Online Medicine Sellers Take Advantage of Vaccine Shortages

Vaccines sold online

Screenshots of vaccine advertisements
from Liang and Mackey's research

Some vital vaccines, listed as in short supply by the FDA, are advertised and sold online. Researchers Dr. Bryan Liang and Tim Mackey examined the online advertisers of these vaccines to see whether they were VIPPS accredited pharmacies, or if they were unreliable sources.

Liang and Mackey reported in Vaccine, November 2011, that the FDA has identified critical shortages in vaccines for Hepatitis B, Pediatric and Adult Hepatitis A and Zoster vaccines. Given that more than 175 million adults use the internet for medical information, the researchers say that it is possible that physicians, hospitals, and patients may seek to purchase these vaccines online.

Worldwide, vaccines have been subject to counterfeiting, including the inoculation 60,000 people in Niger with fake meningitis vaccines, and 1,400 people in Texas injected with fake flu vaccine. Counterfeit rabies vaccine was found in China, and fake flu vaccine sold in drugstores in the Philippines. More worrying, the potential for counterfeit vaccines to become rampant grows during disease outbreaks.

Both medical professionals and worried consumers may want to protect themselves and their patients by purchasing vaccines online.

“Yet,” say Liang and Mackey, “online purchasing of medical products is rife with patient safety risks. The criminal element in combination with poor quality, suspect materials, questionable sourcing, diversion, and improper storage create challenges when purchasing pharmaceuticals online.”

This is even truer for vaccines, which require specialized quality control, storage and transportation. Despite authorities’ warnings that purchasing vaccines online is potentially dangerous, more people purchase medicine online every day. Even social media sources like Facebook and Twitter have been penetrated by illicit online drug sellers, adding to the sources of risk for consumers.

Liang and Mackey sought out vaccine sellers online to see if they sold FDA identified scarce vaccines, and if the sellers were accredited by the National Association of Boards of Pharmacy’s VIPPS program.

Their first surprising conclusion was that all the vaccines subject to shortage were available online. Their second conclusion was that none of the online vendors were VIPPS-accredited. 75% of these sellers were international, and 83% of them were already on the NABP’s Not Recommended Site list. Liang and Mackey found suspect vaccine vendors in Google search results, but also in Facebook and Twitter. Adding to the deception, sellers claimed that these vaccines were over-the-counter medicines available without prescriptions.

Say the researchers, “Such misleading advertisements may induce unknowledgeable persons, particularly patients, to purchase and self-administer without appropriate oversight.”

Then Liang and Mackey expanded their evaluation to cover all vaccines on the WHO Essential Medicines List (EML). Similarly, all the vaccines on the list were available for purchase online, from international sellers that appeared on the NABP Not Recommended Sites list. They even found one website that claimed VIPPS accreditation, but it was false.

“Vaccine shortages may lead some providers and patients to seek out alternative sources, including the Internet. Yet Internet purchasing is inherently dangerous with poor quality and/or counterfeit forms of various types of medicines that have injured and killed unsuspecting patients,” say the researchers.

Liang and Mackey warn that only purchases from online medicine websites that are VIPPS-accredited pharmacies are safe.

But the risks are not just for American consumers. Say Liang and Mackey, “With an estimated 1.7 million children under 5 currently dying worldwide from vaccine-preventable diseases due to low vaccination rates and economic disparities in developing countries, international global health initiatives, such as the Global Alliance for Vaccines and Immunizations, have responded by improving access and have enjoyed boosts in funding. However, an influx of counterfeit products could deal a major setback to these efforts.

By S. Imber

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