The drastically decreased supply of inactivated influenza vaccine for
the 2004-2005 US influenza season presents a unique challenge for health care
institutions. At the core of this challenge is the dual responsibility that
health care institutions have to protect patients as well as the health professionals
who are integral to the functioning of the institution. Many major hospitals
and long-term care facilities have reduced or no supplies of inactivated influenza
vaccine and have limited guidance about how to obtain additional vaccine or
whether to expect redistribution from the remaining supply. Consequently,
issues have arisen ranging from the appropriate allocation of vaccine to the
role of the intranasal live, attenuated influenza vaccine (LAIV) within a
health care institution. These issues pose an interesting juxtaposition of
science, public policy, politics, law, and ethics. This article will briefly
review available literature that may assist institutions in making the difficult
decisions associated with an influenza vaccine shortage.
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