Too Much Medicine

Last year at this time, Dr. James Nordin had run out of flu vaccines. This year, the Health Partners Medical Group in St. Paul, Minn., where Nordin is a pediatrician has 3,000 unused doses that are headed to the Dumpster if more patients don't take them.

And Minnesota isn't the only place overstocked with the shots. Though the flu season has yet to hit many parts of the country, doctors at several clinics in the U.S. are struggling to get people to take the vaccine.

"Once Christmas comes, people no longer think about flu shots," says Nordin.

Public health officials say that a delay in production, problems in the distribution system and good old fashioned psychology are to blame for the excess vaccines. And if the problems persist, it could mean a shortage of vaccines next winter.

Serious Problems

The flu shot isn't your typical vaccine. Its formula is changed every year by officials who try to predict which strain of the virus will hit next, and its distribution is handled mainly by private companies who earn comparatively low profits for their efforts. And each year, the Center for Disease Control releases recommendations for which segments of the population should take the shot.

All these moving variables make finding the balance between surplus and shortage each year very difficult. And the problem is serious: an estimated 36,000 Americans die every year from the flu, and 200,000 are hospitalized.

Two years ago, a flu shot shortage caused Sen. John Kerry to comment during his presidential campaign that he would not be taking the shot, leaving one of the only 54 million U.S. doses available for someone else more at-risk. This year, almost twice the numbers of shots are available, and doctors are having trouble even giving them away.

And because the flu shot costs clinics $11 to $20 per dose, that could mean big financial losses nationwide.

The surplus problem started last fall, when production of the flu vaccine was delayed by a month due to sterilization issues with some manufacturers. Because most people who get flu shots do so in the early fall, many patients were turned away from their clinics.

"Everybody comes in September [to get the shot]" says Dr. Mark Siegel, a New York University doctor who writes often on flu issues. Siegel had to turn away several patients because he didn't have the vaccine in the early fall.

Matthew Rowan, the President and CEO of the Health Industry Distributors Association, said flu vaccine distributors got calls from doctors wondering when the vaccine would come in.

"Anything that would help manufacturers safely produce vaccine in a more timely way is important," Rowan tells The vaccine is currently produced using 11-day old fertilized chicken eggs as incubators; a process experts agree is too time-consuming and costly. But the government has recently begun supporting new cell-based technology -- in which the vaccine is made in the cells extracted from caterpillar ovaries -- that scientists hope will produce the vaccine more quickly, and cheaply.

"We think that's a good thing," Rowan says.

But it wasn't just a late production cycle that caused excess flu shots this year. After the flu season last year, the CDC widened its recommendations on who should be vaccinated -- chief among them was the that all children under five should get the shot. This season, manufacturers distributed a record 102 million doses, according to government estimates.

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