Who gets bird flu vaccine first when there's not enough to go round?

According to the top health official in the U.S., it will be three to five years before the United States can produce enough bird flu vaccine to inoculate its population against a potentially deadly outbreak in humans.

Michael Leavitt, the Secretary of Health and Human Services, says that until production capacity is sufficient for the entire population, supplies would have to be rationed in the event of an outbreak.

Leavitt says the U.S. will not have the capacity to produce 300 million doses of a vaccine for three to five years, as the vaccine manufacturing industry has diminished and will need to be rebuilt.

He says that once the capacity is there, another six months would be needed to produce sufficient quantities of the vaccine.

Leavitt says that there will not be enough for everyone and some very difficult, and agonizingly decisions will need to be made as to who should be given priority.

Apparently his agency has developed a plan that would give top priority to health-care workers and people who make the vaccine, while older people and other high risk people would have a high priority.

Healthy school-aged children are relatively low on the priority list.

Although the list has been revealed for public debate, Leavitt says but it would be up to individual states to develop their own set of priorities for limited supplies of the vaccine.

He says the decision on how to allocate scarce resources during a time of a pandemic will mean very difficult and troubling choices.

To date millions of birds have been slaughtered, mostly in Asia, in an attempt to stop the spread of the bird flu virus.

As yet the virus cannot easily infect people, but it has sickened 130 people in five countries in Asia, killing 68 since late 2003.

Experts are concerned that the virus will mutate and spread more easily among humans and say governments need to be prepared for the worse case scenario, a global pandemic.

According to Dr. Anthony Fauci, head of the U.S. National Institute of Allergy and Infectious Diseases, even if a pandemic does not happen it does not mean that preparedness is wasted, because sooner or later a pandemic will happen.