Variability is its specialty

Abstract

In early October 2004, the US Food and Drug Administration (FDA; Rockville, MD, USA) announced that influenza vaccine supplies for the coming winter season would be dangerously low. The vaccine produced by Chiron (Emeryville, CA, USA) in the UK was contaminated with bacteria and was therefore unusable, which effectively cut the total US supply in half. The news unleashed a veritable frenzy in the USA, where citizens are unaccustomed to healthcare rationing. ‘Medical tourism’ has been one creative response to the vaccine shortage: Americans are paying US$105 to take the high‐speed ferry from Seattle, Washington, to Victoria, British Columbia, or are crossing other borders into Canada to get influenza vaccines. Earlier this autumn, pictures of the elderly waiting in line for hours for an influenza shot, and the death of one woman who was queuing in the hot sun in the southeastern USA, dominated the news coverage. > …the production of the vaccine in chicken eggs is slow and inflexible, and a last‐minute shortfall can take on crisis proportions To deal with the clamour for the vaccine, the US Centers for Disease Control and Prevention (CDC; Atlanta, GA, USA) convened an ethics committee to draft principles for the future use of influenza vaccines and to determine who has the highest priority—the elderly, infants, children or the chronically ill. Meanwhile, federal and local authorities made deals with foreign governments to buy additional doses of vaccine. The shortage even became a campaign issue before the presidential election, with Democratic candidate John Kerry asserting that the lack of government subsidies for vaccine production was to blame for the fact that only two companies still produced influenza vaccine for the USA. President George W. Bush promised that he would try to obtain additional doses from overseas—a week after he said that it was unsafe to …