German based production of influenza vaccines for the 2007-8 season totalled 30.2 million doses, up almost 30% from 23.5 million a year ago. But demand from patients in Germany for flu vaccines has not kept pace with increased production. This has left an oversupply of unused doses on pharmacy shelves—and possibly triggered a spate of news stories based on press releases that urge people to be vaccinated.
Susanne Stöcker, spokeswoman for the Paul Ehrlich Institute in Langen, which records vaccine production for Germany, told the BMJ that the institute does not know what percentage of the record 30.2 million doses have been used so far this season. However, she said that in past years spot shortages had developed by January, and she normally receives many telephone calls from pharmacies and patients who are seeking flu vaccines.
This year she has received no such telephone calls. “I don’t think there is a problem with supply this year,” she said.
Demand for flu vaccines in Germany this winter has been slow partly because of a relatively mild flu season so far. And in recent weeks news stories in the German press have warned of flu upsurges in surrounding nations and quoted pharmacy associations or medical specialists urging people not yet vaccinated to do so immediately.
Those stories are based in part on a press release issued in late January by the European Centre for Disease Prevention and Control, in Stockholm, which warned of “significant influenza activity” in 13 nations and urged people in high risk groups to get vaccinated.
Such public pleas urging flu vaccinations are common in the German press from late September into November but are rarely seen, if ever, after December. The BMJ asked a spokesperson at a German research institute that tracks flu cases whether a surplus of unused vaccines might have helped encourage press releases and news stories in an effort to trigger demand for flu vaccine. The spokesperson chuckled and said, “If there were a shortage [of flu vaccinations], I do not think we would be seeing this.”
The BMJ contacted the European centre and several other agencies and organisations in an attempt to learn whether Germany’s huge increase was confined to Germany or is reflected in European or global production figures. The BMJ was not able to find a central repository of flu production data for the current season, despite the fact that many scientists have predicted a global flu pandemic.
Neither the European Pharmaceutical Industry Association, in Brussels, nor the International Federation of Pharmaceutical Manufacturers and Associations, in Geneva, were able to provide total production numbers.
Spokespeople at the European disease control centre; the European Medicines Agency, in London; and the World Health Organization, in Geneva, also were unable to provide production data.
Dr Stöcker said of German vaccine makers, “We do not know why the pharmaceutical companies increased the production by so much. They did it absolutely on their own. One possibility could be an increasing number of advanced bookings, reservations. Or it could be an effect of the rising interest in getting a flu shot since we had the discussion about avian, pandemic, and seasonal flu in 2005.”
Surplus supply would be a problem for manufacturers or healthcare providers with unsold stocks because vaccines are developed and produced during the summer for influenza strains expected to pose the biggest potential threats in the upcoming winter. New vaccines must be developed to fight new strains for the following season. If drug firms did overproduce this year or healthcare providers bought too many doses, that could have an effect on next year’s production.
Gerrit A van Essen, of the University Medical Centre in Utrecht, the Netherlands, and a member of the European Scientific Working Group on Influenza, told the BMJ, “Flu vaccines are like milk, what you produce you have to sell or get rid of it.”