WHY YOU CAN'T GET SWINE FLU VACCINE
The shortage of swine-flu vaccine results not from drug- company greed or outsize demand but almost entirely from the government's decision to pander to unfounded and unscientific fear.
As The Wall Street Journal reported last week, the US government set out to have the H1N1 vaccine produced largely in single-dose syringes -- a demand that has set back production considerably, because multidose vials are far easier to make.
And the only reason to seek single-dose production was to please people needlessly worried about the preservative thimerasol, which is used to provide multiple doses of the vaccine. The fear -- utterly groundless and repeatedly debunked is that thimerasol can cause autism and other neurological disorders in infants and other young children.
If not for that decision, we'd have more than enough vaccine. Instead, because the government yielded to pressure from antivaccine fringe groups, we're behind the curve on protecting millions of children from swine flu.
It's a tribute to the effectiveness of pandemic planning and the introduction of new technologies that the nation will likely have plenty of H1N1 vaccine within a month.
Flu strains don't show up when expected. H1N1 was supposed to arrive along with the "regular" seasonal flu, but it began three months early. Using genomic technologies, public-health officials and such vaccine developers as Novartis and Sanofi-Pasteur isolated the H1N1 strain and identified antibodies for production in record time.
Yet, despite this technological ability to adapt quickly to a pandemic threat, our system has been hamstrung by pseudoscience evangelists.
The thimerasol scare, disproved time and again, persists in part because the same public-health entities that encourage immunizations have made significant concessions to small, persistent fear-mongering activist groups.
In 1999, the Food and Drug Administration and the Centers for Disease Control called for the maximum removal of thimerasol from vaccines -- even though both stated there was no scientific evidence of side effects.
Beyond pressuring the government, antivaccine activists have had an indirect effect on the private sector's ability to meet the need for vaccines. Lawsuits in the '80s claimed that DTP (diphtheria, pertussis, tetanus) vaccine caused brain damage; the court actions scared off investment in production facilities using the new recombinant technologies.
As a result, the number of firms producing DTP and other vaccines plummeted. In 1980, 18 companies made vaccines; by the end of the decade, only four were left.
The loss of innovation, investment and profitability in the vaccine industry means we have a gene-based development process for the 21st century -- but a production process that hasn't changed in the last 100 years.
We reap the consequences of that antiquated production process today -- visible on signs posted outside local drugstores and clinics across the country: "Out of H1N1 Vaccine."
But production hasn't been the only casualty of antivaccine hysteria. Since the 1980s, many children have been left unprotected against diphtheria, pertussis and tetanus. How many hundreds of thousands of American children have suffered, from pertussis or other diseases, because of a crackpot minority? How many more will suffer during the current shortage?
By bowing to the unfounded concerns of a few, our government has compromised the safety of many. It's done an admirable job, so far, of communicating with the public about the H1N1 threat and boosting immunization rates. But perhaps its most important job moving forward is to properly align policy with established scientific opinion and the public's best interests.
Twisting the canons of science endangers the public's health and exposes our children to real harm.
Robert Goldberg is vice president of the Center for Medicine in the Public Interest. rgoldberg@cmpi.org
