The Winter Shield Is Missing – How Pakistan Ran Out of Flu Vaccines Before Flu Season Began

ISLAMABAD : Pakistan has entered its peak flu season without its most important shield. With October marking the start of the annual influenza wave, the country is facing an acute, nationwide shortage of seasonal influenza vaccines, triggering a parallel black market of fake and spurious shots.

Minute Mirror has pieced together the full chain – from pricing committee to pharmacy shelf.

1. The Crisis on Ground:

According to health department and market sources, all major flu vaccines have almost disappeared from licensed medical stores:

– *Vaxigrip Tetra* (Sanofi, France)
– *Influvac Tetra* (Abbott / Viatris, Netherlands)
– Chinese flu vaccines (SinoPharm affiliates)

Distributors in Lahore, Karachi and Islamabad confirm zero stock for the last 3 weeks. What little stock exists is being sold at 300-400% black market premium, or is counterfeit.

2. The Fake Vaccine Racket Exposed:

Taking advantage of the shortage, counterfeiters have flooded the market.

*Major Raid in Lahore:* On a tip-off, Drug Inspectors raided a pharmacy in Lahore this week and recovered a heavy consignment of suspected fake *Influvac Tetra*. Two accused were arrested on the spot. The stock has been sent to the Drug Testing Laboratory (DTL), Lahore for analysis. A case is being registered under the Drug Act 1976.

*DRAP Rapid Alert:* DRAP has issued a critical Rapid Alert *No. I/S/10-26-47 on October 27*, declaring *Batch No. Y4B34 of Vaxigrip Tetra as spurious / falsified*. DRAP confirmed this batch was *never imported, never cleared, and never distributed* in Pakistan through legal channels.

3. Why Did The Shortage Happen? – The Pricing Committee Loop

The reason is not supply, but price.

Federal Health Minister Dr. Musadik Malik has admitted on record that the federal cabinet did not approve the price increase demanded by multinational companies.

*The inside story:* Minute Mirror has learnt that:

1. A multinational company refused to import its vaccine altogether this year, citing unviable pricing.
2. A second multinational agreed to import only in December _after_ revised prices are fixed.
3. Chinese companies’ limited stock imported earlier has already exhausted.
4. DRAP had proposed new prices, but on scrutiny, the Federal Government found that the *import cost was lower than the proposed retail price*, indicating over-pricing. Flaws were found in the costing of 3 flu vaccines.

The file is now stuck in a “committee over committee”. A pricing committee’s recommendations were sent to another review committee. That committee is still pending. No price has been notified. Without a notified price, companies cannot get import clearance.

Result: The usual October vaccination drive never started.

4. What is Seasonal Influenza? Why October Matters:

Seasonal influenza is a highly contagious viral respiratory infection.

*Types:*
– *Influenza A:* Most common, causes severe epidemics. Subtypes H1N1 and H3N2 are currently circulating.
– *Influenza B:* Milder but can cause severe illness in children. Includes Victoria and Yamagata lineages.
– *Influenza C & D:* Generally mild, not included in vaccines.

In Pakistan, flu season starts in *late October and peaks from December to February*. The vaccine takes 2 weeks to build immunity, hence WHO recommends vaccination in October.

*Who is at highest risk:* Elderly above 65, children under 5, pregnant women, diabetics, cardiac and asthma patients, and immunocompromised patients. Doctors say they are the ones now hunting for vaccines.

*Cure / Treatment:* There is no direct cure for the virus. Treatment is supportive. Antiviral *Oseltamivir (Tamiflu)* is effective if given within 48 hours. Annual vaccination is the only effective prevention. The quadrivalent vaccine covers 4 strains – two A strains and two B strains.

5. All Stakeholders – Where They Stand:

*a) Patients’ Voices:*
At Mayo Hospital and PIMS, patients said: “My father is 72, diabetic. The doctor advised flu vaccine every year. We visited 7 pharmacies in Lahore – all say not available. One offered it for Rs 8,000 without bill, we refused fearing fake.” – A son of a patient in Lahore.

*b) Pharmaceutical Companies / Importers:* Off the record, they say: “We cannot import at a loss. Our global cold-chain cost, dollar rate and freight have increased by 40%. DRAP must give a realistic price.”

*c) Distributors & Pharmacies:* “We have advance bookings from hospitals but no supply. Now we fear even if we buy from grey market, we may be caught for selling fake. We are asking for DRAP’s official list of authentic batches,” said a Lahore-based distributor.

*d) DRAP (Drug Regulatory Authority of Pakistan):* Officially maintains it is reviewing prices rationally to prevent overcharging. It has issued the alert for Y4B34 and has asked all DTLs to remain vigilant.

*e) Drug Inspectors / DTL:* Field force has been activated for sampling. DTL Punjab has been directed to prioritize flu vaccine samples on a fast track.

*f) Federal Ministry of National Health Services:* Claims it has ordered DRAP to re-calculate prices within days and genuine stock will be available in limited quantity by *late November or December* – by which time half the flu season will be over.

6. What Should Citizens Do?

Drug Control Authority has issued a precautionary advisory:

1. Buy vaccines ONLY from licensed pharmacies, never from online sellers or unregistered medical stores.
2. Always check *Batch Number, Manufacturer’s Seal, Expiry, and Cold Chain* – flu vaccines must be kept at 2-8°C. If the pharmacy takes it out of a drawer, not a fridge, it’s fake.
3. Ask for the bill with batch number mentioned.
4. Report any suspected fake vaccine to *DRAP Helpline* and nearest Drug Inspector. Verify batch Y4B34 – if anyone offers it, it is 100% fake.

*Bottom Line:* This is a man-made shortage. While committees debate pricing, patients remain unprotected and counterfeiters are making a killing. Until DRAP notifies a price, Pakistan’s flu shield will remain missing.