022 - Distribution of Vaccines and Serums by the State Laboratories

This is a short post about a short article, but I thought it was interesting, considering all the people who are suspicious of vaccines because they're made by huge greedy pharmaceutical corporations. See what you think.

C.A. Shore, the author, was the director of the North Carolina State Laboratory of Hygiene back in 1919. Back then, the lab had been trying to decide what its mission included: definitely diagnostic work, possibly some education and research (though those were secondary), but what about vaccine production?

Considering the success of typhoid vaccinations, which in 1913 had cost $2.50 per three injections (too expensive!), the NC lab started producing their own typhoid vaccines and distributing them to registered physicians for free! This worked so well that at least 1/5th of the state had been vaccinated since 1913. The bill for this was charged to the state, $15000.

That worked pretty well, so the lab expanded its production services to pertussis and smallpox vaccines and diphtheria antitoxin (antitoxin is a solution of antibodies that bind to and inactivate the bacterial toxin, used to treat people who are infected with toxin-producing bacteria). They could buy the antitoxin for $8 per 5000 units, but decided to make their own, and charge only $0.25 per package (regardless of whether it contained 1000 or 10000 units), just the cost of syringe and packaging. This small fee was to discourage waste that might occur if it were completely free.

The budget for all of this production and distribution was $25000 in 1918, but the lab hoped to get $35000 for the next year to be able to produce tetanus antitoxin and anything else that was proven to be effective.

Why couldn't the state do this kind of thing today, you may ask? Well...
1) For one thing, inflation: $15000 in 1919 was about the same as $209,000 today. Which still doesn't seem like a lot...
2) Also because producing vaccines in 1919, before very many pharmaceutical regulations were in place, would've been easier and cheaper. Just grow up the cells and kill them, in the case of typhoid. No  purification or recombinant technology or anything like that. But...
3) Nevertheless, some do! Such as this and this. Probably because, relative to other medical treatments, vaccines are cheap, and worthwhile.

Citation: Shore, C. A. Distribution of Vaccines and Serums by the State Laboratories. Am J Public Health (N Y) 9, 106–107 (1919).