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Panel May Suggest Universal Flu Shots

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Some members of a panel of experts who advise the federal government on vaccination policy said Tuesday they support a change in policy that would recommend flu shots for every American, every year, because many lives would be saved.

But the full Advisory Committee on Immunization Practices, which helps formulate public recommendations for the Centers for Disease Control and Prevention, took no action and agreed to study the issue. Universal flu vaccination would expand the approximately 80 million people who take the shot every year to all 292 million Americans.

Meeting in Atlanta, the advisory panel warned that implementing blanket shot campaigns would pose significant challenges in educating the public and expanding vaccine-manufacturing capacity.

Members of the committee, which includes academic experts, members of medical societies and representatives of other federal health agencies, said they support universal vaccination because it would reduce the estimated 36,000 flu-related deaths and 114,000 hospitalizations that occur in the United States each year.

"To embark on this is to embark on something that is really unprecedented," said Dr. Keiji Fukuda, the CDC's chief of influenza epidemiology, as he opened debate on the proposal.

The appeal of the concept became clear as meeting participants unrolled the first comprehensive public look-back at the current flu season, which began earlier than any season since 1976.

At least 135 children and adolescents in 38 states died, another 31 developed neurological conditions, and hospitals across the country ran short of staff and beds and turned patients away, CDC representatives said during the meeting.

For the first time in at least five years, every U.S. dose of traditional injectable flu vaccine was sold --- even though, according to one study, the vaccine may not have provided good protection against this winter's strain of flu.

But participants said the launch of FluMist, a new inhaled vaccine made of weakened live virus, failed. Eighty percent of the doses manufactured, a total of 4 million, were never sold and will have to be destroyed.

Dr. Peter Patriarca, of FluMist's manufacturer MedImmune, blamed the lack of interest on what he called excessive restrictions placed on the vaccine by the Food and Drug Administration. If the vaccine had been accepted, he said, it could have eased spot shortages of flu shots across the country.

The current season's well-publicized shortages of injectable vaccine occurred because news of child deaths in Colorado and Texas drove many more parents to seek vaccine, authorities said, driving demand beyond what manufacturers had expected based on flu-vaccine orders.

The 2003 flu season has effectively ended, with only a few states continuing to report sporadic cases. The CDC is as yet unable to say whether this season was objectively worse than past years'. So much attention was paid to flu this year, experts said at the meeting, that many additional studies were launched to study its impact. But because the studies are being done for the first time, there will be no way to compare results with previous years.

Presentations at the meeting, made by CDC staff, academic medical researchers and pharmaceutical company representatives, provided snapshots of significant impact in certain places and on certain groups.

At least 135 children and teenagers --- from toddlers to 17-year-olds --- died as a result of the flu, according to Dr. Jennifer Gordon Wright of the CDC's flu branch. Thirty-nine children developed neurological conditions; 31 of them survived, while eight who died were counted among the 135 deaths. An additional 45 possible cases of flu-related neurological problems are still being evaluated, she said.

Because of the increased patient load, hospitals around the country were hit hard, said Dr. Michele Pearson of the CDC's National Center for Infectious Diseases. Of 221 hospitals surveyed around the country --- 40 percent of them in the South --- 25 percent ran short of vaccine and 50 percent ran out of the rapid tests that quickly diagnose flu.

There were bed shortages at 28 percent of the hospitals.

Copyright 2004 The Atlanta Journal-Constitution


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