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Disease Outbreak News

Monday, June 2, 2008

Pandemic flu vaccine program needs help

Pandemic flu vaccine program needs help


June 01, 2008

A government document — never released — presents a troubling picture of a vaccine shortage during an influenza pandemic: Overall, about 2 percent of Americans with influenza illness die. Hospitals are overwhelmed. People riot at some vaccination clinics as they are turned away or supplies run out. Trucks transporting vaccine are hijacked. Public anxiety heightens mistrust of government. Mortuaries and funeral homes are overwhelmed. The majority of people still have not been vaccinated when a second wave of influenza begins.

These descriptions come from an October 2006 New York Times article by Gardiner Harris, who obtained the government document. The document was never released to the public as originally planned. Its portrayal of public chaos and a heightened mistrust of government is a reminder of past blunders — and this may have hit too close to home.

Are these scenes an accurate forecast of a disaster that lies ahead? Or, instead, will the federal government be ready with enough vaccine when a pandemic strikes? The government has announced its plans, and they are not reassuring. The official word is that it will be several years before government-funded vaccine manufacturers are fully ready to produce vaccine. Even then, there won’t be enough vaccine for everyone until six months after the start of a pandemic.

The government’s pandemic flu vaccine program is a fairly good one, with scientists who are among the best in vaccine research and production. But the program has an obvious and easily corrected weakness: lack of transparency.

The sheer quantity of information on the government’s pandemic flu Web site,, with its hundreds of documents and thousands of pages, is impressive. But much important information is missing, raising the question: Why not disclose it?

There are striking gaps in the information posted online:

• The government’s multimillion-dollar contracts with vaccine manufacturers are not posted. The contracts should be out in the open, along with evaluations of contractors’ performance, updated periodically.

• Vaccine production is based on two methods: one using chicken eggs devised more than a half-century ago, and the other a cell-based method about a decade old. Promising new methods are just now being considered for the manufacture of vaccine — methods that can produce large amounts of vaccine quickly after the start of a pandemic. However, the government’s investment in these novel approaches may be too small and too slow. The timetable, budget and other plans for large-scale implementation of the new methods should be available online for examination and comment by nongovernment experts.

• When a pandemic strikes, foreign sources of materials needed for U.S. vaccine production will probably be blocked. If any part, even a small part, of the manufacturing process in the U.S. depends on foreign sources, this fact should be disclosed publicly, along with plans for full self-sufficiency of U.S. manufacturers.

• Some nongovernment experts have indicated that the pandemic flu vaccine program is dangerously underfunded. Detailed plans and justifications of future budgets should be posted online.

A recent Project on Government Oversight report, “Pandemic Flu: Lack of Leadership and Disclosure Plague Vaccine Program,” has a fuller discussion of the points raised above. The report — under the publication library link at — also covers other information that should be disclosed online.

The argument is strong for posting more information. If public health and vaccine experts outside government have ready access, they can then examine the facts more easily and comment on current plans. The same is true for investigative reporters. The government’s goal should be the greatest possible transparency — disclosure of weaknesses along with strengths.

The nation’s top health official, Secretary of Health and Human Services Michael Leavitt, should make sure that the documents and information missing from the government’s pandemic flu Web site are posted — or explain why this information can’t be disclosed.

Ned Feder, staff scientist for the Project on Government Oversight, previously was a scientist at the National Institutes of Health.

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