December 16, 2003 -- Volume 1, Number 8 
Issues & Answers
Vaccine Shortage Exposes Homeland Gap
By
Robert Green
Senior Editor
Homeland Security-related concerns regarding vaccines for smallpox and other possible biological threats got a little closer to the forefront as the nation experienced a dramatic shortage of flu vaccine in early December.
The shortage followed in part from an unwillingness in the pharmaceutical industry to invest heavily in vaccines while liability issues remain on Congress's back burner and vaccines themselves remain economically marginal.
Why The Pain?
In the 1980s, as many as a dozen companies manufactured vaccines for flu and other maladies. That number is now down to five, with only two flu vaccine makers, both announcing they will have no more vaccine ready this season.
According the Wall Street Journal there have been seven "preventive vaccine shortages" since 2000. Health care reform of the 1990s exerted so harsh a cost on vaccine makers that the industry began to dissipate at the prospect of little or no profit. After the Oct. 2001 anthrax attack on the U.S., a new requirement for vaccines arose in the public mind, but legalities have since stymied any real restoration of the industry.
White House Remedy Stymied
A White House-backed remedy for making sure that the threat of law suits would not stunt vaccine production was sliced out of last year's Homeland Security bill by a trio of northeastern Republican senators, who later promised to re-visit the issue but never did.
Pharmaceutical companies are often branded "special interests" on Capitol Hill with little or no regard for how public health issues might be effected. Attempts last year to address the need for government to prepare for biological attacks often ran afoul of the same industry-bashing instinct.
A new smallpox vaccine for government, health care and military personnel produced last year received more attention for its related liability issues than it did for root health issues or evidence that rogue nations are known to house new strains of the lethal biological weapon in their arsenals.
Rebuilding The Public Health System
"This is a problem that extends far beyond getting appropriate vaccines to every American citizen," said Thomas Coughlin, M.D., director of the Homeland Security Technology Council. "The fact of the matter is that we have essentially dismantled our entire public health system, and poor vaccine dissemination is only a symptom of a much greater problem.
"The public health system is in such a mess that if we should have a major natural or man-made disaster requiring large scale medical resources, the system would be inundated and incapable of handling the casualties….Right now, any widespread medical emergency in almost any city would be dealt with poorly or not at all as far as treating the individual victims."
Perhaps the flu vaccine shortage that managed to get front page attention will ultimately rivet some additional attention on Congressional failure to confront a serious homeland security gap.
"What is needed here is a rededication to upgrading the public health system," Coughlin said. "Not a sexy topic, but a necessary one."
Senior editor Robert Green can be reached at RobertGreen@PubSector.net.
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