According to the WHO in their Global Pandemic Influenza Action Plan published in 2006, “At the present time, if an influenza pandemic were to occur, the potential vaccine supply would fall several billion doses short of the amount needed to provide protection to the global population,” http://www.who.int/csr/resources/publications/influenza/CDS_EPR_GIP_2006_1.pdf
The amount of vaccine in the U.S. that would be available during the early stages of a pandemic also falls short of the amount needed to immunize our entire population . This mismatch between demand for vaccine and supply of vaccine during the first wave of a pandemic requires some difficult decisions about vaccine prioritization. A Federal interagency working group comprised of members of all sectors of the government has tackled this difficult problem and recently produced the Draft Guidance on Allocating and Targeting Pandemic Influenza Vaccine. http://www.pandemicflu.gov/vaccine/prioritization.pdf
The work-group considered scientific and ethical issues and solicited public input in developing their prioritization . Their primary objectives for vaccination are well thought out and they have a tiered approach based on the severity of the pandemic. The document is posted for public comment at the following link. http://www.aspe.hhs.gov/panflu/vaccinepriorities.shtm
Guidance about rationing of scarce vaccine should be made well in advance of a pandemic and the committee has tackled this very difficult task. I encourage everyone to look at where you potentially fall in the vaccination prioritization and to comment if you do not believe it is based on sound reasoning.