H1N1 Vaccine Arriving, but Slower Than Hoped

Kate Traynor

BETHESDA, MD 16 October 2009—Fewer doses of the pandemic 2009 H1N1 influenza virus vaccine than originally projected will be available by the end of the month, the Centers for Disease Control and Prevention (CDC) announced today.

The initial projection of 40 million doses by the end of October will be short by about 10–12 million doses, said Anne Schuchat, director of CDC's National Center for Immunization and Respiratory Diseases.

Schuchat said manufacturers blamed the shortfall on lower-than-expected yields of antigen from the egg-based production system that is used to produce licensed influenza vaccines in the United States. She characterized the problem as a production delay.

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"There is more vaccine coming out every day," Schuchat said. "Eventually, anyone who wants to be vaccinated will be able to be vaccinated. But the next couple weeks will continue to be a slow start."

Influenza activity is widespread in 41 states, up from 37 last week. CDC surveillance data show that 6.1% of visits to physicians' offices were attributed to influenza-like symptoms, a situation that Schuchat said is unprecedented for this time of year.

"It's a very busy and difficult flu season," she said.

Of concern to CDC is a spike in reports of pediatric deaths attributed to the virus. Schuchat said 10 pediatric deaths were reported to the agency last week, for a total of 43 pediatric deaths since August 30.

"Forty-three deaths essentially in one month is a lot," Schuchat said. She said that typically, about 40–50 children die during the course of an entire influenza season.

Essentially all influenza infections are being caused by the 2009 H1N1 virus, Schuchat said. But CDC continues to recommend that Americans get vaccinated against the seasonal influenza strains that are expected to circulate later this season.

Schuchat acknowledged that finding trivalent seasonal influenza vaccine can be "frustrating" for many. She said 82 million doses of trivalent vaccines have been distributed so far and more will be available later during the flu season.

MedImmune expects to ship supplies of FluMist, the company's live, attenuated intranasal influenza vaccine, through December and early January, company spokeswoman Karen Lancaster said. She said MedImmune expects to meet its initial projection to supply 10 million doses of the vaccine for the U.S. market.

Sanofi Pasteur spokeswoman Donna Cary said the company expects by the end of November to have distributed 50.5 million doses of Fluzone, the company's inactivated trivalent influenza vaccine. She said the company met its target projection for vaccine production.

Novartis recently completed the distribution of 27.1 million doses of Fluvirin trivalent inactivated influenza vaccine. Spokesman Paul C. Newman said the amount was slightly short of the 30 million doses predicted in July.

Under normal circumstances, Newman said, Novartis could have extended the production time to make additional doses. But he said the company, working with federal officials, halted the production of seasonal vaccine to clear the way for the production of an H1N1 vaccine in late July.

GlaxoSmithKline has distributed about 12 million doses of FluLaval and 6 million of Fluarix, the company's two licensed trivalent inactivated influenza vaccines. Spokesman Jeff McLaughlin said GlaxoSmithKline had projected that it would produce 20 million doses but revised that estimate downward in September because of manufacturing issues.