Yes We Have No (Flu) Vaccine

by Rod Moser PA, PhD, a primary care physician assistant with more than 35 years of clinical experience.


The lack of the availability of the H1N1 vaccine is troubling for us medical providers in the primary care trenches. Every day, or should I say, every hour, I am trying to explain to anxious parents that we do not have any H1N1 vaccine...yet.

"It's coming", is really all that I can tell them.

Although supplies are erratic, we do seem to have a small, albeit dwindling, supply of the seasonal flu vaccine. The shortage of this vaccine has been attributed to vaccine producers having to make the H1N1 vaccine instead. While this may be true, we tend to have flu vaccine shortages in our office every year. As a matter of fact, we seem to have shortages of other essential, pediatric vaccines, like HIB and pneumococcal vaccine. These shortages have also been blamed, in part, due to the H1N1 production. Again, I am not sure what to believe.

I find it puzzling that a large medical group, like the one that I am in, has shortages of any vaccine, especially the seasonal flu vaccine. I see full page ads in the newspaper where several local pharmacies are providing flu vaccine. If pharmacies can get easy access to vaccines, then why are some medical groups having problems?

A few years ago, one of our refrigerators went on the brink over a weekend. This resulted in the loss of over $20,000 worth of vaccine. Another time, the refrigerator became too cold and ruined another expensive cache of vaccines that require very specific storage temperature requirements. I suspect that we are keeping less of an inventory now because of these two incidents.

In an environment where many people mistrust vaccines, the companies that make them, and the organizations that promote them, it is heartening to know that people are asking to be immunized. I have always been a proponent of vaccines, since I know that vaccines have saved more lives on this planet than just about any public health effort, short of clean water supplies. Vaccines are gold in my eyes.

Starting in the 1950's, people lined up around the block for vaccines that prevented polio, measles, whooping cough, rubella, and diphtheria. They were given in schools, by public health nurses, and they were free. In the more recent past, say in the last few years, we often have to twist people's arms to get them to take immunizations. The media hype linking autism to vaccines hasn't helped their reputation. Many misinformed parents feel that ANY vaccine is linked to autism now, and I am seeing very little public education to the contrary. The benefits of vaccines are not really news, but if one child has a rare adverse event associated with a particular vaccine, this is big news. One poorly-researched news story results in thousands and thousands of people not get them.

Medical providers hate to ration care. If we had it our way, vaccinations would be free to everyone, but alas, that is not the case. People get turned away for vaccines because of their insurance (or lack of insurance). When we get down to our last dozen or so doses of flu vaccine, it is announced that we will only provide the vaccine to those with the greatest need - children who are immunosuppressed, diabetic, or asthmatic, for instance. For a parent, ANY child at risk for getting a potentially, life-threatening disease is of greatest need. I have even had parents try to bribe me to get a vaccine that was in short supply! Affordable medical care is really everyone's right, but public health efforts, like vaccines are really something that should be freely-available, and in my opinion, free - just like the Old Days.

A few years ago, at another time where there was a serious shortage of seasonal flu vaccine in our area, a local physician informed our group that he had some extra vaccine that he would like to sell us. He had ordered a hundred doses, but for some reason, the company had sent him 1000 doses (perhaps another reason why we experienced a local shortage). He offered to sell his extra 900 doses for twice the price he paid for them. Exploiting a vaccine shortage for personal profit is not unlike the local ER doctor that was arrested last week for stealing a patient's Rolex watch after he died. Did they not teach ethics in their medical schools? Of course, dishonesty and profiteering are personality faults that cannot be altered by educational efforts.

As you might expect, there are black markets now for vaccines, and hundreds of Internet scams that are linked to substances that are supposed to cure or prevent influenza. It seems that there are never any shortages of scams.