This fall, flu season brought a bug of a different sort – the shutdown in the United Kingdom of Chiron Corporation, a major manufacturer of the influenza vaccine.

As a result, the United States will have only about half as much vaccine as was thought necessary by the US Centers for Disease Control and Prevention (CDC). Thus, early last month, the CDC modified its earlier goals and issued interim recommendations for use of available vaccine during the 2004-05 season.

According to the CDC, the top priority groups for vaccination (in no order of importance) are:

  • All children aged 6—23 months
  • Adults aged 65 years or over
  • Persons aged 2—64 years with certain chronic medical conditions
  • Women who will be pregnant during the influenza season
  • Residents of nursing homes and chronic care facilities
  • Children aged 6 months—18 years who take aspirin daily
  • Health care workers involved in direct patient care
  • Out-of-home caregivers and household members of children less than six months old

“For the rest of us,” says LHSFNA Health Promotion Division Director Mary Jane MacArthur, “avoid contact with people who are sick, eat healthy, exercise and wash your hands. If you get the flu, you will have to rely on the old-fashioned cure – bed rest, over-the-counter medications to relieve symptoms and lots of liquids.” More information is available from the American Lung Association.

The CDC concurred, saying in a formal statement, “Persons who are not included in one of the priority groups described above should be informed about the urgent vaccine supply situation and asked to forego or defer vaccination.”


  • Fever
  • Headache
  • Extreme tiredness
  • Dry cough
  • Sore throat
  • Runny or stuffy nose
  • Muscle aches
  • Nausea, vomiting, diarrhea (more common in children than adults)

Good Health Habits

  • Avoid close contact with sick people
  • Stay home when you are sick
  • Cover your mouth and nose when coughing or sneezing
  • Clean your hands
  • Avoid touching your eyes, nose or mouth

For more information, visit the CDC website.

Though the immediate cause of the shortage was the shutdown of the Chiron plant in Great Britain by the nation’s Medicines and Healthcare Products Regulatory Agency (MHRA), the problem has deeper origins.

Influenza is caused by a virus which, itself, mutates every year. Vaccine makers must track virus strains, then develop a slightly modified vaccine for each flu season. Once the formula is developed, it must be injected by hand into millions of fertilized chicken eggs. Each egg produces four or five doses of vaccine. The process is time-consuming and expensive.

Due to a variety of factors, the market for vaccine sales varies from year to year so it is difficult for manufacturers to predict how much will be needed and sold. It is not uncommon for a manufacturer to make millions of doses that go unsold. It cannot be saved and modified for another season.

This kind of unpredictability has caused many pharmaceuticals to get out of the business. Since the early 1970s, the number of flu vaccine makers has shrunk from more than a dozen down to two.

With only two makers, a problem like the one at Chiron can mean a major disruption in service.

Because of this year’s elections, however, the long lines of seniors waiting for flu shots created a negative photo opp for the Bush administration. However, US Health and Human Services Department Director Tommy Thompson urged seniors to be patient, saying his agency would monitor the situation and move available supplies around so that most seniors would be able to get shots. He asked seniors to consult with their doctor or to notify the CDC if they are unable to get a shot.

On the other hand, many critics suggested that the administration should have been watching more closely. Apparently, all national health agencies that had ordered vaccine from Chiron were informed in August that the shortfall would occur. Most made arrangements to purchase additional amounts from the world’s other supplier, Aventis Pasteur, Inc. Though US officials, too, were informed, they placed no additional orders. However, they denied any malfeasance and stressed that enough shots will be available to inoculate most people who have high risk.

It is not known how dangerous the flu will be this season. Throughout the 1990s, the infection played a role in about 51,000 American fatalities each year, including about 8,000 attributable directly to the virus. Faced with the lessened availability of vaccine, an emphasis on good nutrition and personal health precautions is a must throughout this flu season.

[Steve Clark]