Agency Fights Criticism Over Vaccine-Handling : Government: General Service Administration insists it can ship drugs for children’s program. Clinton’s plan assailed by Congress, manufacturers.

Morris Boiman normally spends his time overseeing shipments of toilet paper and paper clips to federal office workers. But by a strange quirk of fate, he now finds himself serving as a primary defender and architect of one of President Clinton’s major initiatives: a $500 million-a-year program to vaccinate preschool children.

Boiman, an ebullient ex-taxi driver, was thrust into this unusual role when the Clinton Administration made a hotly disputed decision to establish an entirely new, government-run vaccine distribution system headquartered in the giant government supply depot here in this distant suburb of Philadelphia.

It might have been seen as a vote of confidence in Boiman and his co-workers at the General Services Administration’s 3-year-old, state-of-the-art facility to be chosen for such an important task.

But much to their chagrin, it has turned into a public relations nightmare--forcing them to defend their abilities, the reputation of their agency and the competence of government bureaucrats in general.

Indeed, the vaccine program is controversial in large part because of the central role being played by GSA, the government supply agency with a reputation for fouling up. Just last week, Congress’ General Accounting Office issued a report questioning the GSA’s ability to handle the vaccine distribution, and some prominent lawmakers have moved to delay the program past its scheduled Oct. 1 start date.

Of course, it is not entirely a surprise to GSA employees that some people in Washington are questioning their ability to deliver millions of doses of precious vaccine to physicians around the country.

Boiman admits that even he was initially daunted by his new assignment. As he recalls, “When it was first described to me, I asked, ‘How will we ever do it?’ We didn’t know (anything) about handling vaccines.”

Nor do GSA officials deny that they have contributed to the consternation by deciding to keep the delicate vaccines in close proximity to rooms where they store paint, turpentine and other highly flammable materials. While the vaccine will be surrounded by double-thick fire walls, a catastrophe might destroy millions of dollars worth of childhood pharmaceuticals.

Nevertheless, Boiman and his colleagues are now convinced that they can do the job, and they have come to see themselves as pawns in a larger political struggle between the Administration and the drug industry.

So far, GSA has invested $750,000 in storage freezers, a computer and other equipment needed for the President’s program. The floor of the future vaccine department already has been marked to show where new equipment will be placed, and officials say they will be ready to begin shipping by mid-September.

“After all,” Boiman said confidently, “this is not rocket science. It is not difficult. We can do it.”

The attention focused on GSA is understandable, considering that the Vaccines for Children program was Clinton’s first major domestic policy initiative, and because the health of many preschool children hangs in the balance. Some states, such as California, will depend exclusively on the Burlington facility for giving children free or low-cost vaccinations against such diseases as polio, measles, mumps, diphtheria and whooping cough.

Under the President’s program, the government is expanding the existing opportunities for children to get these free or low-cost immunizations by making them available through more than 70,000 private physicians. At present, free or low-cost shots are available only through public health clinics.

The task facing employees at the GSA distribution center looks simple enough. They will accept deliveries of vaccine from manufacturers, all of whom are located within several hundred miles of this facility; they will put the vaccine into specially designed boxes to be shipped to physicians, and then they will give them to Federal Express to deliver.

But the General Accounting Office, the investigative arm of Congress, and Sen. Dale Bumpers (D-Ark.), who is trying to halt implementation of the program, insist that the vaccines could lose their effectiveness as a result of GSA’s lack of experience in handling them. Until now, the vaccines have been distributed to physicians only by the manufacturers. In particular, GAO criticized GSA’s failure to test the shipping containers to see if they will keep the vaccines sufficiently cool.

In response, William P. Nichols, an official with the federal Centers for Disease Control and Prevention in Atlanta, who is helping with GSA planning, said that Bumpers and the GAO have exaggerated the difficulty of shipping vaccines. He said it is a simple matter of using dry ice to keep the polio vaccine frozen and regular, picnic-style ice packs to keep the other vaccines at around 34 degrees.

GSA officials note that even the pharmaceutical companies rely on Federal Express to ship their vaccines. They also stress that they will be abiding by the same regulations as the companies.

The only real difference between distribution by the government and the pharmaceutical companies, they say, is the cost. The CDC estimated the GSA will realize a savings of about $30 million.

GSA claims to be able to ship vaccine for 40 cents per dose--one fifth the amount the Administration estimates it would cost privately. Vaccine manufacturers dispute these figures and, in any case, maintain they could beat the government’s price.

Boiman insists he can ship vaccine more cheaply than the manufacturers for three reasons: GSA will consolidate vaccine from several companies into a single shipping container; GSA gets the lowest possible price from Federal Express, and GSA is not trying to make a profit.

Understandably, GSA is defensive about the criticism it has received since the vaccination distribution program became an issue in Congress.

Boiman says he was taken by surprise when GAO auditors showed up without warning at the Burlington facility. As a result, he said, he supplied them with incomplete information.

Under questioning by the GAO auditors, Boiman acknowledged that he would have preferred a few more months to implement the program. He said the GAO misinterpreted his remarks to mean that the GSA facility would not be ready to implement the program as scheduled Oct. 1.

But GSA’s biggest handicap has nothing to do with the details of the vaccination distribution program. Critics of the President’s vaccine program have been quick to bring up past problems at the agency. They cite as an example a 1992 audit that found GSA had sold $123 million worth of government property for $13 million.

Boiman and his co-workers insist the GSA’s bad reputation is based on ancient history. Not long ago, they noted, GAO auditors praised the construction and operation of the Burlington center.

Indeed, the controversy over the vaccination distribution program comes at a time when the GSA, under Administrator Robert W. Johnson, who previously headed a Fortune 500 company in Southern California, has undertaken a serious effort to burnish its image.

Some GSA officials see the vaccine distribution program as an opportunity to help reverse the agency’s decline. If GSA succeeds in distributing these vaccines, Boiman predicted, it will attempt to take over vaccine distribution for the Defense Department and the Veterans Affairs Department.

According to GSA officials, vaccine makers are fueling the controversy in Congress because the program cuts into their profits.

Manufacturers now are forced to sell about 50% of their vaccine to the government at sharply discounted prices. Under the new program, they likely will be required to sell about 80% of their vaccine at a discount. Their distribution profits also will be cut by the government-run system.

Nevertheless, the vaccine manufacturers appear to be cooperating with government officials in implementing the program. Five of 15 anticipated purchase contracts with the manufacturers already have been agreed upon.

Nor is Bumpers known to be aligned with the industry.

Before his reelection in 1992, Bumpers received $2,000 each from two of the biggest vaccine makers, Merck & Co. and Connaught Laboratories. But neither Bumpers nor the other leading critics of the plan--Sen. John C. Danforth (R-Mo.) and Reps. Scott Klug (R-Wis.) and Ron Wyden (D-Ore.)--are among the top recipients of drug industry campaign contributions in Congress.

As Clinton Administration officials see it, Bumpers opposes the President’s plan primarily because he was an early architect of the existing childhood program and because his wife, Betty, is closely identified with current efforts to immunize preschoolers.