The Bird Flu Pandemic Blues: Is the US Prepared for Outbreak?
by Jim Kouri, CPP
With the immense media coverage of the Avian Bird Influenza, concern has been rising about United States preparedness to respond to vaccine shortages that could occur in future annual influenza seasons or during an influenza pandemic--a global influenza outbreak.
Although the timing or extent of a future influenza pandemic cannot be predicted, studies suggest that its effect in the United States could be severe, and shortages of vaccine could occur which increases the danger Americans face. For the 2004-05 annual influenza season, the nation lost about half its expected influenza vaccine supply when one of two major manufacturers announced in October 2004 that it would not release any vaccine because of problems with the manufacture of the serum.
Recently, analysts from the General Accounting Office examined federal, state, and local actions taken in response to last year's shortage, including lessons learned from past problems. The nation's experience during the unexpected 2004-05 vaccine shortfall offers insights into some of the challenges that government at all levels will face in a serious or severe pandemic.
A number of lessons emerged from federal, state, and local responses to the 2004-05 influenza vaccine shortage that carry implications for handling future vaccine shortages in either an annual influenza season or a devastating influenza pandemic.
First, limited contingency planning slows response. At the start of the 2004-05 influenza season, when the supply shortfall became apparent, the nation lacked a contingency plan specifically to address severe shortages. The absence of such a plan led to delays and uncertainties on the part of state and local public health authorities on how best to ensure access to vaccine by individuals at high risk of severe influenza-related complications.
Second, a streamlined strategy to expedite vaccine availability are key to an effective response. During the 2004-05 shortage, for example, federal purchases of vaccine licensed for use in other countries but not the United States were not completed in time to meet peak demand. Some states' experience also highlighted the importance of methods of transferring available vaccine quickly and easily from one state to another.
Third, effective response requires clear and consistent communication. Consistency among federal, state, and local communications is critical for averting confusion. State and local health officials also emphasized the value of updated information when responding to changing circumstances, using diverse media to reach diverse audiences, and educating healthcare providers and the public about prevention alternatives.
Over the past five years, GAO has urged the Department of Health and Human Services to complete its plan to prepare for and response to an influenza pandemic. GAO has reported on the importance of planning to address critical issues such as how vaccine will be purchased and distributed; how population groups will be given priority for vaccination; and how federal resources should be deployed before the nation faces a pandemic. On November 2, 2005, HHS released its pandemic influenza plan, which is being examined by several government agencies including the GAO, Centers for Disease Control, Department of Homeland Security and others.
VACCINE FOR BIRD FLU
Initial testing showed the first U.S. vaccine against H5N1 bird flu virus is safe, but only partly protective, researchers reported Wednesday in The New England Journal of Medicine.
The vaccine sparked a protective immune response in 54 percent of the 451 volunteers who got two shots of the highest dose, which is 90 micrograms of antigen, 12 times the use in the regular winter flu shot.
The experimental bird flu vaccine sparked a slightly lower immune response in 70 percent of the recipients, but scientists could not determine whether such a response is protective.
Humans have never been exposed to the H5N1 bird flu virus, and it takes time for the immune system to ramp up to fight unique types of influenza, said lead researcher Dr. John Treanor of the University of Rochester in New York.The good news is that the vaccine seems to be safe, even at very high doses.
Researchers are giving the receivers a third dose to see if the vaccine would work better, while other studies are seeking to strengthen the effect of the vaccine at regular dose through adding immune-enhancing chemicals, alum or MF59.
The vaccine is made by a unit of Sanofi-Aventis and based on a version of H5N1 virus culled in Vietnam in 2004. It is unknown if the vaccine could partly protect from a slightly different version that emerged in Indonesia last year.
Sources: US General Accounting Office, Department of Health and Human Services, Centers for Disease Control, Department of Homeland Security, the New England Journal of Medicine, National Association of Chiefs of Police Security Committee
Jim Kouri, CPP is currently fifth vice-president of the National Association of Chiefs of Police. He's former chief at a New York City housing project in Washington Heights nicknamed "Crack City" by reporters covering the drug war in the 1980s. In addition, he served as director of public safety at a New Jersey university and director of security for a number of organizations. He's also served on the National Drug Task Force and trained police and security officers throughout the country. He writes for many police and crime magazines including Chief of Police, Police Times, The Narc Officer, Campus Law Enforcement Journal, and others. He's appeared as on-air commentator for over 100 TV and radio news and talk shows including Oprah, McLaughlin Report, CNN Headline News, MTV, Fox News, etc. His book Assume The Position is available at Amazon.Com, Booksamillion.com, and can be ordered at local bookstores. Kouri holds a bachelor of science in criminal justice and master of arts in public administration and he's a board certified protection professional.