Influenza, or the flu, causes approximately 36,000 deaths and 200,000 hospitalizations annually in the United States and costs the American economy between $11 and $18 billion each year (General Accounting Office 2001b, page 1). The primary method for preventing influenza is the flu vaccine, which is generally available in a variety of settings including clinics, hospitals, schools, workplaces, and other convenient locations. The vaccine is typically distributed in October and November in anticipation of the winter flu season, which usually begins in late November and peaks in February. For the 2004-05 flu season, the Centers for Disease Control and Prevention (CDC) recommended that as many as 185 million Americans receive flu shots. Among those 185 million, almost half (90 million) are considered high-risk (Centers for Disease Control 2004, 2; General Accounting Office 2004). The high-risk population includes adults 65 and older, infants six to 23 months old, pregnant women, health care workers, those who care for children under six months old, and people with compromised immune systems or chronic illnesses such as asthma, lung cancer, and cystic fibrosis (Centers for Disease Control 2004; General Accounting Office 2004).
In recent years Americans have faced flu vaccine shortages on multiple occasions. At the beginning of the 2000-01 flu season, demand for the vaccine outstripped supply, which resulted in an uneven distribution of available vaccines and sharp price increases for flu shots (General Accounting Office 2001b, 2). The following year supply exceeded demand. In 2003-04, demand exceeded supply when millions of doses were inappropriate for that year’s flu strain (Brown 2004; General Accounting Office, 2001b, 2004).
The Institute of Medicine (IOM) notes that these recent shortages have “highlighted the fragility of vaccine supply” which is further complicated by declining financial incentives to develop