Projection For Swine Flu Vaccine Was Too Optimistic

STEVE INSKEEP, host:

News that the swine flu vaccine is safe might not be much comfort to people who can't get it. The government says the virus is now widespread in 48 states. Hospitalizations and deaths are increasing. And the government still has less vaccine on hand than expected. Presidential advisor, David Axelrod, defended the administration's efforts last weekend on CBS.

(Soundbite of TV show, �Face the Nation�)

Mr. DAVID AXELROD (Presidential advisor): We were told by the manufacturers of the vaccine - and we started that process very quickly - we were told by the manufacturers that they would have 40,000 doses ready by last week. We have 28 - I'm sorry - 40 million doses. We have 28 million as of last week. It's growing every day. We expect to get 10 million this week. And we're catching up quickly. But we did represent to the public what we were told by the manufacturers and that turned out not to be the case.

INSKEEP: Let's assess the government's response now with Michael Osterholm. He's director of the Center for Infectious Disease Research and Policy at the University of Minnesota. He's on the line.

Good morning.

Mr. MICHAEL OSTERHOLM (Director, Center for Infectious Disease Research and Policy): Good morning to you.

INSKEEP: Is what we just heard a fair defense?

Prof. OSTERHOLM: Well, first of all, we've known for many, many years that this influenza vaccine is a very difficult vaccine to make because it's always variable around how much virus will actually grow in the chicken egg. So I think many of us were concerned that the projections made earlier this year may have been far too optimistic, given that. But having said that, there is a lot of truth to the fact that no one really knew what the amount would be and no one did anything wrong in terms of not making the vaccine the right way. They've made it safely. They've made as much as they can make, and we're just now living with the 1950s technology that is, unfortunately, terribly unreliable in amount - not in safety, but in amount.

INSKEEP: Was there any substantive damage done by making it an overoptimistic prediction?

Prof. OSTERHOLM: Well, I think there is, in the sense that we still have a significant communication problem with the public. We now have about 30 million doses that have been made. However, even as of Friday, only 16.9 million of that has been shipped. You've heard that we're going to need two doses in children under the age of 10, and there's at least 150 million Americans that probably want this vaccine, and a large number of those want it right now.

If you think about the fact that we're ramping up at about 10 million doses a week for the next few weeks, that means that there are many Americans who will not have access to this vaccine well after Thanksgiving, while the disease continues to ramp up now. I think you're going to see a collision course kind of scenario here in the next two to three weeks as more and more Americans want the vaccine, have this perception because of the messaging that there's a lot of it out there and not be able to get it, and I think you're going to see some real angry people out there. And we've got to start to better communicate to them what the issues are, how much is there and when they can really expect to get it.

INSKEEP: How do you go about that? I mean, the fact is no matter what you tell people, they're going to want the vaccine.

Prof. OSTERHOLM: I think that's absolutely the case, but I think what we have to do is just be honest with them and say this is how much we have. This is why we have what we have and why we're trying to get it to the people we are.

The first and most important message is those people who are at the highest risk for having the severest disease: pregnant women, individuals with asthma, people who are overweight, particularly those obese. People like that really need to get this vaccine first, because it's not that the rest of us won't get disease, but they are much more likely to have severe disease.

I think the second thing that we have to do is get the message out then how to get this vaccine effectively. What we're seeing happen now is that people in their almost panic-like mode are calling medical clinics every day, they're calling pharmacies every day, and we're starting to see phone lines tied up where we can't do routine business. People who have other conditions are having a hard time getting through to the medical clinic.

We've got to get those people out of that scenario. We've got to get them into phone lines where they can call and know where the vaccine's at and communicate more clearly so that I know when my chance is. Part of the problem right now is people just don't know when it's going to be there. They just keep turning to the media: there's lots of vaccine out there, which is, as we just discussed, is not the case yet.

INSKEEP: Mr. Osterholm, one other question, this disease comes after a period of years in which the government has said it's been trying to prepare for a bioterror attack of some kind if that were to happen, and there were also discussions of other pandemics. What does the swine flu episode tell us about the nation's preparation for that kind of disaster?

Prof. OSTERHOLM: Well, actually, not that much. We are much better prepared for a bioterrorism event. Remember, if that occurs, that's going to occur in likely very specific locations, like�

INSKEEP: Oh, like somebody poisons a city, or something like that.

Prof. OSTERHOLM: Yeah, in other words, it's going to have - this is happening, every village, town, city, county, state at the same time. And it's also relying on the one, I consider, most vulnerable vaccine we have in terms of production, the influenza vaccine. So we need to clearly deal with this 1950s technology, but I think that it would be unfortunate to draw any conclusions that we are or are not prepared for any bioterrorism events. I think we're much better prepared there.

We just need - as a world, not just the United States, but the entire world needs to address this issue. We can no longer reuse this old technology to rely on - for influenza vaccine.

INSKEEP: Professor Osterholm, thanks very much.

Prof. OSTERHOLM: Thank you very much.

INSKEEP: Michael Osterholm is director of the Center for Infectious Disease Research and Policy at the University of Minnesota.

(Soundbite of music)

INSKEEP: You're listening to MORNING EDITION from NPR News.

Copyright © 2009 NPR. All rights reserved. Visit our website terms of use and permissions pages at www.npr.org for further information.

NPR transcripts are created on a rush deadline by an NPR contractor. This text may not be in its final form and may be updated or revised in the future. Accuracy and availability may vary. The authoritative record of NPR’s programming is the audio record.