Learning from a plague of vaccination woes

Yesterday, some of the country's top medical groups held hands with the CDC as they joined a loud chorus of experts begging pregnant women to get vaccinated against the H1N1 virus. They're among the most vulnerable to the new flu--which has been spreading around the country as fast as a storm front--and among the least likely to get the shot.

The statisticians say that only about 15 percent of pregnant women typically get vaccinated against influenza, half the rate of the general population. And those stats help highlight the enormous problem the U.S. faces when it comes to pandemic planning. Despite some incredible advances in the lab that allowed a string of manufacturers to create a new flu vaccine that could be ready for marketing in a matter of months, the market itself is badly fractured. It's been dogged by stubborn myths about phony safety issues and hampered by a health care delivery system that is easily overwhelmed, even when only a fraction of the people who should turn out for an inoculation campaign actually show up at a doctor's door.

Federal officials, many new at their jobs, weren't any help when they started claiming at first that up to 140 million doses of new vaccine would be ready this month, then revised their forecast to 40 million by mid-month. The actual figure appears to be closer to 13 million. In New York, officials backed off a mandate requiring healthcare workers to get vaccinated after they discovered they didn't have a big enough supply. Millions demand it, millions refuse it and millions more don't know what to think. And when a large segment of a population goes without a vaccine, you lose the herd effect that can offer broad immunity.

Pharma companies, many with a history of troubled safety records, bear much of the responsibility for this. It's hard to regain trust once it's been lost. But when respected medical organizations are ignored on a healthcare issue, you've got a real problem. And it doesn't help matters when a new Secretary of Health and Human Services stands in front of a Senate committee blaming the country's woes on its reliance on foreign manufacturers. The vaccine industry operates on a global level, and the U.S. is part of that. "Me first" is not a rational approach to vaccine production.

There are some remarkable new vaccine technologies in development that will solve the world's supply issues. Satisfying the country's vaccine skeptics and offering a quick and efficient vaccination campaign seems more elusive than peace in the Middle East. -- John Carroll

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