Facing the vaccine shortage. (When the Free Market Fails).

THERE WAS no flu shot available for Bill Gaines last November. The Ann Arbor Veterans Affairs Medical Center had received an unusually small vaccine shipment. Shots were restricted to patients with serious illnesses. Gaines, who suffers from emphysema, qualified. But before his turn came the vaccine supply had run out. Told to try his luck again in a couple of weeks, he left frustrated and angry. Having served in the Army for almost a decade, he felt he deserved better treatment.

Gaines' experience was repeated across the country--a serious matter, because the influenza virus does not merely cause the achy, sneezy, sniffly thing called "the flu." In people with chronic illnesses it often leads to bacterial pneumonia, which kills 20,000 Americans each winter.

Since it was impossible to know the number of lives lost as a direct result of not getting a flu shot--many people with chronic afflictions die from respiratory infections every year--there was not much of an uproar about last fall's public health fiasco. Over the past five years hospitals and clinics in the United States have also experienced shortages of tetanus vaccine and antibiotics such as penicillin. In those instances, too, it has been very difficult to identify victims of the scarcities, so relatively little political pressure built to end them.

The post-September 11 anthrax scare, perhaps more than any other single event, highlighted the deficiencies in U.S. health care and the importance of maintaining adequate reserves of antibiotics and vaccines. To fully understand the implications of the situation, though, one has to trace its development.

The story of our medication shortages begins in Mission, Texas, with a girl named Anita Reyes. She received her polio vaccination on May 8, 1970. Fourteen days later, she contracted the disease and became paralyzed from the waist down. Her parents sued Wyeth Laboratories, charging that its vaccine had caused the girl's polio. During the trial, Wyeth's expert witnesses demonstrated that the virus isolated from Anita's stool on the day she was admitted to the hospital was "probably wild," meaning …