The Selling of the Vaccine

Last week, the new vaccine for pandemic influenza H1N1 reached the American public, with some 4 million doses available nationwide and promises that an additional 20 million doses will reach U.S. vaccine dispensers weekly through the rest of this year.

courtesy Sanofi Pasteur

courtesy Sanofi Pasteur

Along with the vaccine came a high-intensity publicity campaign by government officals urging the American public to get vaccinated. On Tuesday and Wednesday, Kathleen Sebelius, Health and Human Services secretary, appeared on a series of morning news shows promoting the vaccine. Also last Tuesday, Dr. Thomas R. Frieden, director of the Centers for Disease Control and Prevention, spoke in a press conference where his main message was that the new vaccine was safe and effective. On Friday, the CDC’s Dr. Anne Schuchat, director of the National Center for Immunization and Respiratory Diseases, made similar pitches in a second news conference.

A cynic might say the CDC, HHS, and possibly the entire Obama administration has a major stake in making sure the H1N1 vaccine gets widely used and succeeds. After all, HHS has spent more than $6 billion in this effort and has placed a whole lot of reputation, credibility, and careers on the line. If the vaccine becomes mired by an adverse effect,  poor performance, or an unconvinced public that refuses to get vaccinated, it’s easy to expect that heads would roll, embarrasment would run rampant, and the vaccine cause would be set back a few decades.

The 2009 H1N1 vaccine program is a public health juggernaut that’s a lot more than business as usual for the CDC and HHS. As Dr. Schuchat noted on Friday, the CDC usually handles about 10% of the annual, seasonal flu vaccine program, with 90% in other hands. In contrast, the H1N1 vaccine is 100% Uncle Sam, with the government fully responsible for footing the bill and hence also in line to take the credit or the blame depending on how it sorts out.

But there’s more to the last week of salesmanship than bureaucratic responsibility and fear of failure. While I have no prior, personal experience covering Secretary Sebelius or Dr. Frieden, I have seen Dr. Schuchat talk on various infectious disease and public health issues over the years, and, based on that history I’m convinced she now sincerely believes this vaccine is what’s best for the health of the nation. It’s moments like these, when a possibly calamitous infection is knocking on the door, that the public-health lifers at places like the CDC train for and live for.

Last week also brought the good news that the uptake bar might not be set very high for the H1N1 vaccine to succeed. A modeling analysis released by Annals of Internal Medicine showed that vaccinating 40% of the population in a hypothetical city of 8 million people in October or November stood to prevent morbidity in tens of thousands and save hundreds of millions of dollars. Even vaccinating just 15% of the population in October could avert more than 700,000 infections and more than 700 deaths and save more than $160 million in one large city.

—Mitchel Zoler, 12:30 AM Oct.12 in Wynnewood, PA (on Twitter @mitchelzoler)

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Filed under Family Medicine, Infectious Diseases, Internal Medicine, Pediatrics, Practice Trends, Primary care

One response to “The Selling of the Vaccine

  1. Pingback: Selling of the H1N1 Vaccine: Phase 2 « EGMN: Notes from the Road

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