completed five of the eight actions FDA required of it, is manufacturing vaccine and is working on the final three actions, he says. The actions dealt with quality control and contamination. “Our goal is to provide distribution in a timely manner,” Macione says.
Wyeth-Ayerst spokesman Douglas Petkus, whose company supplies 27 million doses, or approximately a third of the market, is telling clients to expect shipment in four to six weeks and is working with the FDA about the agency’s concerns regarding vaccine manufacturing and plant renovation. His firm normally ships in August, he says.
Then there is the ripple-effect that influences the nation’s supply of influenza vaccine from other manufacturers:
Len Lavenda, spokesman for Aventis Pasteur, a vaccine manufacturer in Swiftwater, Pa., that supplies about 50 percent of the market, says he’s concerned the Parkedale and Wyeth-Ayerst situation may actually lead to a shortage this year. His company is beginning to ship some vaccine now, but most will arrive in late November, he says.
By late November, opportunities to immunize many of our patients against influenza will have come and gone. While we have had plenty of the intranasal FluMist vaccine to give so far, many of our patients who are considered high risk — children under two years of age, and those with chronic medical conditions like asthma, diabetes, immunologic disorders, cancer — cannot receive this live, attenuated vaccine. They need — their lives might even depend on — the injectable flu vaccine. So they wait. We wait.
Most practicing pediatricians have seen terrible consequences of unimmunized children getting sick with the flu. Kids especially — even those who are not considered high risk — can get very, very sick from this common virus.
Sorry for sounding so dramatic, but the clock is ticking.
More PediaBlog on influenza here.