By David B. McKinley, P.E. and Mary G. McKinley, RN, MSN, CCRN

Do you know someone who had a flu shot this year and still got the flu? It’s happening a lot this year. Have you wondered how this could happen? Let us share some of the background.

For well over fifty years, health officials in Washington convene each year in February to project what type of influenza will occur perhaps 9 months later. They then select a vaccine to combat the flu strain(s) they’ve identified.

Unfortunately, 20% of the time they get it wrong. This year they really got it wrong.

For the current flu season, the Center for Disease Control (CDC) projects that 200,000 people could be hospitalized and 50,000 people may die because of the ineffectiveness of their vaccine. Think about that: More Americans will die this year from the flu than were killed in combat in the Vietnam War.

America deserves better.

First, the process to select a vaccine is an archaic procedure that needs immediate reform. It is too much a “game of chance” rather than reflecting the science that is available. Once a vaccine is chosen, it then takes up to 6 months to bring it to market. We’ll discuss the problems with that later in this column.

Flu strains are complex and constantly evolving. Almost immediately after the particular strains were identified last year, the deadliest strain began mutating, or “drifting,” and by September it was 50% different than it was in February.

Despite the CDC goal of an effectiveness rate of 60% or more, the current vaccine will only be 23% effective this season. That means that only one in four getting the vaccine has been effectively protected; this is unacceptable.

Therefore, the House Energy and Commerce Subcommittee on Oversight and Investigation held a hearing on February 4^th of this year to discuss what went wrong and how to better address the issue going forward.

At the hearing, the CDC claimed they only knew their vaccine would be ineffective in September of last year – too late to make any new vaccines. However, it became clear that in May the CDC found that the “drift” of the dominant strain was becoming a concern. Instead of acting then, our public health officials made excuses for their inaction.

In the weeks following September the CDC still did not send out a health advisory warning doctors and nurses of the risks and proper treatments. Meanwhile, new flu vaccines were being developed for South America’s flu season – the kind of vaccine which could have saved lives in the United States had it been brought to the market.

What could the CDC have done instead of make excuses? In 2009, Americans were given the option of receiving an additional targeted vaccine for the swine flu virus not treated by that year’s standard flu vaccine. As a result, only 20 people died from this unexpected and deadly strain.

Additionally, the CDC could have used public service announcements advising people to get an antiviral drug within 48 hours after developing flu symptoms. Or for adults, a high-dose vaccine could have been administered. All of these would have lessened the harsh, flu-related hospitalizations and deaths the American public is experiencing.  

As for the issue of a prolonged production schedule, shouldn’t our medical community be able to use the science available today and shorten the time it takes to bring a vaccine to market? Almost 90% of America’s vaccines are still produced using a slow, egg-based process that is more than 80 years old.

The National Institutes of Health should prioritize new types of flu vaccines that are more reliable and effective. There has been research into new technologies such as recombinant DNA techniques and cell-based manufacturing, which would allow faster production of the flu vaccine and would eliminate the guessing game.

In the testimony given on February 4th, a panelist acknowledged that a modified vaccine could have been made in 12 weeks, but in quantities insufficient for the entire population. Apparently the decision was made that if 150 million modified vaccines could not be available, then none would be made! They did not even make enough for the most vulnerable population, our elderly and young, and which would have saved lives.

This pandemic raises questions about CDC’s public health strategy and whether they manage taxpayer dollars effectively. For example, between 2000 and 2014, the CDC budget nearly doubled from $3.5 billion to $6.8 billion. Instead of funding a more effective vaccine-selection process, shortening production timelines, or developing additives like adjuvants to existing vaccines, they spent taxpayer dollars on teenage dating sites, sexual violence, firearm related injuries, and youth violence. These latter issues all have value, but the CDC itself may be “drifting” from its core mission of disease control. 

Americans need to be vaccinated, but they need peace of mind that their public health agencies are doing all that they can to help protect them. We need to ensure that funding is going towards development and research of medicines that can save lives and that in times of crisis those medicines are reaching those in need.

The American people deserve better from their public health officials, and unfortunately the current flu vaccine program is not serving them.

David B. McKinley, PE, is a Member of Congress representing the First District of West Virginia since 2011. He is Vice Chair of the House Energy and Commerce Subcommittee for Oversight and Investigation. He also was a member for 28 years of the Board of Trustees for the Ohio Valley Medical Center.

Mary G. McKinley, RN, MSN, CCRN, is a critical care nurse with more than 30 years experience.  Agraduate of West Virginia University, Mrs. McKinley isapartneratthefirmCriticalConnectionsandisaClinical EducatoratOhioValleyMedicalCenter.She is also thepastPresidentof theAmericanAssociationof CriticalCareNursesandisapublishedauthoronnursing,criticalcareandhealthpolicy.