IMPROVING THE RELIABILITY OF THE US VACCINE SUPPLY - AN EVALUATION OFALTERNATIVES

Since taking office, President Clinton has devoted considerable attent ion to childhood immunization and to the overall U.S. policy toward va ccine development, delivery, and pricing. But the reliability of U.S. vaccine supplies has received far less attention, despite several rece nt interruptions in vaccine production and supply. Moreover, the incre asing producer concentration in the U.S. and global vaccine industries raises the possibility that more and more important vaccines will be produced by a single firm, often in a single production facility. Is a federal policy for vaccine supply assurance necessary, and what form should it take? Are sole-source suppliers a weak link in the U.S. vacc ine supply chain? Are the recommendations of the Institute of Medicine 's Committee on Emerging Infections for a publicly owned ''standby pro duction capacity'' of critical vaccines feasible or cost-effective? We consider these and other issues in our discussion of the U.S. vaccine industry, the potential role of foreign vaccine suppliers, and the us e of existing federal facilities and policies to address a possible in terruption in critical vaccine supplies.