When The Shots Flu The Coop

Got your flu shot yet? That became a loaded question this year as traditional vaccination campaigns gave way to pleas that healthy Americans step aside to keep the vaccine available for those who need it the most.

The flu-shot shortage spilled out of the medical domain into society and presidential politics. Luckily, the flu season is off to a mild start. By year's end, some states reported dwindling demand for flu shots, as many people apparently followed government advice or gave up because of frustration or apathy.

News of the shortage mixed with continuing concern over the prospect of a deadly worldwide outbreak of flu someday.

And it shared the headlines with some other major medical news this year, much of it regarding the safety of prescription drugs. There was the recall of the arthritis drug Vioxx from the market in late September because of links to heart problems. Other drugs like it were also questioned. And there were continuing concerns over antidepressant use in children, which led federal regulators in October to order that all antidepressants carry warnings that they increase the risk of suicidal thinking and behavior in children.

The flu-shot shortage appeared in early October. The nation's expected supply was suddenly cut in half when British regulators suspended the license of a Liverpool vaccine-making plant owned by Chiron Corp. Shocked public health officials called on healthy Americans to refrain from getting the shot, so supplies could be conserved for high-risk people like children ages six months to 23 months and adults 65 or older.

Suddenly, a plain old flu shot became a hot commodity.

"Tomorrow is Election Day," comedian Jay Leno told his "Tonight Show" audience. "How many are voting first thing in the morning? How many are voting later in the day? How many are going to wait until everyone else is in line to vote and then sneak in and get a flu shot?"

Some Americans went elsewhere for a vaccination. One drugstore just north of the border in Saskatchewan, Canada, attracted 80 Americans on a single day. Meanwhile, vaccine suppliers were accused of price-gouging, including one company sued by the state of Florida for allegedly boosting the price of flu vaccine by more than 900 percent. The case was settled.

Some states felt compelled to outlaw giving flu shots to people who aren't at high risk, and some towns set up lotteries to parcel out their scarce supplies.

And the issue made political waves. After Senate Majority Leader Bill Frist, R-Tenn., made his office a makeshift clinic for giving shots to senators, there were cries of unfairness. And while neither President Bush nor Democratic challenger Sen. John Kerry got a flu shot, Kerry blamed the White House for the shortage during the campaign.

But health experts are looking beyond the current flu season to an even bigger project: getting ready for the next global outbreak of killer flu, a pandemic. Projections for the death toll range from 2 million to more than 50 million.

The germ would probably emerge in Asia. Health officials there are keeping a close watch on bird flu in chickens, and especially its spread from chickens to humans. That's because a bird-flu virus could run rampant through a human population if it gets the ability to spread easily from person to person, and if people carry no natural immunity to it.

More than 40 cases of humans sickened with bird flu have been recorded this year in Thailand and Vietnam, with more than 30 deaths. Especially worrisome was a suspected case of human-to-human transmission in Thailand, in which a 26-year-old woman died in September after apparently getting the virus from her 11-year-old daughter. Luckily, no epidemic followed.

The federal government took several steps this year to deal with the threat of a pandemic, such as publishing a plan to respond to that event and boosting its stockpile of antiviral medicine.

In addition, the government awarded a contract to the nation's sole flu-shot supplier to move toward year-around vaccine production, which should allow faster action if a killer flu strain emerges. Federal officials also announced a project to crack the genetic code of thousands of human and bird flu viruses. That should help scientists find targets for vaccines and therapies against both ordinary flu and pandemic flu viruses.

And the government awarded contracts to two companies to produce and test an experimental bird flu vaccine, which might come in handy if a pandemic appears.

That worrisome event probably won't happen this flu season, Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, told reporters recently. But it's on the horizon.

"We have a lot of chickens getting infected, and we're getting more and more (virus) jumping from chicken to human," he said.

Nobody can predict when a pandemic will arrive, but "is it going to happen sometime in the reasonable future? ... The answer is yeah," Fauci said "We're due for it."