The government panel that sets U. S. vaccine policy already has begun discussing "universal immunization" as a way to boost vaccination rates and reduce flu-linked sickness and death, Dr. Scott Harper of the federal Centers for Disease Control and Prevention said at a vaccine meeting this week.
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Harper acknowledged that the recent crisis momentarily upstaged universal immunization discussions, but said it remains a viable proposal.
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The vaccine meeting, held every year, seeks to set an agenda for the upcoming flu season. Participants many with a financial stake in getting more people vaccinated--said the universal vaccination push is likely to come within the next five years.
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Also, flu vaccine is altered every year because there are always different flu strains circulating. The unused vaccine is discarded at season's end, making flu shots financially unappealing for manufacturers.
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Sanofi Pasteur's Philip Hosbach said the company has two idle U. S. factories "because there's not the return on the investment." Universal vaccination could in the long term help stabilize supply if it increased demand, he said.
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Demand has historically been a problem, too. Millions of the at-risk patients routinely skip annual shots. Some people worry the vaccine isn't safe or they simply don't like shots, but many also underestimate the seriousness of flu, said Dr. Ann O'Malley, a researcher at the Center for Studying Health System Change.
A. "Part of our job is to just keep this issue on the radar screen," Harper told vaccine providers, distributors and manufacturers at the national flu vaccine summit here.
B. So far only one company, Sanofi Pasteur, is licensed to make U. S. flu vaccine for the upcoming season, though public health officials hope two others, including Chiron, will soon gain approval.
C. Estimates suggest that in an average year, flu infects about 82 million people nationwide, hospitalizes 200,000 and kills 36,000.
D. Dr. Herb Young of the American Academy of Family Physicians said recommending shots for everyone could ease the confusion--and that his group is moving toward supporting the idea.
E. The hurdles, some observers say, are daunting. Unstable supply is one of the biggest. This year the best case scenario--having about 90 million shots available--isn't even enough for the 180 million high-risk people advised to get shots, let alone the total population of 280 million.
F. The end of a chaotic season where many people seeking flu shots were turned away because of a shortage might seem an odd time to broach the idea of vaccinating even more people.
G. But I'ra Longini, an Emory University biostatistician who specializes in vaccine analysis, said universal vaccination would be unworkable unless supply problems can be resolved.