# 3247
(With apologies to Smokey Robinson)
Yesterday it was announced that the HHS had entered into agreements with three drug companies to manufacture enough doses of vaccine to cover 20 million high risk individuals and those working in health care, national security, and emergency services.
This story from the Washington Post.
U.S. Asks Firms to Make Swine Flu Vaccine
By David Brown and Rob Stein
Washington Post Staff Writers
Saturday, May 23, 2009
The federal government has asked three drug companies to make enough swine flu vaccine to immunize at least 20 million people in key positions in health care, national security and emergency services, officials said yesterday.
The order, announced by Health and Human Services Secretary Kathleen Sebelius, is part of a $1 billion investment in immediate production and testing of vaccine against the newly emerged strain of the H1N1 flu virus. Further orders for potentially hundreds of millions of doses of vaccine are expected.
If you are one of 305 million Americans, you may be puzzled by the ordering of just enough vaccine for 20 million people. After all, some elements of the media (see A Vaccine Reality Check ) have acted as if everyone would get a swine flu shot this fall.
The answer lies in the tiered priority system developed by the HHS for delivering a vaccine to the American people during a pandemic.
It simply isn’t possible to manufacture and deliver enough vaccine to vaccinate 300 million Americans all at once.
People at greatest risk, or who perform key jobs important to national security and the nation’s infrastructure - are by necessity -first in line to receive a vaccine.
The goal, of course, is to offer a vaccine to all Americans. But that could take months to accomplish.
The tier system, illustrated above, may see some modifications over the coming months, but should give you some idea of the prioritization process.
The first, or top tier, consists of about 24 million people and that includes deployed military forces, healthcare workers, pregnant women (a very high risk group), infants and toddlers.
Next come two tiers of mostly critical occupations.
Followed by two more tiers that take in the rest of the nations population.
Those at lowest risk may not receive a vaccine until months after the first, highest risk tier is vaccinated.
The logistics of delivering a vaccine to 300 million people cannot be overstated. It will certainly take months, particularly if two shots (30 days apart) are required per person.
For now, there are good reasons not to order 300 to 600 million doses of vaccine straight away.
Three big ones include:
- If the virus remains mild, or goes away completely, then quite understandably the majority of people won’t want to take a vaccine for it.
- We don’t know right now how much antigen will be required in each shot, or if it will take 1 shot or 2 to convey immunity. Big questions that must be answered by human trials later this summer, and that will affect the amount of vaccine that will be needed.
- The possibility always exists that the virus may mutate, or change, over the coming months rendering any vaccine made based on today’s virus less effective.
By ordering enough vaccine right now to cover essential personnel, and those at greatest risk, the HHS is putting into motion the machinery that will be needed later in the summer to produce far more vaccine, to cover far more people.
After human trials have been conducted, and public opinion over willingness to take a vaccine has been sampled, the HHS will have a better idea about how much vaccine they will need to order.
Until then, ordering enough vaccine to cover 20 million people is a good, prudent, first step.
