CDC Director Provides Update on Influenza Vaccine Supply and Distribution

On Thursday, Nov. 10, 2005, Julie Gerberding, MD, MPH, director of the Centers for Disease Control and Prevention (CDC), held a briefing on current efforts to secure the critical number of vaccine doses to fight avian influenza.

One piece of good news to start off with is that this year's flu season has not gotten off to an aggressive start and we have less flu in the country than at the same time last year, Gerberding said. States are showing sporadic or no flu activity of no states in the pink, purple or red which would indicate more widespread flu. So that's a good thing because it gives us time to get the vaccine out there. People still have many opportunities to get vaccines.

Gerberding continued, As you know, so far at least 71 million doses of influenza vaccine have been distributed. We expect by the end of November we will have distributed more than 81 million doses of vaccine. That is close to the highest amount of vaccine we've ever had available, and depending on the supplies that emerge in December toward the end of the manufacturing cycle, we might actually end up with the most ever influenza vaccine for the country.

What is going on at the local level now is that some vaccinators including physicians and clinicians in office practices are having trouble getting vaccines, she added. One of the reasons for this is that Chiron was not able to get their vaccine out as fast as they would have liked. They're also not producing as much vaccine as they had projected at the beginning of this year. Many clinicians order their vaccine from Chiron; they've been one of the important distributors to that sector. So those clinicians are delayed. My own mother called me this week because her doctor told her that her vaccine was not available. She wanted to know if she should go to the neighboring state to get her shot. The first question I asked her was, Is there a flu outbreak in the community? and she said, No. I said, When does the doctor think he'll have the vaccine? and she said, By the end of the month. I said, Good, you'll get it in time. Just wait and make your appointment so that you can get it when it's available.

Gerberding added, We also know some good news about pediatric vaccines. Doses of vaccine especially formulated for children have been distributed. We don't seem to be experiencing any significant shortages of vaccines for children. If we continue along this track of the production coming out of the manufacturing and distribution process as we predict and the demand being constant as we're still primarily in the pre-peak season of influenza, we expect we'll have time for most people to receive their vaccines. There was focus this year early on, on the most priority groups, the people at greatest risk for flu complications. Those people did get a head start, and in most communities that has resulted in the people at greatest need for the vaccine getting it and getting it now.

We're doing some additional things to help out, Gerberding noted. I think everyone appreciates that the government and CDC in particular does not own very much flu vaccine. Unlike the situation of vaccines for children, the vast majority of flu vaccine is in the private sector and we have very little capacity to move vaccine around. So what we are doing is preparing our own stockpile of vaccine, getting about 800,000 doses of vaccine from Chiron at the end of November, and we'll use those doses to help offset shortages in communities where there is no one with vaccine available. So in those locations where the clinics have been closed and the doctors don't have vaccine, CDC will be able to offer a little bit of help and potentially even more help in December.

Gerberding continued, We also have wonderful cooperation from our health officials and folks in the immunization programs across the country who are working on solving local distribution problems. The National Association of County and City Health Officials, this is an association that represents local health officials, and they're going to do two things. One is that the local health departments will work directly with the health care providers to try to make sure that the people at highest risk for flu complications do get the vaccine first at the community level. What that means is that in some communities the specific advice about vaccine availability may differ than is present in the nation as a whole or even in a neighboring community. So people need to pay attention to what their local health officials are saying about the availability of clinics, where to go to get vaccine and who should be prioritized to receive it. These health officials are also really going to help with the redistribution process, so they're reaching out to find out who has surplus vaccine, who still needs doses, and they'll work on trying to redistribute that at the local level. We are also continuing to recommend that people who are healthy between the ages of 5 and 49 years of age remember that there is another alternative for them. The FluMist vaccine that's made by MedImmune is a nasal vaccine. This is an excellent vaccine for healthy people. It provides wonderful immunity. It might even be even more efficacious than the standard flu vaccine, and it's something that we would really encourage for those people who can't find a flu shot but are in that 5- to 49-year-old age range where FluMist is a great option.

Gerberding added, From a long-term perspective, look upon this as a situation that has a solution in sight. This past week the President announced a budget proposal for $7.1 billion for pandemic influenza. A solution to create manufacturing capacity and modernize flu vaccine manufacturing capacity to solve a pandemic problem is exactly what we need to solve the seasonal flu problem, and I think we in public health all recognize that in the future we'll be able to get influenza vaccine shortages off the table and really help reduce some of this incredible frustration that people experience worrying about whether they can get a flu shot or the inconvenience about having to stand in line and reschedule appointments and so forth when the shot isn't available when expected. So in the long run, the solution is in sight. We wish we had that solution today, and we're sorry that we don't and we're sorry that we have another frustrating year for some people. But the big picture here this year, unlike last year, we expect many more doses of flu, and there is still plenty of time for people to get vaccinated. So that's part of our message, if you cant get it right now, be persistent and patient if you can and check back with your physician because you may be able to get your shot a little bit later this month or next month, and that's, I think, the overall important message. We also want to really thank people who have been patient this year. We thank the clinicians who are vaccinating and the clinicians who are still waiting for their vaccines. We especially thank all the people in the state and local health agencies who are working so hard at the local level to redistribute vaccine and to put the information out to people to reassure them that more vaccine is coming and that we're doing everything we can to try to get it to them and into their arms as quickly as possible.

Source: CDC