A particularly nasty flu season this winter has exposed some flaws in the nation's immunization system.
A run on vaccine after an aggressive strain of flu swept through a couple dozen states has exhausted the supply even though peak flu season is a month away. (The federal government ordered more vaccine, but children's doses won't be shipped until next month.) And those who did get their shots were inoculated for a more mild strain of flu and therefore aren't getting full protection.
A study earlier this year by the Institute of Medicine anticipated such complications and raised a more widespread concern: Both the number of vaccine makers and immunization rates are in decline. Where 25 companies produced vaccines three decades ago, only five do so today and only two are U.S.-based. Meanwhile, fewer Americans can afford immunization because of rising costs of the vaccine and shrinking insurance coverage.
The institute found the supply situation particularly alarming. Eight vaccine products, including those for measles-mumps-rubella, tetanus and polio, have only one supplier each, and should a company falter, it would take two years to replace the vaccine in sufficient numbers. Vaccines aren't the moneymakers that drugs are, so the government needs to find a way to offer adequate financial incentives to producers to assure a reliable supply.
Of course, accessibility will do no good if large numbers of adults and children cannot afford to be immunized. The institute found that as vaccine prices rise, the costs are less likely to be covered by insurance or they carry a higher deductible or co-payment. The result can be tragic, as was the case in Colorado.
At least eight children in that state have died of the flu in recent weeks, and the threat doesn't stop there. Colorado has the lowest percentage in the nation of children who have all of their inoculations, yet the state recently stopped new enrollments in its Children's Health Program, the Rocky Mountain News reported.
That means fewer children have a primary care doctor who is likely to administer the necessary shots. Nationwide, adults are even less likely to be insured (only 16 percent have adequate private insurance), yet many should be vaccinated annually against flu and pneumonia because of age or disease.
The Institute of Medicine recommends a three-part solution. The federal government should mandate vaccine coverage in insurance benefits, subsidize both insurers and providers of vaccinations and provide vouchers for uninsured families to receive immunizations. The fix won't be cheap, but as the institute noted, it would be "a cost savings to society because of the reduced burden of illness and lost productivity from vaccine-preventable disease."
The deaths of children and the frail are a cruel price to pay for being unprepared.
