H1N1 Vaccine: The Slow Supply Slogs On

It had been a month since I wrote about the H1N1 influenza vaccine supply, and I was curious what had happened during November. The numbers aren’t pretty.

According to a Dec. 4 Webpost by the Centers for Disease Control and Prevention, as of Dec. 3, a total of 63.3 million H1N1 doses had shipped to U.S. providers. Shipments began Oct. 5, so this total represented the output of the first 8.5 weeks of H1N1 vaccine availability. That works out to an average of about 7.5 million doses shipped per week.

To put the numbers in perspective, the U.S. government paid for  production of roughly 200 million doses for administration to Americans this season. As recently as Sept. 18, CDC officials predicted that by October, 20 million new doses would reach providers weekly, a timetable that suggested all 200 million doses would be available by the end of this year. Sure looks now like that’s not going to happen.

Officials running the H1N1 vaccine program began warning in late October that the supply stream wasn’t moving nearly as fast as initially predicted because the vaccine seed strains turned out to have unexpectedly low yields. A little analysis of how the supply has dribbled out so far provides  probably the best guidance on what the near future may hold for when all 200 million doses will reach the U.S. public. 

Here is the vaccine picture in a little more detail. The numbers come from the almost daily tally that the CDC updates (at least give the agency credit for transparency). I focused on the number of doses shipped, rather than the number allocated, as this seems like the most relevant statistic. Here is a week by week tally of how many doses shipped, and the running cumulative total:

Week     Ending Date     Doses Shipped                          Cumulative Total

1                  Oct 12                3.9 million                                  3.9 million

2                  Oct 19                4.9 million                                  8.8 million

3                  Oct 26                4.9 million                                 13.7 million

4                  Nov 2                 8.1 million                                 21.8 million

5                   Nov 9                9.7 million                                31.5 million

6                  Nov 16               9.2 million                                40.7 million

7                  Nov 23              8.9 million                                 49.6 million

8                   Nov 30            7.4 million                                 57.0 million

**8.5           Dec 3                6.3 million**                             63.3 million

Unless a sudden breakthrough in the supply stream occurs, these numbers show some revealing trends. The 3 days since Nov. 30 (what I highlighted with stars to stress that it wasn’t a full week) were the best showing yet, so maybe the process is speeding up. The pace for those 3 days works out to about 15 million doses/week. Even at that rate the last of the 200 million doses won’t reach providers till late January.

But another valid interpretation is that the spurt during the first days of December was catch up from the slow week ending Nov. 30, which included Thanksgiving. If you discount that as an outlier, past performance suggests that the best supply rate we can expect in the coming weeks is about 10 million doses/week. In that case the 200 million dose goal gets met sometime in March.

I think it would be safe to call that timetable disappointing, especially compared with earlier expectations from the CDC and the U.S. Department of Health and Human Services. 

—Mitchel Zoler (on Twitter @mitchelzoler)

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Filed under Family Medicine, Health Policy, Infectious Diseases, Internal Medicine, Primary care

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