Swine flu doses will top 100 million on Friday

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Available doses of the vaccine against pandemic H1N1 influenza will top 100 million in the United States by Friday, Health and Human Services Secretary Kathleen Sebelius said this morning. The vaccine has become sufficiently plentiful that at least 24 states and some other communities have lifted restrictions on who can get it, opening distribution to everyone.Some pharmacies are now starting to get the vaccine for general distribution.

Health officials’ biggest fear now is that, with the perception that the pandemic is waning, many people will decide that they don’t need to get the vaccine. Sebelius, who got her own shot Wednesday, urged everyone to get vaccinated. ‘We have a wonderful window of opportunity to prevent or lessen a third wave,’ she said at a news conference. In the 1957 pandemic, she noted, the fall outbreak tailed off only to be followed by another wave of disease after the first of the year, perhaps triggered in part by holiday travel.

Although the pandemic is ebbing — at least for the moment — in the United States, there is still a great deal of activity elsewhere in the world, Dr. Keiji Fukuda of the World Health Organization said today. Flu activity continues at high levels in parts of Europe, such as France, Switzerland and the Czech Republic, and continues to be high in parts of central Asia, such as Kazakhstan and Kyrgyzstan, as well as Russia. ‘One of the common questions coming to us is, Is the pandemic over? Is it time to call it? And really, the answer is that it’s too early to make such a call.’

Fukuda, special advisor on pandemic influenza to the WHO’s director-general, said the agency plans to begin distributing 180 million pledged doses of swine flu vaccine to developing countries, hopefully within a few days. The first shipments will go to Azerbaijan, Afghanistan and Mongolia because they are in the Northern Hemisphere, where the outbreak is most severe now. The doses have been pledged by the five major manufacturers and 12 countries, although it is not clear how many have come through on their pledges. The United States, for example, has pledged 10% of its supply to the WHO but has not shipped any yet. The WHO’s goal is to ship 200 million doses to 95 countries that would not otherwsie have access to the vaccine. The shots will go primarily to healthcare providers and first responders.

But more may become available soon because many countries ordered vaccine on the assumption that two doses would be required to immunize most people. Now that it is clear that one dose is sufficient for everyone except children younger than 10, there is likely to be a surplus. The U.S., for example, ordered the ingredients for 251 million doses, and it seems unlikely that all those will be used. Germany and Spain have already been in negotiations with vaccine manufacturers to reduce their deliveries and have tried to sell some of their vaccine on the open market.

— Thomas H. Maugh II