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H1N1 vaccine shortage could be political pitfall for Obama

Last week's White House declaration of a national emergency over swine flu prompted many people to get vaccinated who had previously taken a blase attitude toward the threat. But it also pointed up a worrisome reality: There currently isn't enough vaccine available for everyone who needs or wants it.

Back in late July, the administration was confidently predicting there would be enough doses of the H1N1 vaccine available to immunize 160 million Americans by the beginning of this year's flu season. But since then that number has been repeatedly cut -- first to 40 million doses and then, earlier this month, to just 28 million doses, less than a quarter of the original estimate. Meanwhile, people have been flooding clinics and doctor's offices around the country with requests for the vaccine.

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Clearly, the government overpromised on its ability to organize and implement the massive H1N1 vaccination program it envisioned. Now it faces the prospect of a collapse in public confidence similar to what the administration of President George W. Bush suffered over its botched handling of relief efforts in New Orleans after Hurricane Katrina in 2005. If the H1N1 epidemic, which has already killed about 1,000 Americans, turns into a deadly pandemic on the order of the 1918 Spanish Flu, which killed an estimated 50 million to 100 million people worldwide, there's little doubt President Barack Obama will pay an enormous political price for the nation's lack of preparedness.

Part of the problem has involved the difficulty of quickly manufacturing large quantities of the vaccine. The drug companies have experienced bottlenecks in putting the vaccine in vials and syringes, and there also seem to be distribution problems that have prevented health officials from making vaccine available to the highest-risk groups first -- pregnant women; children and young adults between 6 months and 24 years old; and adults 25 to 64 with chronic illnesses or weakened immune systems. In some parts of the Baltimore-Washington region there's a surplus of vaccine, while in others its availability is near zero.

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At this point, federal officials can't even guarantee there will be enough vaccine to immunize everyone in the highest-risk groups before flu season peaks later this year. If the nation manages to avoid a Spanish Flu-type pandemic, it may be as much due to luck -- so far most people infected by H1N1 have suffered relatively mild symptoms -- as to planning. President Obama's emergency order didn't signal a jump in the virulence of the virus; it merely authorized hospitals to set up emergency facilities outside their grounds to isolate flu victims from other patients in the event they are suddenly overwhelmed with seriously ill people. But if Americans were ever actually forced to triage millions of patients across the country, whatever political capital President Obama now enjoys would instantly evaporate under the perception of his administration's inability to cope with a major public health crisis.

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