Strategies for use of a limited influenza vaccine supply.

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.