CDC secures flu vaccine to allocate as needed

New surveillance system will track emerging flu 

The Centers for Disease Control and Prevention (CDC) has formed a partnership with Aventis Pasteur Inc. to distribute 22.4 million doses of unshipped influenza vaccine to identified areas of need throughout the United States.

Some 14 million doses of vaccine will be allocated over the remainder of 2004 through Aventis Pasteur, which contracts directly to high-priority vaccine providers including hospitals, long-term care facilities, nursing homes, and private providers who care for young children. The approximately 8 million doses remaining after the first phase is completed will be shipped to other high-need areas as warranted.

"The overall goal of this is to target the vaccine that we do have to the people who will get the most benefit from that vaccine, and to do it in a way that’s fair and equitable to the greatest number of people across our country," explained Julie Gerberding, MD, MPH, CDC director, at an Oct. 12, 2004, press conference.

Among the first recipients are high-risk children in areas that currently do not have vaccine. "We also will be prioritizing the seniors 65 and older who have not yet been included in the vaccine catchment," she said.

The action was deemed necessary by the loss of roughly half the nation’s flu vaccine supply due to contamination of stocks made by the Chiron Corp. in Liverpool, England. Some state health departments contracted with Chiron for their entire stock. "We’re going to — in this first allocation — make sure that states that haven’t received vaccine get at least 50% of their contracted allotment that they had negotiated with Chiron," Gerberding said.

Over time states will be working on updated projections of need, and some may not need as much as they originally planned. "It’s possible they included people in their proposed vaccination who don’t meet the qualifications for high priority," Gerberding said. "So there may be some downward adjustment at the state level in true need, and we want to allow for that flexibility. We’re going to get that vaccine out to those states that are missing doses as quickly as we possibly can. That’s obviously a very high priority."

Other priority areas include the nation’s Veteran’s Administration medical centers and the Department of Defense. "[That] leaves us with about 8 million doses of vaccine that we have not yet allocated," she said. "Four and a half million doses will be in the CDC’s stockpile, so we will utilize those doses as we identify high-priority gaps, and we’ll have a great deal of flexibility to move that vaccine around in the way that best serves the people at highest risk."

Bioterrorism tool used on flu

The CDC is mapping out where flu is emerging by using its BioSense system that culls electronic information including over-the-counter drug prescriptions and lab tests. The idea is to get early warning of flu emergence so communities can gear up response. The agency also is working with state health departments to track delivery of vaccine down to the individual state counties.

"What we will end up with in a few days is a comprehensive picture — who needs it and where are they, where’s the vaccine, and where’s the disease. We can use that information to help inform the allocation decisions in the next wave of vaccine release," she said. "We think this will help us get the best possible match between the doses we have and the need that people have for the product."

In addition to vaccine, the CDC has stockpiles of antivirals and other flu medications for treatment and prophylaxis." [If] people who are in the high-risk groups for complications become ill or develop a fever or are suspicious that they have flu, they should seek early medical attention, because treatment is most useful if it’s given within the first two days of symptoms," she said.

The CDC also is urging the public to take common-sense measures such as staying home if sick and using hand hygiene and respiratory etiquette. Asked about reports of price gauging for available supplies, Gerberding took a strong tone. "This is a reprehensible thing to be doing — I think an immoral thing in this context, and we are working with the state governments and hope to be able to tell you in the future that these people have been prosecuted to the full extent of the law," she said. "There’s no room for this kind of behavior in an environment where we need to pull together as a country to protect our vulnerable populations."

By the same token, the CDC is primarily relying on an honor code system to ensure high-risk people are given preference over the healthy, she said. "I also think it’s important to recognize that this is confusing for people who last year were told to get a flu vaccine and now this year we’re saying, Oh, guess what? You’re not on the high-priority list.’ So we don’t want to blame individual people."