"Who is going to pay for all of this?" asked Dr. William Schaffner, chair of the department of preventive medicine at Vanderbilt University. "For example, we know that there are 40 million people who don't have medical insurance. Who is going to get the vaccine to those people?"
According to Poland, though, vaccine supplies have been increasing steadily since the widely publicized vaccine shortages from several years ago.
"This year, manufacturers are going to make 130 million doses in America. Last year … we threw away about 12 million doses," he said. "Every year this decade, we've leaned on the manufacturers to make more vaccine, and we've thrown away doses in the millions."
"Until this year, there were concerns that we'd even have enough vaccines to cover our indicated patients," said Schaffner. "However, that concern is receding. We are having more manufacturers coming into the U.S. market. This year we'll have 130 million doses or even more. This year, we are faced with the idea of, 'can we even use it all?'"
According to Poland, however, there could be a very important hidden benefit to addressing these issues now: Americans would learn how to be prepared in case of a bioterrorist attack or a pandemic infectious disease.
"Once you've made a recommendation and then implement the recommendations, you go a long way towards figuring out the ways to operationalize the ways to administer these things to all Americans," Poland said. "You can't make that happen in the middle of an emergency."
Schaffner agreed that the development of such public health infrastructure could be a critically important step for the future.
"If we undertook to vaccinate a very substantial proportion of the U.S. population each year, you'd have to organize everything from vaccine development to production to delivery," he said. "It'd be like a training session or a fire drill that we'd conduct each year.
"So if we had to do it in any kind of emergent situation — for example, anthrax, smallpox vaccine, delivering cipro [antibiotics] — we'd have a trained provider network and a trained public," he said. "Just as most of us know where to go to vote, we'd be trained on where to go to get vaccinated or get your antibiotics or whatever the public health intervention would be."
"It may be something that could lay the groundwork for something looming down the line in the form of an avian flu pandemic," said Dr. Peter Hotez, chair of the Department of Microbiology, Immunology and Tropical Medicine at The George Washington University. "By getting this infrastructure into place by vaccinating the whole population against [seasonal] flu, you lay the groundwork to combat deadly avian influenza.
"In effect, you would be killing two birds with one stone."
But according to Poland, this type of recommendation would likely need some advance warning to allow for the infrastructure to be built.
"I suggest we make the recommendation in advance," Poland said. "For example, something like 'starting next year, we'll be recommending all Americans get a flu vaccine.'"
Carla Williams and Dan Childs contributed to this report.