Only 8 million doses of vaccine against the pandemic H1N1 influenza virus have become available since last Wednesday, calling into question whether the Centers for Disease Control and Prevention will be able to meet even its downsized goal of having 28 million to 30 million doses on hand by the end of this week. As of today, a total of 22.4 million doses of swine flu vaccine are now available, said Dr. Thomas R. Frieden, director of the CDC, at a news conference this morning. The agency had hoped to be getting 20 million doses per week by now and expected a minimum of at least 50 million doses to be on hand by the end of the month, "We are all frustrated that we don't have more vaccine available now," he said.
The delays are due primarily to the fact that virus for the vaccine is grown in chicken eggs, and the virus selected does not grow as rapidly in the eggs as do those used in the seasonal flu vaccine. Also, manufacturers have had to balance production of swine flu vaccine and seasonal vaccine, and that has contributed to the delays.
Frieden said he hopes much larger quantities will be available in the relatively near future.
The slowdown in deliveries is impacting vaccination around the country, including here in the Los Angeles area. Dr. Jonathan E. Fielding, Los Angeles County health officer, said Monday that county-run clinics would tighten their screening procedures to ensure that those at highest risk from complications of swine flu would be the first to be vaccinated. The groups receiving priority at the clinics are pregnant women, caretakers of young children, and people between ages 25 and 64 with underlying health problems. A list of the screening questions is available here. Some of the clinics may also have to close early because of the shortages.
Canada has also been having problems obtaining certain types of swine flu vaccines, particularly those that do not have adjuvants, which enhance the immunity produced by antigens in vaccines. The Canadian government last week approved an adjuvanted vaccine and vaccinations are expected to begin this week. But Canadian Health Minister Leona Aglukkaq said Monday that the country has ordered 200,000 doses of unadjuvanted vaccine from Australia's CSL Ltd. and that those doses will be used to vaccinate pregnant women. Many women carrying fetuses are reluctant to take the vaccines with adjuvants.
In other swine flu news:
- China said today that it will vaccinate all 12,700 Muslims who plan to make the annual pilgrimage to Saudi Arabia, called the hajj. An estimated 3 million Muslims each year make the hajj and many countries are concerned that the mass gathering could lead to spread of the swine flu virus among pilgrims. Arab health ministers in July banned children, the elderly and those with chronic illnesses from attending this year.
The Chinese Health Ministry said Monday that a total of 35,664 swine flu cases had been reported to date, wtih 2,600 new cases since Friday. Authorities expect to vaccinate 5% of the population by the end of the year.
- At least five requests to use the intravenous antiviral drug peramivir have come into the CDC since it authorized emergency use of the medicine late Friday. The drug can be used in patients who are unable to swallow oral Tamiflu or for whom inhaled Relenza cannot reach deep enough into the lungs to reach the virus.
-- Thomas H. Maugh II