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Published October 25, 2009, 12:00 AM

Ahlin: A ‘chicken coop bureaucracy’ in charge of the H1N1 vaccine

Why does Hurricane Katrina come to mind?

By: Jane Ahlin, INFORUM

Why does Hurricane Katrina come to mind?

As October tilts toward November, the trickle of H1N1 (swine flu) vaccine into states across the country says volumes about an overall lack of U.S. preparedness. Because the need has been known for months, the insufficient supply is more than frustrating; it’s inexcusable.

Think back to April and the international warnings about an H1N1 “pandemic.”

True, the warnings came as a shock, and at the time, there were almost as many questions about worldwide overreaction as there were about a worldwide epidemic.

And yet, the notion that six months later the U.S. would not have produced enough vaccine to cover vulnerable populations seemed unlikely. After all, we’re the nation with the most resources on Earth. Meeting tough challenges is what we do.

Well, it’s what we used to do. In recent years, our confidence has taken a hit (think Hurricane Katrina). In the case of H1N1, nothing points to our loss of self-assurance more than the reasons – excuses – given for the current lack of vaccine.

For example, we’re told that the powers that be couldn’t come up with a sufficient number of chicken eggs this summer to make the vaccine. (We’re being assured they have enough now, however, and it won’t be long.)

Chicken eggs? Sounds more like chicken coop bureaucracy to me.

Ignoring the fact that making vaccine with chicken eggs is a 50-year-old process that needs updating, does anybody really believe that explains why the promised “120 million doses,” which should have been available by now, turned out to be “13 million doses”? Put into terms Red River Valley folks understand all too well, that would be like promising 1,000 sandbags but sending 100 along with assurance that as soon as the flood was over, we could get the other 900.

If I seem a wee bit sensitive on the subject, I am. A young family I’m particularly close to has been among the afflicted; in fact, the dad and 2-year-old ended up with cases of pneumonia on the tail end of the flu. Adding to worry for the family, the mom is pregnant and had to go through two courses of Tamiflu. As yet, she hasn’t come down with the disease, but she hasn’t been able to get the vaccine, either. Thankfully, the other family members were healthy going into the disease and now are healthy again. Still, it was a month of missed work for the parents and missed preschool and school for the kids.

And that’s just one family. Multiply its experience by the rate children infect one another and it’s no wonder school officials are in a dilemma. Some, including the Crookston, Minn., school system, decided to close schools for a few days to stem the tide of flu absences. The problem is that without vaccinating the school population, there’s bound to be another surge.

Officials from the Centers for Disease Control and Prevention have made clear that deaths from H1N1 happen disproportionately to younger people. Although we’re not used to thinking in those terms, kids, pregnant women and young adults are the most vulnerable populations for H1N1. Whereas about “90 percent of (seasonal flu) fatalities occur in those over 65,” almost 90 percent of H1N1 fatalities occur in those under 65, with almost 25 percent occurring in the population under 25 years old.

Most recently, we’ve been told that significant regional supplies of H1N1 vaccine won’t be available until after Thanksgiving. Certainly, we’ll take it when we can get it, but it will be too late to make a big difference in the severity of flu for this year. At least, if the Associated Press report of a recently released Purdue University study is correct,

“63 percent of the U.S. population will have caught the (H1N1) virus” before 2009 ends.

That’s unacceptable, and, in the context of the current health care debate, should give us pause. If the delivery of care gets lost in bureaucracy, access won’t mean much.


Ahlin is a regular contributor to The Forum’s commentary pages.

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