An examination of the flu vaccine supply chain might lead one to conclude it's a bit under the weather: sluggish output, inconsistent supplies and a feverish disposition.
In reality, it's working at full capacity as it wrestles with the competing demands of two entirely different flu viruses — and therein lies the problem. The manufacturing processes for the seasonal flu and the H1N1 flu vaccines are incompatible and require varying lengths of time, and manufacturers began the complicated task of switching over to synthesize the H1N1 vaccine as soon as a treatment was approved.
“When the decision was made to produce H1N1, that meant that pipelines that were manufacturing seasonal were cut off,” observed Steve Pellito, national director of wellness for Maxim Healthcare Services, Columbia, Md., the largest flu shot provider in the country. “And there's no turning back, because it's a several-months' process.”
To keep vaccine flowing through the system, bulk H1N1 vaccine needed to be started as soon as the bulk facilities became available, according to the Centers for Disease Control and Prevention. Unfortunately for flu shot clinics, the switch-over occurred before all of the orders for the seasonal flu vaccine could be filled and distributed. As of Oct. 9, a CDC tally showed that 82 million seasonal flu doses — 71% of the 118 million planned for this year — had been distributed to clinics. With H1N1 vaccine production now the priority, there's little hope the rest of the seasonal flu orders will be filled.
“The seasonal flu has been completely overshadowed by H1N1, and vaccine distribution this year has been an absolute disaster,” said Bruce Kneeland, a pharmacy consultant based in Valley Forge, Pa.
“The major clinic providers are just shutting down because they have nothing to work with.”