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$1.5 billion needed to ensure 12-month stockpile of pediatric vaccines
Jim Barlow,
Life Sciences Editor
217-333-5802; jebarlow@uiuc.edu
4/18/2006
|
CHAMPAIGN, Ill.
— A six-month stockpile of recommended pediatric vaccines would
cost $1 billion and could cover more than 90 percent of U.S. children
during a six-month interruption in production, say researchers at two
Illinois universities.
The only problem with such a time period – proposed by the Centers
for Disease Control – is that the six major interruptions, involving
six of eight recommended childhood vaccines, between November 2000 and
February 2004 ranged in duration from seven months to 20 months, the
scientists report in the April 24 issue of the journal Vaccine.
Spending another $500 million up front would ensure sufficient quantities
for a 12-month interruption, said operations researcher Sheldon H. Jacobson,
professor of mechanical and industrial
engineering at the University of Illinois at Urbana-Champaign.
The CDC’s “choice of six months is unclear,” given
the actual timelines of recent production interruptions, Jacobson said.
“It appears that we are being overly concerned in the short-term
over a few hundred million dollars, whereby the potential risk to the
4 million children born every year is so great,” Jacobson said.
“When you consider how strained the nation’s health-care
system is right now, a one-time expenditure of a few hundred million
dollars of stockpiled vaccines goes such a long way to protecting the
approximately 11,000 children born every day in the United States. This
is something we can control. It is not clear why it is not being done.”
The researchers used a stochastic inventory model in which they considered
multiple variables, including differing vaccination coverage rates,
getting vaccines on time, production downtime, the ramp-up process to
replenish supplies and the number of children born each day. While described
briefly in the Vaccine paper, the full technical description of data
and the analyses will be published in a separate journal.
“The results suggest that in the event of a vaccine production
interruption for any of the vaccines that lasts for eight or more months,
there is a reasonably high risk (from 8 percent to 89 percent based
on optimistic or pessimistic scenarios) that the proposed vaccine stockpile
levels will not be adequate to fully vaccinate all children that require
immunization,” the researchers wrote.
An interruption of 12 months, they added, would raise the risk of insufficient
supplies to between 95 percent and 100 percent. A subsequent problem
of shortages is that many children miss their vaccines and must return
to their physicians to catch up, but in many cases parents do not follow
through with the return visits.
The 15-member Advisory Committee on Immunization Practice establishes
the vaccination recommendations for both children and adults. The study
considered eight childhood vaccines. The committee added two more vaccines
to the 2006 pediatric list.
The proposed stockpile covered in the study calls for vaccines to be
stored on a rotating basis, with the numbers of dosages ranging from
2 million for varicella to 10 million for diphtheria-tetanus-acellular
pertussis.
The recommendations came out of a working group that was formed in 2002
after the U.S. Department of Health and Human Services began an investigation
into shortages in pediatric-vaccine supplies. Stockpiles currently exist
for five pediatric vaccines: the inactivated poliovirus (IPV); measles,
mumps and rubella (MMR); Haemophilus influenzae type B (HiB); Hepatitis
B (HBV); Hepatitis A (HAV) and the combination vaccine covering diphtheria,
tetanus, pertussis, HBV and IPV.
Co-authors of the study were Dr. Janet A. Jokela, professor of clinical
medicine and associate director of the internal medicine residency program
for the UI College of Medicine at Urbana-Champaign; Ruben A. Proano, a doctoral student in the department
of mechanical and industrial engineering; and Edward C. Sewell, professor
of mathematics and statistics at Southern Illinois University at Edwardsville.
The National Science Foundation funded the project.
