County officials can help ease anxiety over flu vaccine shortage

(Ed. Note: NACo and the National Association of County & City Health Officials [NACCHO], a NACo affiliate, have been working closely to address the recent news of a massive influenza vaccine shortage due to the shutdown of a British manufacturing plant that supplies nearly 50 percent of the U.S. influenza vaccine supply. Following is an article written by NACCHO Executive Director Patrick M. Libbey and Carol Moehrle, director of the North Central District Health Department in Nez Perce County, Idaho.)

The nation is facing an enormous public health challenge. We all learned on Oct. 5 that nearly half of the total national supply of flu vaccine would not become available. County officials, as leaders in their communities, can help make sure flu vaccine gets to the people who need it the most.

The Chiron Corporation, which had expected to deliver about 46 million doses of flu vaccine for use in the United States, announced that it would deliver no doses because of a shutdown of its manufacturing facility by the British government for alleged manufacturing defects.

Overnight, the public health goals for this year’s flu season changed. The nation’s local public health departments had previously encouraged all persons to get vaccinated against influenza, a disease that causes 36,000 deaths and more than 200,000 hospitalizations every year. Now, faced with a shortage of vaccine, we must promote voluntary rationing of flu vaccine, so young children, the elderly and others who are the most likely to become very ill or die from the flu will be able to receive the vaccine.

County public health departments have long played important roles in promoting flu vaccination and giving flu shots. This year’s shortage is the fifth year in six years the nation has experienced disruptions in supply and distribution of influenza vaccine. In response, public health departments have increasingly engaged in monitoring vaccine supplies in their communities and facilitating reallocation to health care providers for persons most in need.

This year’s shortage is far more severe. We fully expect many healthy adults and older children will need to forego flu vaccinations. The Centers for Disease Control and Prevention (CDC) has identified priority groups for flu vaccination (see sidebar). These include people who are most vulnerable to the complications of influenza, health care workers who have direct contact with patients, and persons in the household of infants less than six months old. The total expected supply of about 54 million doses is enough to vaccinate a little more than one-half of these high-priority populations if every high-priority person were to receive a shot.

Past experience tells us that around half of the high-priority groups seek flu vaccination. If this pattern holds, there should be enough nationally for persons in the high-priority groups who want a flu shot to get one. However, this will only be possible if we find ways to distribute the precious vaccine appropriately.

For every healthy person aged 2 to 64 who gets a flu shot, there will be one small child or elderly person who will not be able to receive one. It is essential that physicians, hospitals and clinics, employers, pharmacies, grocery stores and all others who customarily provide flu shots observe CDC’s priority guidelines. Because most of the nation’s supply of flu vaccine is in private hands, we must appeal to the goodwill and citizenship of everyone, both people who want flu vaccine and the entities that provide it.

County officials, the leaders of their communities, can help greatly in helping people remain calm and in maintaining fair, orderly, access to flu vaccine.

Here are some things they can do:

• Publicly promote the use of flu vaccine supplies in accordance with CDC’s guidelines. Urge healthy persons aged 2 to 64 to forego their flu shot this year.
• Urge people to stay home and not go to school or work if they come down with the flu.
• Learn what the local health department is doing to assess or redistribute vaccine supply.
• Support the local health department in gaining the cooperation of physicians, hospitals, community health care providers and other entities, such as pharmacies and chain stores, that may have vaccine but may be asked to reallocate to facilities most in need, such as nursing homes.
• Publicly promote ways that people can reduce their chances of getting the flu. These include simple but effective hygiene measures such as frequent hand-washing and covering your mouth when you cough or sneeze.

(NACCHO, a NACo affiliate, is the only national organization representing the nation’s nearly 3,000 local public health departments. These departments – in counties, cities, and towns – work every day on the front lines to protect the health of their communities.

Patrick M. Libbey, NACCHO’s executive director, is the former health director for Thurston County, Wash. Carol Moehrle, director of the North Central District Health Department in Nez Perce County, Idaho, chairs NACo’s Health Steering Committee’s Subcommittee on Public Health.)