The striking difference in H1N1 vaccine uptake, compared with the reception the seasonal flu vaccine received in September through November, isn't surprising because “people looked at the H1N1 vaccine differently,” Dr. Poland said in an interview.
“People are familiar with the seasonal vaccine and presumably more comfortable with its safety; drugstores and supermarkets heavily promoted [seasonal] flu shots; and most important, in contrast to H1N1, there was seasonal vaccine available to meet demand at the time vaccination was being heavily promoted. The public heeded the call to be vaccinated early,” said Katherine M. Harris, Ph.D., a senior economist at RAND Corp. and lead researcher on RAND's flu vaccine surveys. “Three times as many people were vaccinated against seasonal flu in September compared with the same time last year.”
Dr. Georges C. Benjamin, executive director of the American Public Health Association, agreed. “Seasonal vaccine was available in an environment when people were concerned about the flu. Public health officials were effective at promoting the need to get seasonal vaccine. The diminishing risk of high mortality and morbidity from H1N1 in the broader population reinforced the belief that the [H1N1] vaccine was not essential. The failure of a third wave to occur to date has also reinforced this belief.”
Dr. Benjamin also cited the public's safety concerns about the “new” H1N1 vaccine, and confusion about the number of vaccinations needed for protection.
Dr. Poland highlighted the tiered approach that targeted the earliest available H1N1 vaccine exclusively to high-risk people as another factor that dissipated momentum of the vaccination effort last fall.
“It caused delay, and as a result we'll have tens of millions of H1N1 vaccines go to waste.”
The major underlying problem appears to have been a mismatch between vaccine supply and demand, which meant missing the key vaccination window as the second wave of H1N1 infection built and peaked last fall.
“The single biggest problem is that we did not have enough vaccine early enough,” Dr. Schaffner said. “The bulk of the vaccine began to arrive between the [Thanksgiving and Christmas] holidays, and there was a sense by then that H1N1 had peaked.”
Because the vaccine strain of the H1N1 virus grew more slowly than expected, “the output of vaccine was not optimal,” Dr. Benjamin said. “This argues for current efforts the scientific community is undertaking to use newer methods to make the vaccine.”
Disclosures: Because the federal government fully funded H1N1 vaccine production, the sources in this article have no relevant disclosures, except for Dr. Schuchat, who is a government employee.
'We have ample supplies of vaccine and few customers right now. The stock is not moving.'
Source: DR. SCHAFFNER