While administration officials blame drug manufacturers for the H1N1 flu vaccine shortage, there are two ways to get the vaccine to more people: better security and regulations need to be set to ensure the vaccine gets into the right hands, and for health reasons, women should be given a lesser dose than men.

Regulating who gets what, and why

In Chicago, a refrigerated truck carrying 930 doses of the vaccine was stolen. Though it was found 40 minutes later with none of the vaccines taken, the doses were sent back to their manufacturers to ensure they were not tampered with; the truck company was fired; and new rules have been placed that these cargo trucks holding the H1N1 doses must be escorted by a police squad.

But while the story is outrageous, it shows desperation. The thief was either in dire need to get vaccinated, wanted to share the vaccine with someone else, or knew that people will pay a lot of money to get their hands on the vaccine. The idea of someone stealing this drug seems less absurd than the major companies in New York that are getting their hands on the vaccine before people in high-risk categories, which include people ranging from 6 months to 24 years of age, pregnant women, medical staff, and people with underlying medical problems.

These large companies – inclusive of Citigroup, Goldman Sachs, Time Warner and JP Morgan Chase – are similar to the Chicago truck thief, except their form of stealing is dimmed because they have the money, and they have the power.

Citigroup has been supplied with 1,200 doses and Goldman with 200, said Jessica Scaperotti, a press secretary for the New York Department of Health and Mental Hygiene.

Goldman’s 200 doses can be compared to the 200 doses received by the Memorial Sloan-Kettering Cancer Center. However, Goldman asked for 5,400 H1N1 vaccines, while the Cancer Center asked for 27,400 doses for patients, workers and volunteers.

These large companies are promising they will only distribute the vaccine to people who meet the Centers for Disease Control and Prevention (CDC) criteria to be considered high-risk. But how many employees do these major companies have who are under the age of 24? How much medical staff do these business and financial companies have? And are there more medical staff outside of hospitals who are not receiving doses of the vaccine? These unanswered questions leave obvious room for suspicion. 

So aside from scientific vagaries, the main cause for the shortage of the H1N1 vaccine, which is out of our control, is the need for better management on where the doses are distributed, as well as a publicized guideline on how distribution decisions.

In BusinessWeek magazine, Scaperotti said that large companies are getting the vaccine because “they placed an order ... it’s not out of the ordinary.” She compared big-time companies getting vaccines with elementary schools that have received doses for students. 

Instead, vaccines should be distributed to only hospitals and clinics. With the exception of schools, there should be no first-come, first-serve when discussing medicine – especially if hospitals must also play in the bidding game and are losing.

Lessen the dose for women

Another way to put the H1N1 flu vaccine into more effective use is by considering the biological differences between men and women. 

A research study called the “Half- vs. full-dose trivalent inactivated influenza vaccine (2004-2005)” published in the Archives of Internal Medicine said that healthy adults aged 18 to 64 years were randomly given half or full doses of a flu shot, with results showing women produce equal amount of antibodies with half the dose compared to men, who receive the full dose.

Though this half-and-full-dose theory was not tested specifically on the H1N1 virus, according to a study conducted in 2008 called “Sexual dimorphism of humoral immunity with human vaccines,” it held true in treating yellow fever virus, measles, mumps, hepatitis A and B viruses and the herpes simplex virus.

More research must be done on the differences between women’s and men’s immunity, but for certain instances such as the current problem with a lack of the H1N1 vaccine, this study could ultimately save money. 

Also, women who received the half dose were also spared some of the normal side effects of getting a flu shot. These include less pain at the injection site and less chance of inflammation and fever, all symptoms more common in women than men.

According to the CDC, as of Nov. 13 approximately 41.6 million doses were distributed within the U.S., and Hawai‘i has received 130,000 of those doses. If the half-dose theory holds true for most women, poorer countries may have a chance at getting the swine flu vaccine after the U.S.