Hunt, Sheaffer, ASHP Staff Confer with Surgeon General Satcher, CDC Officials
Satcher underscored the need for the pharmacy groups to work with CDC to achieve its high-priority goal that adults over 65 and people at high risk for influenza-related complications receive the vaccine as soon as possible. He acknowledged that disparities exist in supply of the vaccine from manufacturers and distribution throughout the nation. Satcher asked ASHP and others to work with CDC in a "very special partnership" to reach the high-risk populations first and delay until December or January immunization of people not in a high-risk category.
ASHP has asked Satcher and others to intervene with manufacturers that do not follow CDCs recommendations to ship the vaccine to hospitals and health systems. CDC agreed to contact manufacturers and urge them to make direct shipments to health care providers serving high-risk patients. CDC officials pointed out that the agency recently ordered 9 million more doses of the vaccine and will prioritize order fulfillment. Officials said the Nov. 3 issue of Morbidity and Mortality Weekly Report describes special ordering procedures for this new supply to be provided by Aventis-Pasteur Inc. To date, only 250,000 doses have been ordered.
CDC officials also said manufacturers report that, as of Oct. 31, only 31 percent of the current vaccine supply has been distributed. Thus, over two-thirds of the seasons supply is still in the manufacturing and distribution channels. Officials underscored that deferral of immunization for non-high-risk patients until December or January is still appropriate and would be effective because the flu season does not usually peak until January or February.
CDC officials agreed to contact the Food and Drug Administration concerning the public-health and best-practices issues that might arise when alternative distributors transfer the vaccine multiple times. ASHP also raised a concern about the evolving gray market conducted by these suppliers who are charging up to five times the prices quoted by manufacturers this past spring. CDC officials expressed concern about this development but did not offer solutions. However, ASHP has written to officials at the Federal Trade Commission seeking a review of this aspect of the problem.