Health officials in Japan have warned that a shortage of influenza vaccine could leave millions of elderly people at risk of catching the virus, exposing them to pneumonia and other potentially fatal complications.
Hospital officials say the emergence of new influenza strains and heightened fears of an outbreak of severe acute respiratory syndrome (SARS) in east Asia have prompted a rush on vaccinations. 37 of Japan's 47 prefectures are reporting shortages of the vaccine, which does not prevent SARS or influenza, but is said to reduce the severity of the symptoms.
In 2001, the government ordered local health authorities to provide regular, sub-sidised influenza vaccinations to the 24 million Japanese people aged 65 years and older.
But although record numbers of people of working age and their children are paying the full price to be vaccinated, those most at risk—the elderly—are not taking up the offer of subsidised shots. Last year, only about a third of Japan's over-65s were vaccinated.
The change in the law was reportedly prompted by data from the USA—itself in the grip of an influenza epidemic (see Lancet 2003; 362: 2075)—showing that vaccination could prevent up to 80% of annual influenza-related deaths in the elderly.
After Japan was hit by an unusually high number of influenza-related deaths in early 2003, pharmaceutical firms were ordered to produce 14·8 million doses of the vaccine—a 40% increase from the previous year and enough for 30 million adults—for the current influenza season.
Yet even those stocks may not be enough. In Saitama, north of Tokyo, for example, fewer than 30 of the city's 400 medical institutions are able to offer the vaccine, according to The Yomiuri Shimbun newspaper.
Since it takes months to produce new doses of the vaccine, the health ministry has taken the unusual step of asking drug firms to earmark some of their existing stocks for the worst-hit regions, such as Hokkaido and Yamagata in the north.
Although fewer influenza cases have been reported this season than at the same point last year, the number is expected to rise over the next 2 months as spells of cold, dry weather give the virus its perfect breeding ground.