Academic journal article Independent Review

Weakened Immunity: How the Food and Drug Administration Caused Recent Vaccine-Supply Problems

Academic journal article Independent Review

Weakened Immunity: How the Food and Drug Administration Caused Recent Vaccine-Supply Problems

Article excerpt

Since 2000 in the United States, there have been serious supply problems involving nearly all childhood vaccines recommended by the U.S. Centers for Disease Control and Prevention (CDC). (1) Such problems have occurred with other vaccines as well, including influenza vaccine. Some headlines illustrate the story:

"Vaccine Shortages Threaten Kids" (MSNBC News, September 17, 2002)

"Vaccine Shortages Frustrate Everyone" (Amednews.com [American Medical Association] March 4, 2002)

"Health Officials Warn That Flu Vaccine May Be Too Little, Too Late" (Philadelphia Inquirer, September 6, 2000)

"Flu Shot Delays Reported for Many Who Are at Risk" (New York Times, November 7, 2000)

These and other stories tell of frustrated doctors and health-care workers unable to get vaccines (Chang 2000; "Physicians Weigh In" 2002). They describe elderly patients standing in long lines at flu shot clinics or arriving at clinics only to find that supplies had run out (Borgatta 2000; Stapleton 2001). Other stories speak of "price gouging" as hard-to-find vaccines are sold for many times the usual price.

It is unclear why these difficulties happen, but many people place the blame squarely on the free market and vaccine manufacturers. "We're not distributing shoes for the prom," one doctor told the Los Angeles Times, November 4, 2000, during the flu vaccine shortage. "This is a public health issue," she said. U.S. senator Jack Reed of Rhode Island declared, "It's clear ... that we have a system that cannot guarantee an adequate supply of vaccines from year to year and is unprepared to handle a potential outbreak of routine childhood diseases." He called for several government agencies to "coordinate their oversight of manufacturers" (Reed 2002). U.S. representative Peter DeFazio of Oregon stated, "I would hope we're not making life and death decisions based on someone's ability to compete in the market." He introduced legislation that would give the secretary of the Department of Health and Human Services the authority to declare a "public health emergency" by reason of a flu vaccine shortage. The government could then "take title to such quantities of vaccine as the secretary determines to be necessary for purposes of the public health" (U.S. House 2001, emphasis added). On May 21, 2001, DeFazio told the Eugene, Oregon, Register Guard that "a market driven system for delivering vaccine doesn't work when there's a shortage or outbreak" (Christie 2001).

Did the free market really fail? Can it deliver only prom shoes and other "nonessential" goods? Is more government intervention necessary to guarantee that Americans get immunizations? In this article, I maintain that the U.S. vaccine market is far from "free" and that government intervention itself has caused the recent supply difficulties.

What Happened?

The vaccine shortages are a recent phenomenon. According to a U.S. Government Accounting Office (GAO) report, childhood vaccine supplies started to run low "in the fall of 2000 when supplies of the tetanus and diphtheria booster (Td) fell short" (U.S. GAO 2002, 8). The supply problem with influenza vaccine also emerged at that time, although the CDC had warned of it a few months earlier (U.S. CDC 2000). Over the next thirty months, nearly all of the CDC's recommended childhood vaccines were at one time or another in seriously short supply.

Seriousness of the Problem

All of the vaccine supply problems began at approximately the same time. In January 2001, just a few months after the Td and influenza vaccine shortages took hold, the vaccine known as DTaP (for diphtheria, tetanus, and pertussis) fell into short supply. Pneumococcal conjugate vaccine came next (PCV), in September 2001, followed by measles, mumps, and rubella (MMR) and chicken pox (varicella) in October 2001 (U.S. GAO 2002, 8). At the same time, shortages also occurred for the hepatitis B and haemophilus influenzae type b (Hib or meningitis) vaccines ("How to Shore Up" 2002). …

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