Vaccinating Everybody Will Cost You

It's never been done before but it is the official goal: Vaccinate every American against a new flu virus between next fall and the following spring.

A tall order, and costly. How does $17 billion strike you?

 

Now, officials haven't yet decided to pull the trigger on a mass-vax campaign. They won't until next fall. First they'll assess what kind of threat the new swine flu virus presents. And they'll look at some data about the safety and efficacy of the new vaccine.

But what happens if they decide it's a go? The new vaccine won't be available all at once. It'll be doled out according to a rationing scheme yet to be worked out. Fire-fighters, doctors, and nurses are likely to be among the first to get it, followed by children and young adults, with everybody else perhaps months later.

Two Shots For Good Measure

Everybody's likely to need two doses to get adequate immunity. So there will have to be some system to keep track of who's gotten the first round so they can be called back for dose two.

Then, the price tag. Jeff Levi, of the nonpartisan Trust for America's Health, has run the numbers and tells me it will cost $8 billion just to buy the vaccine — 600 million doses of it for 300 million Americans.

Why So Expensive

Levi says it will take at least $15 a dose to administer the vaccine. That's another $9 billion, for a total of $17 billion.

So far, the House has voted a $2.05 billion appropriations item for flu vaccine. And this week President Obama asked Speaker Nancy Pelosi to provide another $2 billion plus the authority to redirect already appropriated funds from other programs. Levi thinks all this could add up to about $11.6 billion.

That leaves a gap of more than $5 billion. No telling yet where it would come from.

U.S. Suppliers Can't Make Enough

One more challenge is cranking out 600 million doses of the vaccine. Right now there's only one plant in America—Sanofi Pasteur—certified to make conventional killed-virus flu vaccine. (Another company makes a live attenuated-virus nasal spray vaccine.)

Sanofi's Pennsylvania plant can make 100 million doses of the usual, trivalent flu vaccine (containing 3 flu virus strains) that's given every year. That might be stretched to 300 million doses of a single-virus vaccine, and stretched further by adding an immune-booster called an adjuvant.

But it's pretty clear the United States will have to buy a lot of swine flu vaccine from abroad to meet the goal of having enough for everybody, and other countries have the same idea. Levi says we'd better get in line soon.

P.S. Helen Branswell of Canadian Press has a revealing interview with the chief of the World Health Organization on the WHO's handling of swine flu. Margaret Chan says she's still not ready to declare a pandemic, but none of her experts think the new H1N1 virus will fizzle.