title: Influenza vaccine scarcity 2004-05: implications for biosecurity and public health preparedness.
abstract: In the event of a bioterrorist event or a pandemic flu outbreak, it might be necessary to ration vaccine or other treatments. In this article, researchers examine how medical and public health decision makers negotiated the unanticipated 2004-05 influenza vaccine shortage, using the regional hospital system headquartered in Pittsburgh, Pennsylvania, as the focal study site. This account of that case study describes the circumstances that contributed to the national and local vaccine shortage; the improvisation by health policymakers, hospital administrators, physicians, and nurses to prevent influenza cases despite the shortfall; and some of the legal, fiscal, logistical, social, and political pressures that local health professionals faced in deciding who should receive the limited supply of influenza vaccine. This instance of an acute vaccine shortage provided an opportunity to examine the practical and ethical dilemmas of managing medical resources during a public health emergency.
authors.affiliation: Center for Biosecurity of the University of Pittsburgh Medical Center, Baltimore, Maryland 21202, USA. mschoch@upmc-biosecurity.org
authors.forename: Monica
authors.initials: M
authors.lastname: Schoch-Spana
authors.forename: Joseph
authors.initials: J
authors.lastname: Fitzgerald
authors.forename: Bradley R
authors.initials: BR
authors.lastname: Kramer
mesh_terms: D023482:Bioterrorism; D015986:Confounding Factors, Epidemiologic; D003657:Decision Making; D004189:Disaster Planning / Q000458:organization & administration*; D006284:Health Plan Implementation; D006291:Health Policy; D006292:Health Priorities; D006801:Humans; D009980:Influenza A virus / Q000276:immunology*; D007252:Influenza Vaccines / Q000276:immunology / Q000600:supply & distribution* / Q000627:therapeutic use; D007251:Influenza, Human / Q000453:epidemiology / Q000276:immunology / Q000517:prevention & control* / Q000821:virology; D007857:Leadership; D010414:Pennsylvania; D015980:Public Health Practice; D012040:Regional Health Planning; D012308:Risk Management; D012637:Security Measures
chemical_list: D007252:Influenza Vaccines