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2009 Seasonal influenza vaccination: October 14, 2009
CDC has heard from some health care providers and other immunization providers who are frustrated because they are not currently able to obtain seasonal influenza vaccine.
Their concerns mirror some anecdotal media reports that this year demand for seasonal influenza vaccine appears to be substantially higher than last year.
Hard evidence of increased demand and its relationship to supply is not available. However, what we do know about vaccine supply and availability should help all of us get vaccine to people who need and want it.
The good news about vaccine supply is that current projections of the number of doses of seasonal influenza vaccine that will be available is very close (97%) to the planned number.
- Manufacturers now estimate that a total of 114 million doses will be brought to the U.S. market.
- In June, the 5 manufacturers estimated that they would produce 118 doses. (specific figures can be found at http://www.preventinfluenza.org/presentations_2009.asp)
- The difference between planned and the ultimate number of doses varies by manufacturer, but
there have been no major reductions in production. Other good news is that the seasonal flu vaccine has been made available earlier this season than ever before. As of the first week of October, 77 million doses have been distributed in the private and public sectors.
People have been responding to vaccine availability by getting immunized earlier this season.
• Two systems that look at vaccinations administered and billed show that many more individuals have been vaccinated this season than at the same time last year. However, this is most likely due to the early availability of vaccine.
If the anecdotal reports about increased demand turn out to be correct, the extra demand may not be fully met.
- Because the total number of doses that will be made this year is approximately the same as the number of doses that were actually administered last year, an increase in demand cannot be met this season.
- Manufacturers are not able to produce more seasonal influenza vaccine for this season.
Their facilities are currently being used for H1N1 vaccine production, which takes several months. Thus, these facilities would not be available for additional non‐H1N1 vaccine production in time for this influenza season.
- When the manufacturers made their estimates in June, related to the number of seasonal flu vaccine doses that they would bring to market, they were already planning to switch their facilities to the manufacturing of H1N1 monovalent vaccine
- Influenza vaccine takes several months to make. Early processes include making bulk vaccine; later processes include blending, filling, and packaging the vaccine.
- The manufacturing process is like a pipeline. To keep vaccine flowing through the system, bulk H1N1 vaccine needed to be started as soon as the bulk facilities became available, which was before all of the seasonal flu vaccine was filled and finished.
• The supply could still be reduced if the manufacturing steps after the bulk vaccine steps encounter problems. For example, a lot could fail FDA inspection.
We are working with manufacturers, states, and immunization providers to identify existing seasonal flu vaccine and get it to providers who can administer it to people who need and want it.
The situation is dynamic, and we expect it to continue to evolve as the influenza vaccine season continues.
• Some manufacturers fell short of their planned number of doses, and took orders that exceed the number of doses they now expect to make.
o This has caused their distributors to cancel or cut back on some vaccine orders
- In addition, some manufacturers have had a delay in the availability of vaccine, and this is resulting in orders that won’t be completed until November.
- Each year, some immunization providers order vaccine from more than one manufacturer or distributor, and then cancel other orders after the earliest vaccine is received. Because of this ordering pattern, some vaccine usually becomes available in October.
- However, we have not seen this so far this season. We are not seeing additional vaccine being released into the market as has been the case in past years.
- With orders and availability still being sorted out, CDC recommends that vaccine providers check the National Influenza Summit web site where available vaccine is listed by distributor: http://www.preventinfluenza.org/ in the link for healthcare professionals.
- Right now, this web site shows almost no vaccine available, but that all products are on order.
- We don’t know how much vaccine will become available, but it is unlikely that much more vaccine will enter the market.
- Providers, who have more vaccine than they anticipate using, are being encouraged to work with their local health department to identify other providers for the vaccine.
- One false rumor is that the federal government told the manufacturers to stop making seasonal vaccine earlier than they had planned to switch production to H1N1
- The reality is that the manufacturers are finishing their planned number of seasonal flu doses (to about 97%) and have moved on to their planned H1N1 production
- Another false rumor is that the manufacturers switched to H1N1 vaccine production because they will make more money on the new vaccine. There is no evidence to support this rumor.
You may have heard rumors related to the seasonal influenza vaccine supply.
Individuals should be encouraged to seek seasonal flu vaccine.
- There are many millions of doses yet to be distributed this season.
- Most will be able to obtain vaccine from their usual provider, but some will have to obtain the vaccine from an alternative provider
- People can find seasonal vaccine by checking the American Lung Association web site that identifies clinics that have influenza vaccine available: http://www.flucliniclocator.org/
- We are still early in flu season; there is still time for people to get vaccinated to protect them from becoming ill.
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