Letters

Bobbie Jacobson's analysis of the cause of the recent vaccine supply problems and her suggested remedies ('Public domain', pages 22-23, 20 January) are ill informed and naive.

Take, for example, her statement that 'the meningitis vaccine makers should have further bombs put under them'. Clearly, Dr Jacobson has no knowledge of the massive efforts that have been made by the Department of Health, the Public Health Laboratory Service and the vaccine manufacturers to ensure that these new meningococcal C conjugate vaccines are made available to the UK population as soon as possible, and in advance of their introduction elsewhere.

As a result of the DoH's foresight in commissioning an accelerated research programme in 1994, these new vaccines have been developed with unprecedented rapidity.

The meningococcal vaccination programme is ambitious since it seeks to offer protection to all children under 18 within one year - requiring over 15 million doses. No manufacturer could ever be in the position to provide that amount of a new vaccine in one go. Perhaps Dr Jacobson would have preferred the DoH to stockpile this life-saving vaccine until it had all 15 million doses in the bank.

Given the commercial incentive of supplying the UK market, it is silly of her to imagine that manufacturers could be coerced into providing vaccines faster than they are currently doing.

Vaccine has to conform with the stringent requirements of the Medicines Control Agency with respect to safety and efficacy, together with meeting independently validated batch-release procedures. The shortages for existing vaccines largely result from failure to meet these stringent criteria. Surely Dr Jacobson is not advocating airlifting vaccine into the UK which has not been subject to the UK quality control procedures and giving this to British children?

And I assume Dr Jacobson is not aware that other countries have also faced vaccine shortages. It is public knowledge that the heads of the companies responsible for the shortages were hauled to account before the secretary of state twice last summer. For the DoH to find the funds, develop and implement the meningococcal campaign so rapidly is unprecedented.

Dr Jacobson's claim that our vaccine shortage problems are caused by the lack of political priority given to immunisation is nonsense.

Dr Elizabeth Miller Head of immunisation division and co-ordinator of DoH-funded meningococcal vaccine evaluation programme Public Health Laboratory Service Communicable disease surveillance centre London