Strengthening the supply of routinely recommended vaccines in the United States: a perspective from the American Medical Association.

Influenza virus vaccine shortages and delays in distribution require continued collaborative efforts by all stakeholders to ensure that Healthy People 2010 goals are met. Problems with supplies of other vaccines jeopardize at-risk populations. The American Medical Association recommends that the US Department of Health and Human Services establish a task force to explore the causes of vaccine shortages and maldistribution. The task force should commission an appropriate body of experts to identify solutions for breakdowns in vaccine manufacturing and distribution systems. Potential areas for improvement include earlier notification of shortages to the US Food and Drug Administration, improved communication to physicians, financial incentives to market medically necessary but unprofitable products, and a national stockpile of certain vaccines. The American Medical Association believes that the strategies proposed by the National Vaccine Program Office (i.e., increasing financial incentives, streamlining the regulatory process, establishing government-directed programs, creating and maintaining vaccine stockpiles, and increasing liability protection) could improve vaccine availability; however, increasing vaccine stockpiles is the most promising strategy.