Vaccines are Unique

• Biological products
• Produced from living cells and organisms
• Require growth
• Each lot must be tested for purity/potency
• Lengthy production time
• Regulated differently than drugs
• Safety paramount because recipients are healthy

Flu Vaccine Demand

• 2002 - Insufficient demand Manufacturers discard 12 million doses
• 2003 -Vaccine orders significantly down, indicating demand would be less

Persons at Increased Risk for Complications from Influenza

• People 65 years and older
• People 2-64 years with underlying chronic medical conditions
• Pregnant women
• Residents of nursing homes and long-term care facilities
• Children 6 months-18 years of age on chronic aspirin therapy
• Children between 6 and 23 months

Monroe County Action Steps

• Conducted provider survey - 80,000 doses short for high risk adults
• Covered nursing homes, other congregate care facilities, and HIV and renal dialysis patients
• Determined who had excess vaccine

Ethical Priorities

• Withhold vaccine from non-high priority persons
• Reserve doses for high priority persons who may not seek vaccine
• Develop coordinated and consistent communication messages about who should be vaccinated

Stabilize Vaccine Supply

1. 1. Increase number of manufacturers and capacity of existing manufacturers
   • Financial incentives
   • Streamline regulatory process
2. Increase value public places on vaccines
   • healthcare workers vaccination
   • healthcare worker recommendation