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<P><FONT SIZE=2 FACE="Arial">We are hearing about federal and state efforts to plan responses in case of an avian flu outbreak or other pandemic. We have read about possible stockpiles of anti-viral drugs such as Tamiflu ® and Relenza ® and the need for about 40 million 2 course doses of flu vaccine. </FONT></P>
<P><FONT SIZE=2 FACE="Arial">This raises some questions:</FONT>
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<LI><FONT SIZE=2 FACE="Arial">Whether the responses involve stockpiled vaccines or vaccines made if novel virus is found ---is anyone figuring the cost of disposal of unused vaccines? </FONT></LI>
<LI><FONT SIZE=2 FACE="Arial">If some or all of those "gazillion" doses are unused, who is going to pay for disposal? </FONT></LI>
<LI><FONT SIZE=2 FACE="Arial">Are manufacturers going to take back their unused products for proper disposal?</FONT></LI>
<LI><FONT SIZE=2 FACE="Arial">How likely is it that an avian flu vaccine would contain thimerosal (mercury preservative) in amounts that might make it a RCRA hazardous waste when discarded? </FONT></LI>
<LI><FONT SIZE=2 FACE="Arial">Similarly, would anti-viral drugs contain enough thimerosal or something else that might make them RCRA hazardous waste when discarded? </FONT></LI>
<LI><FONT SIZE=2 FACE="Arial">Or are these vaccines going to contain live virus, which may need to be managed as infectious waste when discarded?</FONT></LI>
<LI><FONT SIZE=2 FACE="Arial">Where can state waste regulators get more up-to-date information about pandemic planning? </FONT></LI>
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<P><FONT SIZE=2 FACE="Arial">This is my personal opinion: I think it would be wise if planners would consider the cost of the dose AND the cost of disposal. While vaccines with thimerosal may cost less initially, the cost of managing excess vaccine may be more than for non-thimerosal vaccines. </FONT></P>
<P><B><FONT COLOR="#800080" SIZE=2 FACE="Arial">Barb Bickford</FONT></B>
<BR><FONT COLOR="#800080" SIZE=1 FACE="Arial">Wisconsin Department of Natural Resources</FONT>
<BR><FONT COLOR="#800080" SIZE=1 FACE="Arial">608-267-3548 </FONT>
<BR><FONT COLOR="#800080" SIZE=1 FACE="Arial">barbara.bickford@dnr.state.wi.us</FONT>
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