Oct. 20 (Bloomberg) -- In a presidential campaign where the candidates have been stressing the same topics for months -- terrorism, Iraq, jobs -- an issue few anticipated has pushed its way into the dialogue: Flu vaccines.

John Kerry, the Democratic nominee, is using the shortage of influenza shots to try to persuade elderly voters and mothers of infants that President George W. Bush isn't able to protect the public's health. Bush this week dispatched Health and Human Services Secretary Tommy Thompson to the battleground state of Florida, with its large population of senior citizens, to reassure voters that those who need flu shots will get them.

``If it becomes viewed as a failure of planning, a failure of the administration having a backup strategy, then the Kerry campaign might score some points,'' said Lee Miringoff, director of the Marist College Poll in Poughkeepsie, New York.

In press releases and advertisements this week, Kerry, the four-term Massachusetts senator, accused the Bush administration of ignoring warnings about the potential supply crunch. In a Tampa, Florida, speech on Oct. 18, he criticized the president for not having a solution. The Bush campaign countered by accusing Kerry of opposing legislation that might have helped avert the shortage.

The U.S. lost a supplier of 48 percent of the vaccines for flu -- a disease that kills 36,000 Americans each year -- after the closure of the Chiron Corp.'s U.K. plant by British authorities this month. The flu is most deadly for infants, the elderly and people whose immune systems have been weakened by disease. Florida, Iowa and Pennsylvania have three of the four highest percentages of elderly voters and are battleground states, where the campaigns expect the closest races. People 65 and older vote in higher numbers than any other age group, according to U.S. Census data.

Contamination

The decision by U.K. authorities to close the Chiron plant in Liverpool, in Northwest England, because of contamination means that the U.S. will get 60 million doses of flu vaccine, 23.1 million fewer than the U.S. government distributed last year, according to government figures.

This year's total includes 2.6 million additional doses that Paris-based Sanofi-Aventis SA agreed this week to ship in January and MedImmune Inc.'s 2 million doses of FluMist nasal spray, Thompson said yesterday on a conference call with reporters.

`Not an Emergency'

``We want people to relax,'' Thompson told a news conference in Tampa, Florida, the Associated Press reported. ``The flu season is not here,'' Thompson said. ``This is not an emergency right now.''

The issue is important for parents because ``some people are going to want the flu shots for all their kids no matter what,'' said Stephanie Kiesling, a 36-year-old suburban Chicago mother of two boys. She said she could only have her 22-month-old son Jack immunized. Four-year-old Matthew couldn't get a flu shot this year as he has in the past.

``Last year, since my younger one was under two they gave it to all the kids in the household as a standard of care,'' she said. This year, the decision not to give flu shots to older siblings of infants ``regardless of age'' was dictated by the vaccine shortage, she said.

Kerry criticized Bush's response to the vaccine shortage at a rally in Tampa earlier this week.

Standing in Lines

``With senior citizens standing in lines, mothers frantic how to protect their children, this president gave the public his solution: `Don't get a flu shot,''' Kerry said.

The Bush campaign countered that Kerry's opposition to liability reform in the U.S. Senate helped drive vaccine makers out of business, according to an Oct. 18 press release.

Bush, during a trip to St. Petersburg, Florida, yesterday, said the government is ``doing everything possible'' to speed flu vaccines. ``We have millions of vaccine doses on hand for the most vulnerable Americans and millions more will be shipped in the coming weeks.''

The Kerry campaign and supporters such as Democratic Representative Henry Waxman of California cite reports by the nonprofit Institute of Medicine and the U.S. Government Accountability Office as evidence the Bush administration has been on notice since 2001 that the nation was vulnerable to supply disruption because only Chiron, based in Emeryville, California, and Sanofi-Aventis make flu shots.

Government Reports

In an August 2003 report, the Institute of Medicine warned that ``recent shortages of vaccines have highlighted the fragility of vaccine supply'' for the full range of immunization for diseases such as flu, tetanus and hepatitis and childhood diseases such as diphtheria, measles, mumps and rubella.

The ability of the U.S. government, which purchases half of all vaccines administered in the country, to command low prices means ``companies face declining financial incentives to develop and produce vaccines.'' The report noted the number of vaccine manufacturers had declined from 25 companies three decades ago to five, including the two that make flu shots.

In May 2001, the GAO warned that manufacturing difficulties that delayed vaccine shipments up to eight weeks during the 2000- 2001 flu season ``illustrate the fragility of the system to produce a new flu vaccine each year on a timely basis.'' The government also lacked a system ``to ensure that high-risk people have priority when the supply of vaccine is short.''

`Unresolved'

Janet Heinrich, the GAO's director for health-care and public health issues, repeated that warning Sept. 28 in testimony delivered to Congress. She also said that the Health and Human Services Department's plan for dealing with a possible flu outbreak ``leaves many important decisions about the purchase, distribution and administration of vaccines unresolved.''

The government's plan doesn't set up a ``definitive federal role'' for purchasing and distributing flu vaccine, she said.

Bill Pierce, a spokesman for Thompson, defended the Bush administration's handling of the flu-vaccine issue. ``What we don't need people to do is scare seniors,'' he said. ``Senator Kerry has been doing that.''

Under Bush's presidency, spending on flu-related programs increased from $39 million to $215 million, Pierce said.

``We have been doing a great deal to broaden, diversify and expand'' the supply of flu vaccines, Pierce said. In the corporate tax bill Congress enacted Oct. 11, the government will indemnify flu-vaccine makers against claims of injury from shots, he said.

People who have claims can file them with the Vaccine Compensation Program that Congress set up two decades ago to compensate injury from childhood vaccines.

Repercussions

The shortage of flu shots may have political repercussions for Bush, said Dick Bennett, president of American Research Group Inc., a polling firm based in Manchester, New Hampshire.

``It's like lines at the gas pump,'' Bennett said. ``You don't notice it until there is a shortage. People become unhappy and they do want to blame people.''

``If you're the Bush campaign you don't want to see somebody standing in line all day and not getting a flu shot,'' he said.

In Florida, 18 percent of the population is age 65 or older, the largest percentage in the U.S., according to Census Data. Pennsylvania ranks second at 15.6 percent and Iowa is fourth with 14.9 percent.

If the election is ``close enough in a couple of states, a minor issue could seemingly swing enough votes to change the outcome,'' said Peverill Squire, a political scientist at the University of Iowa.

Because of the shortage, the U.S. Centers for Disease Control urged doctors to reserve flu shots for elderly patients, infants and others most at risk to complications from the flu.

Women Voters

Kerry's attacks may also resonate with women voters, who ``are more apt to be in play and open to arguments later in the campaign,'' Bennett said. Historically, women account for 60 percent to 70 percent of undecided voters, he said.

Difficulty getting flu shots may also be a potent issue for senior citizens, said Susan MacManus, a political scientist at the University of South Florida in Tampa.

``Older voters are a little more informed on the problems of vaccine,'' MacManus said. ``They are going to blame the president. That's the way it is.''

Massachusetts businessman Allyn Coombs, 70, who voted for Bush four years ago, said the vaccine shortage may prompt him to cast his ballot for Kerry this year.

`Another Factor'

``It's another factor in what I consider to be a complete failure of our medical system to take care of us,'' said Coombs, who suffers from cancer, high blood pressure and heart trouble.

Unable to find flu shots in Franklin County, a rural area in Massachusetts near the Vermont border, Coombs said he and his wife, Joan, who also suffers from cancer, may drive to Canada if he can find a place to get vaccinated. ``We desperately need a flu shot,'' he said.

To address shortages in areas where Chiron was the supplier of flu shots, Thompson this week ordered doses produced by Sanofi- Aventis be redirected to states and localities that have no shots, Pierce said.

The flu-shot issue was discussed during the third and final presidential debate Oct. 13 between Bush, 58, and Kerry. 60. Moderator Bob Schieffer asked Bush to explain why the shortage happened.

``We relied upon a company in England to provide about half of the flu vaccines,'' Bush replied. ``It turned out that the vaccine they were producing was contaminated. And so we took the right action and didn't allow contaminated medicine into our country.''

The president said his administration was ``working with Canada'' to get additional supplies. ``If you're healthy, if you're younger, don't get a flu shot this year.''

The president also blamed litigation, saying ``vaccine manufacturers are worried about getting sued'' and have stopped supplying flu shots.

Kerry didn't discuss the flu-shot shortage, except to say ``this really underscores the problem with the American health- care system, it's not working for the American family.''[

Two days later, his campaign began airing ads that accused the Bush administration of failing to heed warnings of potential problem with vaccine shortages.

To contact the reporter on this story: James Rowley at jarowley@bloomberg.net

Last Updated: October 20, 2004 00:12 EDT