I recently read your article arguing that the flu vaccine shortage is a result of the government taking a hands-off approach to the problem. I believe the opposite to be the case. The government has awarded the contract for producing the vast majority of the available vaccine to a single company. As you might expect, this increases the likelihood of problems developing.

DANIEL WODDARD
Dayton Ohio

Dear Daniel,

While it certainly is true that vaccine manufacturing is costly, requires state-of-the-art sterile techniques and is not deemed profitable by most drug companies servicing America, you are wrong on several counts.

First, though the government tries to determine the amount of vaccine doses necessary, at the same time, most of the flu vaccine is purchased by private distributors here, not the government. Second, in countries where the government is more heavily involved, such as the countries of Western Europe, where socialized medicine is the norm, several manufacturers are involved and this problem doesn't exist. (This is partly because of the Food and Drug Administration's desire to heavily regulate sterility, but who could argue with that?.)

Our healthcare system is overpriced as it is, so what you advocate--encouraging the manufacturers to raise their prices in the hope of drawing more consumers in--will only make the problem worse. Plus, as I've said, most drug companies don't like the difficult business of vaccine manufacturing, especially because these products are generic. The solution here is more government involvement to attract more vaccine manufacturers and insure the safety of the population, not less.

I'm writing to say that I stand with you, metaphorically speaking, as you stand by your comments in response to the letter from Ramsey Dallal, who wrote, "Telling a person who is 100 pounds overweight to diet and exercise is a marginal solution." I was more than 100 pounds overweight. On December 26 of last year, I weighed in at 293 pounds. I am male, 5' 10" tall, then 46, now 47 years old. I think my body mass index was about 42. My blood pressure was 140 over 90.

That day, I stopped eating the wrong foods. I started walking more. This was very difficult at first, but as time went by, it got easier. This morning, almost exactly nine months later, I weighed 206 pounds. I'm still classified as "overweight," but I have finally slipped out of the "obese" categorization (BMI below 29.9). My blood pressure at my checkup in July was 100 over 70. My cholesterol is in the healthy range. I feel so much better, and I have so much more energy, it is hard to put into words. I no longer have to purchase clothing at a special store for large people, or limit my choices to garments available in size 3XL. This is a great blessing. (I should mention that I plan to get to a weight that is not in the "overweight" category, and I am working toward that goal.)

To Mr. Dallal, I would say that telling a person who is 100 pounds overweight to diet and exercise is the uncomfortable truth that they need to hear. I have an acquaintance who had the bariatric surgery, and I would not trade the quality of life available through effort and self-discipline for that afforded by the "quick fix" of the surgery. This is a problem that, for most of us, was caused by making too many bad choices about food, and not being active enough. The solution to the problem is to make better choices, and to get up and move.

STEVE LABOUT
St. Peters, MO

Dear Steve,

Bravo. I am very happy to hear a real-life illustration of this point. Hackers and knife-happy surgeons beware. Promoting a need for surgery without exploring less invasive alternatives and lifestyle changes just doesn't "cut it" in my book.

Surely a simple blood test for serum sodium and potassium has been developed for home use, just as a home kit is available for checking blood sugar levels. Of course, the usual professional labs will do it, however, they cost a lot and take so much time.

DORIS DEITS
Milwaukee, WI

Dear Doris,

Not that I know of. Plus, I do think these levels can be indicative of metabolic disturbances, and are best monitored under the care of a physician who can also test the blood.

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