Vaccine shortages

Federal and drug-company officials are describing some shortages of children’s vaccines as the temporary result of manufacturing changes. But a more long-term reason may be that fewer companies are producing these important drugs, pushing Congress toward the conclusions in a recent report from the Institute of Medicine.

The institute, part of the National Academy of Sciences, found that there are only four major vaccine manufacturers in the world today – just two in the United States – compared with more than 16 two decades ago. The shortage problem has been growing since at least 1993, when a committee from the institute noted that, “the private sector alone cannot sustain the costs and risks associated with the development of most” children’s vaccines.

The shortage of manufacturers means that the routine vaccinations of children to protect against rubella, mumps, diphtheria, whooping cough, tetanus, etc. may not be routine much longer. The federal government sent to states last week a report of vaccine shortages for four of 11 common diseases, with intermittent shortages in the vaccine against three others.

The group from the Institute of Medicine wants to meet this problem by creating a National Vaccine Authority, which would conduct in-house research and development, assist companies in piloting vaccines and procure vaccines on its own. It would also help small biotechnology companies with the production of expensive pilot lots of vaccines.

Had the institute’s recommendations been made before September, they might not have made much of an impression on the Bush White House or Congress, but now that the nation’s inadequate supply of an anthrax vaccine has been extensively discussed the proposal of an authority to monitor, encourage, assist and, if necessary, buy needed vaccines is more urgent. Certainly, Congress should have no difficulty supporting the idea of a vaccine authority; the debate would come over what powers the authority should have.

Federal health officials predicted the immediate shortages of vaccines should ease by next spring. The long-term problems will remain, however, making this an issue Congress should start discussing now, well before a crisis in preventable disease occurs.