Winter glut of flu vaccine worries health officials

first_img Like Francis, Ehresmann blamed the vaccine glut largely on the late arrival of much of the supply. “It’s a matter of timing,” she said. “The manufacturers weren’t getting the product to providers until very late—in November. There’s a fairly narrow window of opportunity with the consumer for flu vaccination.” “We always have a little vaccine left over at the end of the season, but I’ve never had in excess of 100 doses. This is really extreme for us,” Francis said. “This vaccine can’t be returned, and it costs over $100 for a 10-dose vial. So it’s close to a $6,000 loss.” Jan 30, 2007 (CIDRAP News) – Dr. Anne Francis, a pediatrician in Rochester, N.Y., says her group practice typically has a few doses of influenza vaccine left at the end of the flu season. But as of last week, with the demand for vaccination nearly gone, the clinic still had 580 doses on hand. Stoller was critical of Sanofi for not announcing the production problem earlier. “Sanofi was not making decisions based on public health, they were making decisions based on their shareholders,” she said. Oct 17, 2006, CIDRAP News story “Flu vaccine delay affects toddlers” Tomsky declined to comment specifically on Stoller’s complaint that Sanofi was slow to report the problem with the slow-growing vaccine strain, but said, “We’ve been careful to project our demand and our production in a way that supports public health and meets customer needs.” “Many decisions about production and ordering have to be made not only by providers but by manufacturers early in the year,” said Allen. “The concern is that if we have millions of doses and they’re not purchased, the manufacturers are going to have to look at how many doses they will produce next year. It’s important not only for the seasonal flu, but that we continue to maintain capacity in the event of pandemic flu.” “I think the demand has definitely waned,” Smith added. “We’re currently having a mild flu season, with 34 confirmed cases so far. We’re trying to keep the momentum going for immunization, but it’s sometimes hard to get the community motivated. . . . There are some people still seeking immunization, but the vast majority have given up.” See also: The company used a “multiphase” distribution strategy, meaning all customers received part of their order by the end of September, she said. “The remainder of the order was shipped through October and November and sometimes early December, but most received it in October and November.” Translated into percentages, that means that 24.3% of the total for the year (through December) were shipped by the end of September and 68.2% were shipped by the end of October. The corresponding figures for previous years were as follows: 2005, 34.7% and 72.8%; 2004 (when close to half of the US supply was lost because of problems at a Chiron plant in England), 31% and 74.6%; 2003, 58% and 92.5%; and 2002, 61% and 99.6%. Smith, the Colorado immunization coordinator, echoed the idea that education is part of the answer to the recurring problems in matching flu vaccine supply to the demand. “We do need to let people know that 100 million doses don’t come out on one day, that there has to be staggered distribution,” she said. “When we were producing much smaller amounts [in the past], it was easy to get it all out. With this amount there has to be staggered distribution.” Jennifer Armstrong, a GSK spokeswoman in Philadelphia, said the company made a total of about 25 million doses of its two flu vaccines, Fluarix and Flulaval, for the US market this season. Another pediatrician, Jill Stoller, MD, of Woodcliff Lakes, N.J., said her group practice avoided having a lot of unused vaccine, but only because they canceled an order for 1,000 doses from Sanofi as soon as they heard about the delay. After canceling, they ordered 500 doses from Chiron (now part of Novartis), which they were able to get immediately. The group also bought 1,300 doses of FluMist, the nasal-spray vaccine from MedImmune. “There’s significant concern that there’s a lot of vaccine out there that hasn’t been used,” said Kristen Ehresmann, manager of immunization, tuberculosis, and international health at the Minnesota Department of Health in St. Paul. “It’s definitely in the thousands of doses” in Minnesota. “And it’ll be millions of unused doses at the national level.” None of the companies was prepared to talk about how many doses they expect to make for 2007-08 or how many their customers are ordering. “We recognize that there are many doses that are going unused at the moment,” said Curtis Allen, a spokesman for the National Immunization Program at the Centers for Disease Control and Prevention (CDC) in Atlanta. Local health departments administer flu shots in public immunization clinics, and some also channel doses to private providers as well, Ehresmann said. “The unused vaccine is happening to all vaccine providers whether public or private. . . . Both sectors are feeling the stress of the unused vaccine—and the fiscal impact.” Educating the publicPublic health agencies have been trying for years to convince the public that October and November are not the only months for flu vaccination. They point out that the vaccine doesn’t materialize all at once, but “comes out like water out of a hose,” in Allen’s words. This season the CDC promoted the week after Thanksgiving as “National Influenza Vaccination Week” in an effort to boost December vaccinations. Stoller, who serves on the executive committee of the American Academy of Pedatrics’ Section on Administration and Practice Management, says many pediatricians have been left with a lot of vaccine this winter. “I talk to people all the time, and I know there were offices with hundreds and hundreds of doses left,” she said. Other states also are seeing signs of a vaccine glut, though officials were not as emphatic as Ehresmann. “I can tell you that anecdotally I’ve been receiving calls from public health departments that they have doses on hand they’re willing to sell to folks or give to folks if needed,” said Roberta Smith, who heads the adult immunization program for the Colorado Department of Public Health and Environment. “Those range from a few hundred to 3,000 [doses].” Karen Lancaster, a MedImmune spokeswoman, said her company made 3 million doses of FluMist for this season. “We began shipping in July, and all doses were released for distribution by the FDA [Food and Drug Administration] the end of September,” she reported. The oversupply comes after a record year for flu vaccine production. The CDC had estimated total production for the US market at 110 million to 115 million doses. Allen said manufacturers have told the CDC they had shipped 102.4 million doses by the end of December—well above the previous record production of 95 million doses, set in 2002. (He didn’t have information on how many doses have been produced but not sold.) Smith said she was unsure to what extent late vaccine shipments were to blame for the current oversupply. “I had some providers who called in August and had vaccine, but there were also providers who didn’t get theirs till the end of November, beginning of December,” she said.center_img Unused doses cause financial lossesIn Minnesota, Ehresmann said many local health departments are reporting they have hundreds of doses of flu vaccine left. “Given the fact that we’re into January, there’s not a lot of confidence that the public will pursue that vaccine now,” she said. The problem was that most of the vaccine didn’t arrive until mid-November, more than a month later than usual, Francis said. “With the vaccine arriving so late, it was logistically impossible to get the same number of people [vaccinated] as if we had gotten the vaccine in, say, early October,” she said. “Once January hit, there’s been very little interest in getting flu vaccine.” If health departments can’t use the vaccine by the time it expires at the end of June, they have to dispose of it, she said. “It’s a loss for the local health departments—and there’s no surge capacity in their budgets.” Francis said her clinic’s doses typically arrive in late September or early October, “which gives us 2-1/2 months to distribute them to patients, including children,” she said. But the delay this year left too little time to vaccinate people before demand evaporated. Manufacturers mum on unsold dosesFlu vaccine manufacturers contacted by CIDRAP News wouldn’t reveal how many doses remain unsold, but one, GlaxoSmithKline (GSK), acknowledged having a “substantial” number. “I don’t have specifics, but we still have a substantial number of vaccines [doses] available,” she said. As a result, she has cut back her vaccine order for next season—3,000 doses, instead of the 3,500 she had ordered for this year. Francis’s situation apparently isn’t unusual this year. A combination of record flu vaccine production with some distribution delays and a mild flu season has created a glut of unused flu vaccine this winter, a situation that could lead to problems next season, according to public health officials. Distribution timingFigures provided by Allen of the CDC show a somewhat slower flow of vaccine from manufacturers this season than in previous seasons. In 2006, according to manufacturers’ reports to the CDC, they shipped no doses in August, 24.9 million in September, 44.9 million in October, 30.2 million in November, and 2.3 million in December. Sanofi Pasteur made somewhat more than the 50 million doses it expected to produce for this season, said spokeswoman Patty Tomsky, but she couldn’t give a production total or say how many doses have not been sold. “The season isn’t over and we’re still selling, so I can’t give a final number yet,” she said. It’s also worth noting that several million doses were shipped in August in each of the previous 7 years, whereas none were shipped in August 2006, according to the CDC data. August numbers for the earlier years ranged from 2.7 million in 2001 to 19.6 million in 1999. Few people are seeking a shot at this point, she added. “In the Northeast we’re seeing very little flu, so it’s not on people’s minds.” The company began shipping Fluarix in early September and Flulaval immediately after it was approved for the United States on Oct 5, Armstrong said. Most doses were out the door by the end of November, with a few delivered in December. Palmer said a combination of mild weather and relatively few flu cases has probably suppressed demand for vaccination. Clinics struggled with delaysLast October, Sanofi Pasteur, the leading flu vaccine supplier for the US market, said a slow-growing strain of influenza A(H3N2) would cause distribution of its Fluzone vaccine to be about 3 weeks later than last year. Two other manufacturers, GlaxoSmithKline and Novartis, were also said to have had some problems growing that strain. The delays particularly affected pediatricians, because Fluzone is the only vaccine licensed in the United States for children aged 6 months to 3 years. She expressed concern that flu vaccine providers will be “reconsidering” their orders in view of the current oversupply. But the situation isn’t all bad, in her view. In 2002, about 83 million doses of vaccine were distributed, leaving manufacturers with 12 million doses they couldn’t sell, according to Allen. The following year, 2003, producers cut back their output to 86.9 million doses. In Texas, Emily Palmer, an assistant press officer with the Department of State Health Services in Austin, said, “Anecdotally we’ve heard of a couple local health departments that are offering the vaccine for free. We also have heard that some areas are looking for preservative-free vaccine and they haven’t been able to find any.” She also noted that Sanofi is increasing its vaccine production capacity, with work under way on a new manufacturing plant and a formulation and filling facility. “Once we get both of those online, we expect our capacity to double,” she said. “The good news is that this year [the amount] is the most vaccine we’ve ever had in our history, so we know what our capacity is. It’s refreshing that we know we have that capability,” she said. “Our consistent message has been that vaccination into January and even into February most years is still very good advice,” he said. “In most years the season peaks in February or later. But we’re going up against history. In the past most people have received their vaccinations in November.” CDC influenza sitehttp://www.cdc.gov/flu/ Health officials worry that if vaccine manufacturers can’t sell all of their supply, they’ll cut back production for next season, and if healthcare providers are stuck with unused doses, they’ll order less as well. That could lead to fewer people getting vaccinated next year—and undercut the public health goal of increasing vaccine production capacity and demand in the interest of pandemic preparedness.last_img read more

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Pardew key to Palace move – Cabaye

first_img With a number of niggling injuries, Cabaye started just 13 Ligue 1 games for Paris St Germain but still collected two league titles, two Coupe de France winners’ medals and the Coupe de la Ligue. Now he will be hoping to help Palace build on their top-half finish from last season and has praised Pardew for playing a big role in bringing him back to the Premier League. “I’m very happy to be here and to work again with the manager,” he said It’s great to be back in the Premier League; the club have given me that opportunity so now I want to do my best to thank them and give my best on the pitch.” “I first heard of the interest in April so I let my agent work with Palace and PSG. The last few days have been long and boring because I have just been waiting but now I’m here and that’s the most important thing. “I know the manager, I know England and the language and I know the Premier League. Now I’m in London too so that’s good. I have worked with him (Pardew) before and I’m confident with him. “I just want to do my best for him because he’s made a big effort for me to come here, as well as the chairman so I have to say a big thank you to them. “He is a good manager; he is close to the players, talks to you a lot and gives you plenty of confidence. It makes you want to fight for him and do your best for the team. “I want to do my best for him because he’s made a big effort to get me to come here, as well as the chairman (Steve Parish) so I have to say a big thank you to both of them.” Although the fee is undisclosed it is reported to be a new club-record deal for the Eagles, eclipsing the fee they paid for James McArthur from Wigan last season. The signing shows just how far the club have come since their promotion to the top-flight two years ago, and their financial woes just a few years before that. With Cabaye on board and a new contract for sought-after defender Scott Dann believed to be close to completion, Parish insists Palace may still have plenty of business to conclude before the start of the new season. “We’re working on three more – I don’t know if we’ll get them all done,” he said. “But that’s the aim and we’re very committed to bolstering the squad and having a really good year. “We want to back Alan, back the fans and back everyone at the club who has put everything in to get the club where we are now. These are very exciting times and hopefully we can sustain this and really build on it.” Crystal Palace new-boy Yohan Cabaye insists he is ready to “fight” for manager Alan Pardew with the pair reunited following the midfielder’s move from Paris Saint-Germain. The former Newcastle man will again link up with Eagles’ boss Pardew, who initially took Cabaye to St James’ Park in 2011. Having developed into a firm favourite with the Magpies, the lure of returning to his native France to represent PSG proved too strong and he completed a big-money move to the Parc des Princes last year. Press Associationlast_img read more

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USATF Men’s and Women’s 1 Mile Road Championships Return to Grand Blue Mile

first_imgDES MOINES, Iowa — Grand Blue Mile (GBM) officials from Wellmark Blue Cross  and Blue Shield and Drake Relays announced the USA Track & Field one-mile road championships will be returning in 2019 as part of the annual Grand Blue Mile. The addition of the prestigious USATF 1 Mile Road Championships elevates the elite-level competition of Grand Blue Mile and is expected to attract Olympians and world championship participants from across the country to vie for a national title and share of the $30,000 prize purse. GBM also hosted the 2013, 2014, 2017 and 2018 USATF 1 Mile Road Championships.  The 2018 Set the Pace challenge community winner, Lohrville, used their award to complete a trail. To watch the video and learn more about the project, click here. Print Friendly Version “As Grand Blue Mile celebrates our tenth anniversary, we are honored and privileged to welcome back the USATF 1 Mile Road Championships,” said Chris Verlengia, Wellmark Blue Cross and Blue Shield’s senior brand marketing manager and Grand Blue Mile co-race director. “Being entrusted to host a fifth national championship in 10 years provides even more reason to celebrate the tremendous impact this special event has throughout central Iowa and beyond.” As part of the challenge, the community with the highest percentage of its residents participating in GBM — measured by the number of registrants for a given ZIP code against its total population — will be awarded $10,000 to use on a project that promotes safe and accessible places in which to be active, such as a park, playground or trail. Early entrants for the 2019 USATF 1 Mile Road Championships at GBM include:·         Riley Masters – 2018 Men’s USATF 1 Mile Road Champion·         Mikey Brannigan – 1500 meter Paralympic gold medalist·         Emily Lipari – 2018 Women’s USATF 1 Mile Road Champion·         Heather Kampf – 2014, 2015 and 2016 Grand Blue Mile Champion Set the Pace Challenge encourages communities to get movingGBM officials also announced the continued partnership with the Healthiest State Initiative (HSI) for the return of the Set the Pace Challenge. This challenge encourages Iowans to develop sustainable, healthy habits throughout 2019 — starting with participating in GBM on April 23. In 2018, more than 40 track and field stars competed for the national title and share of the USA prize purse at GBM. Riley Masters won the men’s championship with a time of 4:03.12. The women’s championship was captured by Emily Lipari with a time of 4:32.87. “We are excited for another year of the Set the Pace Challenge,” said Jami Haberl, HSI executive director. “The award provides a great incentive for communities to rally together around. The benefits are two-fold: They’ll be participating in a fun, physical activity and making an effort to better their community.” “Grand Blue Mile has gained notoriety and prestige with America’s most decorated milers,” said Blake Boldon, director of the Drake Relays. “Now marking the event’s tenth anniversary, we’re proud to continue our longstanding partnership with Wellmark to extend the Drake Relays experience to thousands of participants and spectators alike.”last_img read more

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