Six months into the H1N1 influenza pandemic, the vaccine to protect against it is still flowing more like the drip-drip-drip of an intravenous line than the rushing river it needs to be.
In Minnesota, that means that as the flu season kicks into high gear, vaccine has reached only a small fraction of the estimated 2.4 million state residents at high risk for H1N1's potentially life-threatening complications. There's not even enough vaccine to protect many doctors and nurses caring for flu patients on the front lines. At Park Nicollet Health Services in St. Louis Park, each day begins with an 8:30 a.m. conference call to figure out influenza logistics: how many caregivers are ill and how to parcel out the healthy ones around the system to handle the daily deluge of patients.
That the nation is fighting this dangerous pathogen with inadequate supplies of the most potent weapon against it should come as no surprise. Influenza vaccine shortages have become the rule rather than the exception over the past decade. And while incremental steps have been taken on a federal level to address this, the United States continues to rely on 1940s-era vaccine production technology and a shrinking number of manufacturers to defend against a disease that some refer to as "nature's bioterrorism.''
It's a frightening and unacceptable situation -- one that's been neglected for decades. Casting about for scapegoats is unproductive. Multiple presidents and Congresses have had time to act and chose not to.
Instead, it's time to seize upon the urgency created by the unfolding pandemic and the long, panicked lines at flu shot clinics to build a faster, more reliable influenza vaccine production system. Minnesota's congressional delegation, which counts among its constituents some of the world's top influenza experts, should be at the forefront of this push.
Policymakers won't need to start from scratch in searching for solutions. The Mayo Clinic's Dr. Gregory Poland and the University of Minnesota's Michael Osterholm are among the experts who have laid out smart, practical recommendations that federal lawmakers should embrace to entice drug manufacturers to stay in the vaccine business and invest in new technology.
The United States relies solely on the private sector for influenza vaccine supplies. A key reason why the flu vaccine is still made using eggs -- a slow and unpredictable process -- is that it's not a big moneymaking product. It's sold yearly and inexpensively, unlike brand-name drugs taken daily. It doesn't make financial sense for drug companies to invest the millions or even billions needed for new ways to produce the vaccine.
Remedies include federal tax breaks or subsidies for research and new manufacturing plants, as well as policies that protect manufacturers from the financial risks of overproduction. Too often, millions of doses of flu vaccine are thrown away each year after initial shortages lead to ramped-up production.