Sneezing, Aching and Anger

Even the most ardent libertarian is hard-pressed to argue against government protection from serious public health dangers. Tuberculosis. Typhoid fever. Polio. Influenza. All communicable, predictable and, in varying degrees, deadly. It’s not just sympathy for the suffering victims that drives the idea. Even a week off work by one of every dozen employees carries a shattering total cost to the national economy.

So why was the health bureaucracy of the richest nation in the world caught off guard this week by the loss of half the 100 million flu vaccine doses it had been expecting this season? The shutdown of a key vaccine factory in Liverpool, England, because of bacterial contamination seemed to catch the U.S. government, to say nothing of thousands of hospitals, completely by surprise.

British regulators detected manufacturing errors that inspectors from the U.S. Food and Drug Administration missed. Though it’s possible that the full story won’t be known for months, it’s already abundantly clear that when vaccine maker Chiron Corp. first revealed serious contamination problems at its factory in August, British health officials quickly found other suppliers. Their citizens are not facing a vaccine shortage. U.S. doctors and hospitals will have to turn away millions of supplicants and are likely to see many of them back in costly emergency rooms in coming months with highly infectious flu.

Because it takes up to six months to produce more vaccine, there is no way to fill the chasm created by the three-month closure of the Chiron factory. All that’s left is triage, seeking ways to shift the supplies left to the elderly, ill and very young. A congressional hearing Friday failed to identify any efficient way to do so.

In the longer run, Congress can at least set aside more money for researching new vaccine production techniques, which have changed little since British physician Edward Jenner began antiviral vaccinations by inoculating his patients against smallpox in the 18th century. Congress has funded only half of the $100 million the Bush administration requested earlier this year to research the most promising new technique -- making the vaccine not from chicken eggs, which take months to hatch, but from readily available animal cells. The need for haste should now be obvious to legislators.

Congress also ought to be asking why the U.S. is dependent on just two manufacturers, with much of the supply coming from abroad. What’s missing in the regulatory arena?

Flu vaccines are an unalloyed social good. Public health officials consumed with stockpiling smallpox vaccine and sarin antidotes against a terror attack now face a human and economic cost that would make a terrorist shiver with glee. The boring business of flu vaccine is suddenly a crisis, and government has to own up to its responsibility.