Federal health officials announced a distribution plan yesterday for the remaining 10.3 million doses of flu vaccine, divvying it up to states based on how many high-risk people each has and the number of doses already received.
Vaccine will be directed to people most in danger of developing serious complications from influenza, such as the elderly and young children, said Julie L. Gerberding, director of the Centers for Disease Control and Prevention in Atlanta. The move represents the first time the federal agency has used its clout to effectively commandeer and reallocate a precious commodity for public health purposes.
In early October, Chiron Corp. announced that British authorities had impounded 48 million doses of flu vaccine, intended for the United States, because of bacterial contamination at its manufacturing plant outside Liverpool. That left just one supplier, Aventis Pasteur, which had already shipped 33 million of its expected 58 million doses.
Since then, doctors, patients, the Bush administration and even some governors have scrambled to find vaccine before the flu season hits. But with little to be found, the CDC -- in conjunction with Aventis and state health officials -- took the unprecedented step of devising a rationing plan.
Yesterday's announcement was an attempt to "make sure the remaining doses of vaccine are distributed in the fairest way we can," Gerberding said.
Vaccine will be shipped over the next two months as it becomes available, she told reporters in a conference call. She declined to say how many doses each state would receive. Locally, Virginia officials said they anticipate several shipments totaling 232,000 doses, Maryland expects 135,000 doses and the District will receive about 8,500.
"This is a very good thing," said Greg Reed, program manager for the Maryland Center for Immunization.
The CDC will set aside about 1.3 million doses in case of an emergency or large outbreak. In addition, about 3 million doses of the nasal spray vaccine called FluMist are being given to healthy adults.
The Bush administration has signed a $10 million contract with Aventis to expand its supply of chicken eggs, the critical component in producing flu vaccine. With the ability to stockpile eggs and other supplies, Aventis will be able to produce the vaccine year-round if needed.
While cautioning that several million high-risk Americans still will not be immunized, several state health directors applauded the CDC's attempt to devise an equitable allocation program.
"The shortage can't be fixed at this point," said Mary C. Selecky, secretary of health in Washington state. "This will ensure available vaccine is allocated in the fairest way possible."
Most of those difficult decisions will be made by local health departments. Some, such as Montgomery County, have held lotteries. The District has focused on community clinics, paramedics and the Whitman-Walker Clinic, which treats HIV patients deemed at higher risk because of their weakened immune systems.
Each year, influenza kills about 36,000 people in the United States and 1 million worldwide. Although 29 states have reported flu cases, this season has been mild so far, Gerberding said.
"No states are reporting widespread activity," she said. "We are well within normal for this time of year."
Gerberding discouraged states such as Illinois and New Mexico from trying to buy vaccine outside the United States on their own, saying the Food and Drug Administration is pursuing a way to acquire and quickly license reserves from other countries.
Without enough vaccine for high-risk populations, health leaders renewed their plea for everyone to step up basic precautionary steps such as frequent hand-washing.