Mass vaccination coming

[Guest guest]

http://www.washingtonpost.com/wp-dyn/content/article/2009/05/05/AR2009050503378.html?hpid=topnews

Who didn't see this coming?!?

" The Obama administration is considering an unprecedented fall

vaccination campaign that could entail giving Americans three flu shots

-- one to combat annual seasonal influenza and two targeted at the new

swine flu virus spreading across the globe.

The multibillion-dollar effort would represent the first time that top

federal health officials have asked Americans to get more than one flu

vaccine in a year, raising serious challenges concerning production,

distribution and the ability to track potentially severe side effects.

 

Experts in and out of the administration are evaluating a raft of

complicated issues, including who ought to receive an inoculation against

the swine flu and whether private vaccine makers can simultaneously

manufacture the standard 180 million doses as well as up to 600 million

rounds of the new vaccine.

" We are moving forward with making a vaccine, " said Robin

Robinson, a director with the Department of Health and Human Services who

oversees pandemic response programs. Robinson said that although a formal

decision about the swine flu vaccine has not been made, if the government

goes ahead, it would probably produce two doses for all Americans. If the

threat diminishes, he said, health officials could decide to produce

doses for only a portion of the population.

Vaccine and pandemic experts are working with the administration to

determine how to produce, test, track and educate the public about two

different influenza vaccines in the same flu season.

" They have never tried this before, and there is going to be a great

deal of confusion, " said William Schaffner, chairman of the

Department of Preventive Medicine at Vanderbilt University School of

Medicine.

Memories of the nation's earlier experience with a swine flu vaccine

present another challenge. In 1976, hundreds of Americans developed

neurological disorders after they were vaccinated for a swine flu strain.

The public was asked to receive one of two vaccines developed to combat

the strain.

Health officials have asked manufacturers to ramp up production of the

vaccine scheduled for rollout this fall to make way for the possible mass

production of a swine flu vaccine.

A decision on whether to produce such a vaccine will have to be made

soon, because it typically takes five months to produce a new vaccine and

authorities would want it available for the next flu season.

Dale Morse, chairman of the CDC's advisory committee on immunization

practices, said scientists are assessing the possibility of adding to the

seasonal flu shot an ingredient targeted at the new virus.

Some medical experts said rolling out two vaccines would present

additional challenges in terms of testing and tracking adverse reactions.

Health officials and manufacturers will need to know what the negative

reactions might be for each vaccine on its own and in combination with

the other. Initial tests would be done on animals, after which clinical

trials of people would be conducted to determine side effects before

either vaccine is rolled out.

Harvey Fineberg, president of the Institute of Medicine, said officials

will have to weigh the risks of the time spent on testing against those

of a delayed response.

" All this takes time, money and organization, " said Fineberg,

who led an investigation into the government's handling of the 1976 swine

flu vaccinations.

The greater challenge will be tracking any adverse reactions as millions

of Americans get multiple vaccinations in a matter of months this fall

and winter.

" There will be adverse effects to any vaccine. That's just

science, " said Michael Hattwick, who ran the CDC's vaccine-tracking

system during the last swine flu scare.

Hattwick said a " real-time " tracking system would need to be

established to provide constant updates to the CDC about adverse

reactions. That information, he said, should include lot numbers for the

vaccines so health officials can trace each side effect to the

manufacturer and the date of production. Routine flu vaccinations are not

traced with such precision because reporting is voluntary and often

delayed, Hattwick said.

Anthony S. Fauci, director of the National Institute of Allergy and

Infectious Diseases, said he does not expect additional adverse reactions

with two vaccinations. The traditional flu vaccine is designed to attack

the three flu strains health officials believe to be the greatest threats

in a regular season, he said.

" In a regular seasonal flu, you get three vaccines. Adding an

additional one should not present a problem, " Fauci said.

A record-keeping system would also need to be devised to track which

doses patients have received, health experts said.

Without such a system, patients could lose track of which of the three

shots they have received or fail to get the second swine flu inoculation

at the proper time.

" We will have to keep them straight and separate, " Vanderbilt's

Schaffner said. " This will be an enormous challenge, and we haven't

figured out how to do it yet. That's one of the things we are trying to

sort out. "

 

 

 

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