The first fateful policy decision, made last spring, was to forgo vaccine additives—called adjuvants—that activate the immune system and make shots more potent. Adjuvants allow a smaller supply of vaccine stock to be stretched across more doses. These adjuvants are included in H1N1 vaccines world-wide, but not in the U.S.Once again, we see that overregulation, passed in the name of public health, is actually preventing people from getting immunized against the flu. The hype over swine flu is likely overheated, but it is a particularly nasty strain. Does anyone doubt that the private sector would have been able to distribute vaccine faster and cheaper than government, had it been given the opportunity to do so outside of burdensome and counterproductive regulations?
Why do adjuvants matter? An adjuvanted H1N1 vaccine being used in Europe contains 3.75 micrograms of vaccine stock. The same vaccine in the U.S., without the adjuvant, requires 15 micrograms of vaccine for equal potency. If we used adjuvants, we could have had four times the number of shots with the same raw material.
The second cautious decision was to require that the H1N1 vaccine be a single shot. The government demanded single-dose syringes because they contain smaller amounts of thimerosal than multi-dose vials. This mercury-containing vaccine preservative continues to stir concern it can trigger childhood autism, even though this has been firmly disproven.
The third policy decision was to stick for too long with a proven, but slow process for making flu shots that uses chicken eggs to grow the raw vaccine material. Shots can be made much faster using mammalian cells to grow vaccine, and this process is already being used in Europe. The cell-based vaccines are unlikely to be approved in the U.S. Our precaution when it comes to vaccines means we don't easily embrace novel technologies, even if the Europeans would part with some of their limited supply.
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Thursday, October 29, 2009
Death by Government: Swine Flu Vaccine
Scott Gottlieb writes in the Wall Street Journal that three flawed policy decisions have led to a shortage of swine flu vaccine in the United States.