http://www.newhousenews.com/archive/wylie010804.html SCIENCE AND TECHNOLOGY Experts Advise Against Online Purchase of Flu Vaccines BY MARGIE WYLIE c.2004 Newhouse News Service \ More stories by Margie Wylie In the midst of the nation's flu epidemic, a panoply of influenza preventions and cures is being hawked online, including vaccines not licensed by the federal government and prescription drugs. Buyers should be wary, doctors and the U.S. Food and Drug Administration warn. MedicationX.com, a Web site registered to an address in Costa Rica, offers to ship syringes prefilled with one of two flu vaccines, at $25 to $35 a dose. Neither vaccine is approved for sale by the FDA, making it illegal to import them, said Steven Masiello, director of the FDA center that oversees vaccine quality. "Consumers should beware of vaccines being offered through unusual channels," Masiello said. The vaccines could be fakes, contaminated or simply ineffective from being stored improperly, he said. MedicationX.com did not respond to e-mail, and the telephone number listed in the site registration was not answered in several attempts over two days to obtain comment. The site advertises two vaccines -- FluaRix by GlaxoSmithKline and Imovax Gripe from Aventis. Both meet World Health Organization recommendations for flu strains covered and are for sale outside the United States, according to the manufacturers' Web sites. Neither manufacturer returned calls seeking further details. The MedicationX.com site says flu shots are shipped by mail and can take up to two weeks to arrive. But unrefrigerated vaccine can lose its effectiveness, said Steven Black, co-director of the Vaccine Study Center for Kaiser Permanente, a health maintenance organization headquartered in Oakland, Calif. Even if the vaccine survived the trip, it would take another week after injection before users got any protection, Black said. "By then, we'd be well into next month" and the flu should be waning, he added. "In the best of circumstances, (buyers) will get something that won't do any harm, but it won't do any good either." U.S. licensed vaccines include Fluzone from Aventis Pasteur, Fluvirin by Chiron and the nasal spray FluMist from MedImmune. An unexpectedly virulent flu season has depleted stocks of first two. What remains is being held for seniors, infants, the seriously ill and others at high risk of complications from flu. FluMist remains in ample supply for healthy people ages 5 through 49, according to MedImmune. Online pharmacies are also selling prescription anti-viral medications, such as Tamiflu. Anti-virals can be up to 90 percent effective in staving off the flu and can shorten symptoms by several days once the infection takes root, according to the federal Centers for Disease Control. But to prevent infection, said Dr. Arnold S. Monto, professor of epidemiology at the University of Michigan's School of Public Health in Ann Arbor, anti-virals must be taken every day. Like any drugs, they can have side effects or interact with other medications, so Monto advised against Internet purchases without first seeing a physician. Finally, there is a raft of herbs, vitamins, immunity boosters and "natural" medications -- such as colloidal silver and "influenzinum" -- widely touted across the Internet as flu preventions or cures. Many makers of colloidal silver -- flakes of silver metal suspended in water -- have been repeatedly warned by the FDA against making medical claims for their products, said Stephen Barrett, a retired psychiatrist who operates the Quackwatch Web site. Barrett also dismissed claims of effectiveness for pills containing infinitesimally small amounts of flu virus, or influenzinum. "You might be able to get by with claiming to treat flu symptoms, but preventing the flu is another thing," he said. Black was blunter: "I think it's all wishful thinking and chicanery." Dolisos America, however, stands by its claims for Dolivaxil, an influenzinum compound. "We have three company-sponsored clinical trials that show up to 90 percent efficacy" in preventing flu, "and hundreds of MDs order and use our products," said Darren Krein, vice president of the Las Vegas subsidiary of Pierre Fabre, a French pharmaceutical and cosmetics manufacturer. "We can't keep Dolivaxil in stock right now. It works." Jan. 7, 2004