By Thomas Lang
The politics of flu became an issue earlier this month when British regulators shut down a Chiron Corporation vaccine plant that was set to provide almost 50 percent of the United State’s influenza vaccine. Seizing on the news, John Kerry blamed the shortage on the ineptness of the Bush administration. The Bush campaign, in turn, said the whole problem was indirectly the fault of Kerry and other congressmen like him because of their refusal to put limits on malpractice suits.
A flurry of political stories ensued, cataloging the various charges and counter-charges, but failing, as usual, to tell the reader which aspect, if any, of either candidate’s arguments holds water. Meanwhile, a number of major papers have assigned their Health or Science sections to provide detailed explanations of the crisis. Few though, have managed to effectively mix politics and health together. So here’s our shot at doing just that.
The Kerry campaign has charged, first, that the Bush administration was warned three years ago that the health system wasn’t prepared for a disruption in the supply of flu vaccine, and second, that the administration was warned as recently as August of the impending crisis and failed to act.
The first part of the charge is true. In a report issued May 15, 2001, the General Accounting Office warned, “Currently, there is no system to ensure that high-risk people have priority when the supply of vaccine is short. In a typical year, enough vaccine is available in the fall to meet total demand, both from high-risk individuals and from others who simply want to avoid the flu…When [earlier] shortages developed, manufacturers and distributors had limited ability to identify and give priority to those providers serving more high-risk individuals.” The GAO sent a list of recommendations to the Department of Human and Health Services, where it, based on this year’s trouble, had little or no impact.
The second accusation is more problematic.
In August, Chiron did warn that it had detected contamination problems in eight of its vaccine batches, but it assured US health officials that it would still be able to deliver 46 million to 48 million doses of the vaccine. Is Kerry suggesting that the Bush administration should have found another flu vaccine supply? The fact is that even if the administration had found that Chiron’s entire supply was contaminated, it could not have found an adequate replacement. (That same GAO report from May 15, 2001 notes, “Producing the vaccine is a complex process that involves growing viruses in millions of fertilized chicken eggs. This process, which requires several steps, generally takes at least 6 to 8 months between January and August each year.”) Is the Kerry campaign suggesting that the Bush administration did not adequately respond to the August warning by informing the public and developing a plan to ensure those in the high-risk group receive the vaccine? A spokesman with HHS told me that, after being warned of a potential supply problem, HHS developed revised recommendations to be implemented if the problems in Chiron turned out to be worse than anticipated. At the time the Center for Disease Control and Prevention, after discussions with Chiron, did not “anticipate an overall shortage,” and chose, not to revise its recommendations on just who should be immunized.
Yesterday, HHS Secretary Thompson cited the August release of the Draft National Pandemic Preparedness and Response plan. Today the Atlanta Journal Constitution reports that that plan has been in the works since 1993, and has itself been criticized by both the Government Accounting Office and Trust for America’s Health for leaving “significant gaps in preparation for flu.”
The Bush administration has responded with the counter-argument that it’s really congressional liberals who are to blame for the vaccine crisis. The shortage, it contends, is a result of manufacturers exiting the market because of potential liability lawsuits. (Translation: Trial lawyers like John Edwards did it!) Thus, it says, what’s really needed to ensure a full supply of the flu vaccine is tort reform.
Quick history lesson: As both the New York Times and USA Today reported today, Congress first passed a law, the National Childhood Vaccine Injury Act, limiting manufacturers’ liability 18 years ago. The law created the National Vaccine Injury Compensation Program that requires those injured by vaccines to seek compensation from a special government fund that is supported by an excise tax. Only after being denied by that fund can victims file a lawsuit against a manufacturer. Earlier this year, according to a Human and Health Services Department spokesman, Congress passed a bill that would add the influenza virus to the National Vaccine Injury Compensation Program. President Bush has not yet signed it.