Some things you just don't want to say out loud, or at least too publicly, for fear of being branded a crank, a cynic, even a nut.  So when the vaccine manufacturers cried the blues over vaccine shortages, I mostly kept my thoughts to myself.

After all, the shortages might well be real.  As Senator Frist, in his bid to further limit the liability of vaccine manufacturers noted, with high risks and low profits, there are now only four major vaccine producers, and as a result, there was a shortage of eight of the recommended childhood vaccines this year." 

Similarly, one writer simply said in the case of the flu vaccine, "The real cause of the shortage is the flu vaccine's low price."  While another, a writer for the AMA's American Medical News, stated the most recent flu vaccine "shortages" may not have been shortages at all, instead being due to increased demand for flu shots as a result of the anthrax scare.

On the other hand, there has always been the possibility that not so benign factors might have caused the shortages, like the production halt at Merck as a result of an FDA "enforcement report" due to problems with quality control at their plant.  Still, why not give them the benefit of the doubt?

Well, for one, the fact that flu vaccine supplies and prices have both increased raises a red flag.  The title of  one article says it all - "Flu vaccine is plentiful but pricier, officials say".

Now how'd that suddenly happen, after recent flu vaccine delays and shortages? 

While the above article didn't attribute the price increases to the manufacturers, others have:

"Due to a manufacturing price increase this year, the cost of the vaccine will be $15 for persons not having Medicare or Medicaid." (The Daily Dunklin Democrat)

"The (Ohio) state health department will have 280,000 doses of flu vaccine to parcel out to city and county health departments this fall. That's the same number as last year, though the $1.58 million cost was $222,000 higher than a year ago because of a price increase, said state flu vaccine program manager Tony Payton. " (The Cleveland Plain Dealer)

And according to the AMA: "In addition to increased demand, physicians are reporting significant price increases compared with last season. Manufacturers already had announced early this year that the (flu) vaccine price would increase between 20% and 50%."

Did the vaccine manufacturers limit supply in order to increase demand?

The director of a county health department in Illinois,  "...Laker, whose department is waiting on a shipment before flu vaccination clinics can resume, questions whether there is a genuine vaccine shortage or a plan by greedy suppliers to force prices higher... 'I don't believe there is any shortage of vaccine anywhere,' said Laker..." (The News Gazette)

So which is it?  Did low prices and/or increased demand cause the shortages?  Was it genuine shortages which caused the higher prices?   Or did the desire for higher prices cause the shortages?

Is this all just some unhappy coincidence or is something more insidious operating here?

Who knows yet for sure.  But we must get to the bottom of this.

Sandy Mintz