Sep 1, 2005 (CIDRAP News) – Because of continuing uncertainty about the supply of influenza vaccine this winter, federal health officials said today that inactivated flu vaccine should be reserved for high-risk groups until late October.”Beginning October 24, all persons will be eligible for vaccination,” the Centers for Disease Control and Prevention (CDC) said in this week’s Morbidity and Mortality Weekly Report.The groups recommended to get first use of inactivated vaccine include people aged 65 and older, those with chronic illness, nursing home residents, children aged 6 to 23 months, pregnant women, healthcare workers who provide direct patient care, and household contacts and caregivers of children younger than 6 months.However, people need not wait until Oct 24 to receive MedImmune’s live nasal-spray vaccine, FluMist, the CDC said. FluMist is licensed for healthy people between the ages of 5 and 49, except for pregnant women.The recommendation comes a day after the flu vaccine supply picture improved with the Food and Drug Administration’s (FDA’s) approval of a GlaxoSmithKline vaccine and a positive report on Chiron’s progress in addressing problems at its flu vaccine production plant in England. The CDC said the recommendation was necessary because the overall vaccine supply and the timing of distribution remain uncertain.In today’s article, the CDC gives estimates of flu vaccine supplies for the United States that add up to a range of 89 million to 97 million doses. That includes 60 million doses from Sanofi Aventis, 18 million to 26 million from Chiron, 8 million from GlaxoSmithKline, and 3 million from MedImmune. (Yesterday, as reported here, a CDC spokesman had listed Sanofi Aventis’s expected production at 50 million doses instead of 60 million, yielding a total production estimate of 79 million to 87 million doses.)Last fall and winter, the loss of 48 million doses of vaccine expected from Chiron prompted an effort to reserve vaccine for high-risk groups until late in the flu season. Ultimately, 57 million Americans were vaccinated and about 3 million doses went unused. In the 2003-04 season, which also saw some shortages, about 87 million doses were available in the US market. The US supply in 2002-03 totaled about 95 million doses, according to the CDC.Yesterday the FDA said Chiron had made “significant progress” in addressing the contamination problems that had forced the company to cancel delivery of doses to the United States. But the agency said more work is needed to determine how many doses the company will be able to supply this year.CDC. Update: influenza vaccine supply and recommendations for prioritization during the 2005-06 influenza season. MMWR 2005 Sep 2;54(34):850 [Full text]See also:CDC’s Aug 6, 2005, recommendations on tiered use of flu vaccine in the event of a shortagehttp://www.cdc.gov/mmwr/preview/mmwrhtml/mm5430a4.htm
Foreign direct investment in the USSource: US Bureau of Economic Analysis Immigrants have founded half the start-ups in recent years, but – according to a recent study from Duke University and the Kauffman Foundation – the rate of start-ups has declined significantly, primarily as a result of immigration policies in the US. Trump’s isolationist stance is likely to exacerbate this trend significantly.As Posen argues elsewhere (for example, in this article from February this year), if the US continues its retreat from economic leadership, it will impose serious pain not only on the rest of the world but also on itself.Trump puts forth the belief that the US has somehow been taken advantage of by its allies and trading partners in the multilateral US-led post-war world. There may be some truth in the area of defence: the US provides security guarantees to its allies and an umbrella of nuclear deterrence. The US military also polices the freedom of navigation in international waters and airspace. These, as Posen points out, are classic public services provided by the US, essentially on its own, that every country benefits from whether or not it contributes.When it comes to the everything else in the global multilateral ecosystem, many, including Posen, argue that it is the US that has been the one free-riding in recent years. US president Donald Trump’s actions are proving to have the exact opposite effect to his objective of “America First”.In a recent article, economist Adam Posen, president of the Peterson Institute for International Economics, makes the case that the president is actually ruining the US’s attractiveness as a place to do business – a case of putting “America last”.One strong piece of evidence supporting Posen’s view is foreign direct investment (FDI) into the US. According to the US Bureau of Economic Analysis, in the first quarter of 2016 the total net inflow of investments was $146.5bn (€128.4bn). For the same quarter in 2017 it had gone down to $89.7bn, and by 2018 it was down even further to $51.3bn.As Posen makes clear, this precipitous drop cannot be ascribed to changes in Chinese investment, which flow both ways with little contribution to changes in the figures. The falloff, he says, is a result of a general decline in the US’s attractiveness as a place to make long-term business commitments. US president Donald Trump and Canadian prime minister Justin Trudeau at the G7 gathering in JuneCredit: Adam Scotti, Canadian Prime Minister’s OfficeFrom accusations of not paying its dues to international organisations on time, to spending a far smaller share of its GDP on aid than other wealthy countries, according to the OECD, and withdrawing from international efforts to combat climate change even as other countries have begun to shift toward greener growth. Is the world moving towards a post-American era?China’s president Xi Jinping appears to have become the global spokesman for the cause of global free trade and capitalism. Indeed, at the World Economic Forum in Davos in 2017 he declared: “Whether you like it or not, the global economy is the big ocean that you cannot escape from. Any attempt to cut off the flow of capital, technologies, products, industries, and people between economies, and channel the waters in the ocean back into isolated lakes and creeks, is simply not possible. Indeed, it runs counter to the historical trend.”Posen argues that, so long as the US economy remains very large (which it will) and at the technological frontier (which it probably will), and maintains its commitment to globally attractive values, the country will be capable of remaining the leader.However, even he admits that it is worth watching the flows of direct investment, especially of net FDI, into the US as an early indicator of how far the global economy has moved toward a post-American era. The data on flows of both investment and people suggest that Trump’s approach to globalisation is certainly moving the world in that direction. But it may not just be in investment flows that the US is losing its attractiveness. The best and brightest from across the world have always been attracted to its shores and its ability to attract them has been one of its great strengths. Silicon Valley would not be where it is today without Chinese and Indian immigrants.