Last month's meeting of the AAFP Task Force on Influenza Vaccine shed some light on problems FPs and other front-line health care professionals experienced obtaining influenza vaccine for the 2005-06 flu season. Task force members heard from representatives from the three manufacturers of trivalent inactivated vaccine and others at the gathering.
Sanofi pasteur allotted one-third of its total doses to physicians during its 2005-06 prebooking last April, said Bill Averbeck, director of marketing for sanofi pasteur. Approximately 20 million doses were ordered on the first day of flu vaccine prebooking last year, and the company had to suspend physician prebooking 36 hours after it began.
"Not one single order was canceled or reduced by sanofi pasteur," Averbeck told meeting participants, although the company initially divided many orders into partial shipments in an effort to distribute vaccine equitably. "We did have to limit the amount that could be ordered in some instances, but every prebooking request we accepted, we shipped."
Averbeck also addressed a problem identified by many of the FPs who responded to an AAFP survey sent to members in mid-November. Numerous respondents said they learned too late that vaccine they thought they had prebooked had not, in fact, been ordered. Averbeck explained that, as a matter of course, every prebooking request sanofi pasteur accepts receives a confirmation within 72 hours. "If you didn't get a confirmation from us, we didn't get your request," he said. In addition, when the company prepares to ship vaccine, it notifies recipients to confirm shipping details.
Flu vaccine manufactured by Chiron and GlaxoSmithKline makes its way to physicians only through distributors. And task force members learned for the first time about another link in the chain; some of the distributors Chiron is working with during the current flu season contract with other product distributors -- a situation, task force members agreed, that could complicate efforts to compile reliable information about Chiron's product flow.
Chiron's 2005-06 production suffered as a result of manufacturing problems the company experienced during the 2004-05 flu season. The company's license to produce the flu vaccine was suspended in October 2004 after British health authorities discovered contaminants in some vaccine lots at the company's Liverpool, England, production facility. Although the company's license was reinstated in March 2005, Chiron did not begin shipping vaccine until October and was able to ship only about 15 million vaccine doses this season -- short of its original projected 18-26 million doses. Physicians who ordered from distributors purchasing vaccine from Chiron were particularly affected by these combined factors.
The third manufacturer, GlaxoSmithKline, received FDA approval to market its TIV in the United States for the first time last year. That late approval translated into an abridged role for GSK, which supplied only about 7.5 million vaccine doses this season. Just under 3 million of those doses went to distributor McKesson Medical-Surgical, which supplies physician offices, while the remainder went either directly or via distributor FFF Enterprises to hospitals and long-term care facilities.
