Blood and vaccines: Lifesavers in short supply

Transfusable blood and flu and tetanus vaccines are both essential but reserves are low.

Editorial. Sept. 10, 2001.

First with the mapping of the human genome and then with stem cells, recent months have hinted at a boundless future for medicine. Yet a striking counterpoint comes from the shortages and delays of essentials such as tranfusable blood and flu vaccine. While not yet a crisis, they are cause for concern. There are signs that blood shortages are moving past the holiday and summer slumps and are becoming a chronic problem in many regions, especially the cities. Demand is about 14 million units a year, and a number of factors have converged to limit supply. Last month, for the first time, the federal government announced it will monitor blood supplies on a day-to-day basis in case severe shortages become apparent. In the meantime, the flu vaccine delays of last winter were supposed to be a fluke. Now the Centers for Disease Prevention and Control is already calling for prioritization of immunizations in light of expected delays this time around. Also, the tetanus vaccine remains in relatively short supply and is expected to be so at least until early next year. Blood transfusion became practical shortly after the turn of the last century (physicians had tinkered with the idea for hundreds of years before that); flu and tetanus vaccines entered the scene a few decades later. They are lifesavers that we take for granted. The reasons we shouldn't are varied and go beyond science. Only about 5% percent of Americans donate blood. Changing attitudes and time demands threaten even that number. The most striking recent development is pending restrictions on blood donors who have spent time in Europe, based on concerns over passing along variant Creutzfeldt-Jakob disease. The New York City area, which imports a quarter of its blood supply from Europe, would be especially hard-hit. The FDA's decision to implement universal leukoreduction of blood is another factor. The AMA and other medical organizations have warned it may contribute to a shortage. As for the flu vaccine, the fact that it has become an inexpensive, 80-million-dose-a-year commodity has been a blessing -- except that the result has been relatively little commercial interest. Only three companies now produce it for distribution in this country. As last winter's shortage proved, it can be tough to produce, and it sells for a low price compared to blockbuster drugs. The tetanus vaccine shortage is also based on production issues -- only one company in this country produces it. Flu vaccine distribution was also a problem in the 2000-2001 season. The result was that healthy individuals got their flu shots before those at high risk. On the vaccine front, the AMA has been working with the CDC, including co-sponsoring two summit meetings of all participants, to increase communication by all members of the immunization chain -- manufacturers, distributors, the government and health professionals -- to avoid some of the problems of last winter. That should help in getting the vaccine to those who need it most, earliest in the season -- even if it requires healthy individuals to wait for their shots at least until November. Renewed attention to fundamentals such as these is necessary to keep America healthy. While we look hopefully toward the medical miracles the future should bring, it's essential to keep a firm grip on the ones we already have. Back to top