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SUMMARY: Sudden vaccine shortage underscores the need for more diverse suppliers, greater speed in production.

Failure of a vaccine maker to deliver its flu vaccine to the United States this fall has created a minor health care crisis - one that might easily grow to larger proportions.

U.S.-based Chiron Corp. said Tuesday that it would not be able to deliver

46 million doses of Fluvirin after British authorities suspended the company's license to produce vaccines at its Liverpool, England, facility due to concerns about contamination. The national Centers for Disease Control and Prevention immediately called for rationing of available flu vaccines to give babies, elderly and other high-risk people first shot.

The CDC annually recommends that some 180 million Americans get vaccinated against the latest flu strain; fewer than

100 million usually do. This year, it looks as though there'll be enough vaccine for about 50 million people.

The ramifications may not be all that great. Then again, the effects could be bad. It depends on the severity of this year's flu season, the extent to which available vaccines make their way to high-risk patients and the extent to which people act to reduce flu's spread (try washing your hands well and often, and don't send your sick kid to school). Most people never bother to get flu shots and do fine. Then again, the CDC says flu typically contributes to 36,000 deaths annually, sends 114,000 people to the hospital, forces people to call in sick a combined total of

70 million work days and costs some

$14 billion in health care costs and lost productivity. A flu season doesn't have to be very much worse than average to hit hard.

In light of such statistics, it's amazing to learn (as most of us did this week) that the United States is almost completely dependent on two companies running two factories for flu vaccine.

Chiron produces nearly half of all the country's flu vaccine. Another company, Aventis Pasteur, produces most of the rest, with a third company adding a nasal-spray vaccine in relatively small quantities. What's that old saying about putting all your eggs in one basket? Two baskets aren't that much better.

It's not as if no one saw such a problem coming. The United States experienced flu vaccine shortages last year and in 2000-2001. Well before this week's disappointing news, a national task force examining America's vulnerability to flu had been pointing to the need to find ways to diversify and speed up vaccine production.

Depending on how the next few months go, perhaps now people will listen.

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