The United States' swine flu vaccines will leave millions worldwide unprotected.

Health and medicine explained.
Sept. 17 2009 3:36 PM

To Boost or Not To Boost

The United States' swine flu vaccines will leave millions worldwide unprotected.

(Continued from Page 1)

The painful part is that the adjuvant being used to boost these swine flu vaccines, known as MF59, has been used to boost seasonal flu vaccines in Europe for 12 years now—and those vaccines have caused no more adverse effects than our unboosted U.S. vaccines have. * It appears to be quite safe. Vincent Racaniello, a prominent virologist at Columbia University who also keeps the Virology Blog, told me his European colleagues are aghast that the United States doesn't use the adjuvanted seasonal flu vaccines. "They think we're nuts," Racaniello told me. "They simply don't understand it."

But, as Racaniello noted, what his European colleagues really don't understand—and what the CDC and other U.S. health officials understand all too well—is that this country's anti-vaccine sentiment is so strong, and its distrust of scientists so great, that the sensible, even obvious public-health decision about adjuvanted flu vaccines is an untenable political decision.


"There's simply no way," as Racaniello put it, "that you want to buck that sentiment."

And so we have ordered, with only rare discussion of the consequences, some 195 million doses of an unboosted vaccine that consume enough antigen to make 390 million doses of boosted vaccine. * Even worse, of those 195 million doses, we'll probably use, given our vaccination anxiety, perhaps 60 million to 100 million.   If that is the case, we'll probably throw away about 100 million or more doses.

Our vaccine anxiety runs high—and it, along with a growing distrust of science and medicine and our relentless focus on individual rather than community health, has led us to short the rest of the world some 200 million to 250 million doses. Even if the virus retains its present, relatively "mild" course—killing about as many as the seasonal flu but more heavily concentrated on adults under 60, especially the sick and the pregnant—this could mean some 20,000 to 50,000 deaths.

It is natural to look after your own. It's understandable to seek maximum safety. But from masthead height, this looks mighty ugly. Our insistence on the safest vaccine possible means halving the supply, even as our own domestic drug factories are devoted to more-profitable drugs. Effectively, we're taking two doses from others to give us one. We come off looking rather like the proverbial first-class passengers who, having scoffed at the need for lifeboats because they take up deck, now scramble into the few rafts while steerage looks on.

We could, of course, make some amends by giving away half of the 195 million doses we have lined up, since they're going to go twice as far as anticipated. But with health care and vaccines so laden politically, that, too, seems unlikely.

Correction, Sept. 21, 2009: This piece originally suggested that we will have double or quintuple the expected supply of swine flu vaccine. We will have double or quadruple the vaccine. (Return  to the corrected sentence.) Also, the available supply of antigen could create 390 million doses of boosted vaccine, not 380 million. (Return  to the corrected sentence.)

Correction, Sept. 21, 2009: This piece originally and incorrectly stated that MF59 adjuvant has been used in both Canada and Europe for the last 12 years. Europe has used the adjuvant for that long; Canada has not. (Return  to the corrected sentence.)


Medical Examiner

The Most Terrifying Thing About Ebola 

The disease threatens humanity by preying on humanity.

I Bought the Huge iPhone. I’m Already Thinking of Returning It.

Scotland Is Just the Beginning. Expect More Political Earthquakes in Europe.

Students Aren’t Going to College Football Games as Much Anymore

And schools are getting worried.

Two Damn Good, Very Different Movies About Soldiers Returning From War

The XX Factor

Lifetime Didn’t Think the Steubenville Rape Case Was Dramatic Enough

So they added a little self-immolation.


Blacks Don’t Have a Corporal Punishment Problem

Americans do. But when blacks exhibit the same behaviors as others, it becomes part of a greater black pathology. 

Why a Sketch of Chelsea Manning Is Stirring Up Controversy

How Worried Should Poland, the Baltic States, and Georgia Be About a Russian Invasion?

Trending News Channel
Sept. 19 2014 1:11 PM Watch Flashes of Lightning Created in a Lab  
  News & Politics
Sept. 20 2014 11:13 AM -30-
Business Insider
Sept. 20 2014 6:30 AM The Man Making Bill Gates Richer
Sept. 20 2014 7:27 AM How Do Plants Grow Aboard the International Space Station?
  Double X
The XX Factor
Sept. 19 2014 11:33 AM Planned Parenthood Is About to Make It a Lot Easier to Get Birth Control
  Slate Plus
Slate Picks
Sept. 19 2014 12:00 PM What Happened at Slate This Week? The Slatest editor tells us to read well-informed skepticism, media criticism, and more.
Brow Beat
Sept. 20 2014 3:21 PM “The More You Know (About Black People)” Uses Very Funny PSAs to Condemn Black Stereotypes
Future Tense
Sept. 19 2014 5:03 PM White House Chief Information Officer Will Run U.S. Ebola Response
  Health & Science
Bad Astronomy
Sept. 20 2014 7:00 AM The Shaggy Sun
Sports Nut
Sept. 18 2014 11:42 AM Grandmaster Clash One of the most amazing feats in chess history just happened, and no one noticed.