The Failure to Deal With the Flu

As billions were spent to prevent biological terrorism, officials fumbled a simple vaccine program.

COMMENTARY - By Matthew Davis - October 8, 2004 Over the last three years, the United States government has spent several billion dollars preparing for a biological attack by terrorists. Yet it now seems likely that starting in the next couple of weeks, tens of millions of Americans will be defenseless and thousands will die because we have botched preparations for a natural biological attack everyone knew was coming: the flu. This week, British health authorities halted production at a Liverpool factory operated by California's Chiron Corp. that supplies half of the flu vaccine for the U.S., about 48 million doses. U.S. officials claim to have been surprised at the shutdown despite widely publicized problems at the plant, which in August caused the contamination of more than a million doses of vaccine. There is now talk of a hasty plan to ration this year's vaccine. Ironically, only a couple of months ago, the Centers for Disease Control and Prevention was trying to greatly expand the pool of people it said should get a flu shot, not limit it. This is the second year in a row in which federal health authorities have fumbled the flu vaccine. Last year, the vaccine offered only minimal, if any, protection against what turned out to be the dominant and most virulent strain of the season, and there were shortages of that weak concoction as well. One wonders why, given what is at stake — flu kills about 36,000 people each year and sickens millions more — flu vaccine problems are not being addressed at the highest level. And it's not just the ordinary flu seasons, bad as they can be, that we should be worried about. The flu failures we have witnessed over the last two years are particularly alarming given that most disease experts believe we are long overdue for a flu pandemic. A pandemic is what happens when a new and horrifyingly virulent strain of flu emerges for which people have little if any natural protection. The pandemic that hit in 1918 and 1919 killed 500,000 people in the U.S. and millions worldwide. Americans are right to fear that a system that cannot properly prepare for a regular flu season would be easily overwhelmed in the event of a pandemic. Our government authorities put Americans at risk by stubbornly and stupidly depending on just two facilities, one located outside the U.S. and far removed from federal regulators, to provide all of our flu vaccine. Meanwhile, Britain had at least the minimal foresight to spread its vaccine purchases among several suppliers. Which brings us back to the billions recently spent in the U.S. on public health preparedness. How could we have invested so much yet really be no better prepared than we were three years ago for a major biological threat like the influenza virus? A key reason is that the health preparedness effort has focused almost exclusively on agents that might be used by terrorists, despite the fact that flu invasions are much more likely and, if it's a pandemic strain, will be much more deadly than an attack involving anthrax or smallpox. The proof of this poor judgment is there for all to see in today's easily avoidable flu vaccine shortage and the fact that preparations for a pandemic flu attack have progressed little beyond a draft plan that's been kicking around the federal bureaucracy for years. Moreover, we have failed to take advantage of modern vaccine production practices to improve both the quality and quantity of flu vaccines. Instead, the U.S. continues to rely on outdated, time-consuming methods that are to vaccine technology what the manual typewriter is to the personal computer. So, as we stand grossly unprepared for the upcoming flu season and the threat of an impending pandemic, it is cold comfort knowing that we have warehouses being stocked with smallpox vaccine and sophisticated sensors designed to detect biowarfare agents deployed in major cities. It's enough to make one wish: If only Al Qaeda, rather than Mother Nature, were the one threatening us with influenza. And what a shame that when it comes to biological threats, the human immune system, unlike U.S. policymakers, doesn't make such distinctions.