Delay led to waste of H1N1 vaccines

Posted Aug. 29, 2010, at 9:12 p.m.

AUGUSTA, Maine — Tens of thousands of doses of H1N1 vaccine are no longer usable and are being destroyed as the first doses of seasonal flu vaccine start to arrive in the state weeks ahead of last year.

Nationally about a quarter of the 162 million doses produced for H1N1, or swine flu, are being destroyed, well above the 10 percent of seasonal flu vaccine that is thrown away every year.

“It is about the same here, but we will not know how much until all of the vaccine is returned to the distributor nationally,” Dr. Dora Mills, director of the Maine Center for Disease Control and Prevention, said last week. She said the outdated vaccine likely will be incinerated as have unused vaccines in past years. It will be weeks, if not months, before she knows the actual amount destroyed.

“I think they did the right thing in ordering enough so that we would have sufficient vaccine,” she said, “ but what happened was a huge delay in production and getting it out to the states.”

Mills said the H1N1 flu hit Maine in September, October and November last year, and the vaccine did not arrive in the state in the amounts needed until January, well after the need had passed. She said that contributed to the large amount of unused vaccine.

Richard Hunter, the pharmacy manager at Eastern Maine Medical Center, agreed the delays in production and distribution last year contributed to a lot of wasted vaccine. He could not remember a flu season when so much vaccine has gone unused.

“The government is not going to be involved in the vaccine I distribute through our clinics this year,” he said. “They controlled the H1N1 distribution, and they targeted who should get the vaccine.”

Hunter said the state regulations left some folks without vaccine who would have received it under EMMC policy. He said a person who is not considered in one of the high-risk categories, such as those with a medical condition or because of their age, is told to come back at the end of the clinic. If any vaccine remains, they are vaccinated.

“We used up just about all of our seasonal flu vaccine by doing it that way,” he said.

Hunter said it appears this year the supplies are being shipped early. He received his first shipment last Thursday, when in most years the first shipment does not arrive until late September. Mills said the state also had received its first shipment of seasonal flu vaccine.

“This is earlier and that certainly is good news, “she said. “We will start a public awareness campaign soon to encourage people to get vaccinated this year.”

Mills said the seasonal flu vaccine this year has three components aimed at the most likely flu viruses that will hit this season. She said one of the components is aimed at H1N1, which many experts believe will circulate again this flu season.

“It looks like, so far, that the seasonal flu vaccine for this coming season is in on the mark,” she said.

In addition to the H1N1 component, Mills said, the seasonal vaccine includes a type A variant that has hit the elderly hard and a B variant that tends to hit young people hard.

“We are urging everyone to get the seasonal flu vaccine this year,” she said. “Even if you got the H1N1 vaccine last year or earlier this year, you should get this seasonal vaccine because it will reinforce your protection.”

Mills also cautioned that the only thing more unpredictable than the strain of flu that will hit is whether there will be vaccine supplies available. She said that in the past six years, there have been shortages in three.

“Part of the problem is we are still making vaccine the same way, one dose at a time,” she said. “We need to improve the way we make vaccine so we can more quickly respond.”

Hunter agreed. He said the injectable form of flu vaccine takes a separate egg for every dose and that is a lot of eggs when you are talking about millions of doses.

“The flu mist is about 40 doses from each egg, but that does not work well with all populations, “ he said.

Mills said the federal government needs to invest in developing new ways to make vaccine that not only improve the speed with which a new vaccine can be deployed, but also lower the costs so they can be provided to everyone.

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