Flavia Montiero Colgan | Bush flip-flops, we get the flu

THE KERRY campaign has finally put its finger on the Bush administration's Achilles heel: incompetence, and a terminal case of flip-flopping.

"If you can't get flu vaccines to Americans, how are you going to protect them against bioterrorism? " Kerry said late last week. "If you can't get flu vaccines to Americans, what kind of health-care program are you running? "

The administration's response to the flu vaccine crisis matches its standard M.O.: Put profits before people. If you get into trouble, cover your tracks with overblown rhetoric.

The latest Bush flip-flop is potentially deadly because, according to the CDC, the flu contributes to about 50,000 deaths a year. And it's a flip-flop because it turns the Bush policy on importation of affordable drugs from Canada on its head.

The brouhaha also has an intimate connection to Pennsylvania, the third-largest egg-producer in the U.S. Current vaccine production uses eggs as an incubator for the vaccine. One hand-injected egg produces enough flu virus for four or five doses.

By 2002, there were only two flu-vaccine production facilities left in America, both in Pennsylvania. The combination of antiquated egg technology (soon to be replaced by cell culture) and the fact that the virus mutates from year to year, makes the production of flu vaccine a risky business. Wyeth, the company that closed its plant in Marietta, Pa., eliminating 800 jobs, lost more than $50 million over the last three flu seasons.

The U.S. needed about 100 million doses of vaccine for this season. When the Marietta plant closed, there was just one domestic production facility left, in the northeast Pennsylvania town of Swiftwater, capable of producing half the 100 million doses.

Up stepped Chiron, a California company that saw a quick profit if it could find a plant already running. It did: in England. The administration said fine, relying only on the company's own reports about the status and safety of the vaccine supply.

Unfortunately, back in the summer of 2003, U.S. health regulators had found quality-control problems in the Liverpool plant. But nothing was done until British authorities recently revoked the plant's license.

On Oct. 5, Chiron said it wouldn't be able to deliver 48 million doses bound for the U.S. They were impounded by the British for bacterial contamination.

Dr. Irwin E. Redlener, of the public health school at Columbia, called the shortage "utterly predictable," saying, "you cannot have a vital function like vaccine production limited to the manufacturing capacity of two companies. It leaves no room for failure. "

The General Accounting Office, the government's watchdog agency, raised an alarm three years ago, saying, "a production delay or shortfall experienced by even one of the remaining manufacturers can significantly impact overall vaccine availability. "

Well, now for the punchline: What is George W. Bush's response to the missing 48 million doses of flu vaccine?

"My call to our fellow Americans is if you're healthy, if you're younger, don't get a flu shot this year," Bush said. "Help us prioritize those who need to get the flu shot, the elderly and the young. " Essentially, Bush's plan is exactly as John Kerry described it: "Pray you don't get sick. "

Shortly after the president gave his sage advice on staying healthy, the Centers for Disease Control and Prevention issued guidelines giving certain groups priority to receive flu vaccine: infants, people over 65, those with chronic medical conditions, pregnant women and health workers with direct patient contact.

What about the other 50 million people at risk? What about the impact of the disease in lost work time and preventable health-care costs? How can the Bush administration, with a straight face, call this policy anything but a colossal failure?

And the kicker: After all the fuss about protecting pharmaceutical firms' profits by prohibiting drug importation from Canada, what does George W. Bush propose?

Yes, ladies and gentlemen . . . Flip-Flopper-in-Chief George W. Bush wants to "work with Canada" to "help us realize the vaccine necessary to make sure our citizens have got flu vaccinations during this upcoming season. "

What's next? Rebaptizing Freedom Fries as French Fries?