State health officer says fake flu shots symptom of much bigger problem
By M.J. Ellington
DAILY Staff Writer
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MONTGOMERY — State Health Officer Dr. Don Williamson says that fake flu vaccines given in Alabama and Texas are symptoms of a larger problem that the country cannot ignore if it wants to prepare for a pandemic.
Williamson and Larry Dixon, the executive director of the Alabama agency that licenses and disciplines doctors, say they believe the Alabama case is a first for the state. But they agree that such cases bring up larger questions of whether the country's flu vaccine supply and delivery systems are falling short.
In the Texas case, a home health agency is accused of giving 1,000 Exxon-Mobile employees and 14 residents of a nursing home fake vaccine this fall. In Alabama, Dr. Zev-David Nash gave up his state medical license after accusations he gave fake flu vaccine to employees at company clinics in Montgomery this year and in 2004.
Williamson said solutions must address three areas: the lack of a guaranteed government supply, the way companies make vaccine and the lack of a central tracking system to determine the amount and destination of vaccine each year. He believes the government must address all three before the yearly flu shot program stabilizes.
For most routine types of vaccine, like those for polio and measles, state and federal governments guarantee to purchase at least 50 percent of the vaccine supply ordered each year if private providers do not buy it. Williamson said private providers buy 90 percent of the vaccinations in this country each year. He says the government guarantee motivates more companies to manufacture the vaccines, which results in no chronic shortages unlike the production of flu vaccines with no similar guarantees.
Williamson said the flu shot production process is slow and out of date. The process takes one chicken egg to act as an incubator for each dose of flu vaccine. Williamson wants a more modern flu vaccine production that bypasses chicken eggs and uses a cell culture vaccine that protects against the constants — the elements in flu virus that are present from year to year. That type of vaccine would give longer protection that could be updated periodically with booster shots.
"Suppliers cannot ship all at once, and they also cannot save vaccine from one year to the next," Williamson said. "Every year the virus changes and every year vaccine not sold has to be thrown away because of that." Supplies also arrive sporadically, making it difficult for doctors to predict when they will have the vaccine.
He expects a federal flu summit in January to address these issues and others, including a central way to track where the country's vaccine goes each year.
Dixon, the executive director of the Alabama Board of Medical Examiners, said Nash, a Montgomery internist, gave up his medical license and closed his practice because of accusations of fake flu shots. Dixon said he does not believe Nash will practice medicine again in any state. Alabama is notifying other states about Nash's situation.
Dixon said investigators believe Nash injected about 90 people with fake vaccine in a similar clinic for the same company in 2004, a year when supplies were scarce.
"I do think that supply shortage plays into the pressure that physicians feel to deliver vaccine to their patients," said Dixon. But Dixon said the Nash case raises questions about ethics and greed that cannot be ignored.
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