Going Shopping To Replace Potassium Iodide for Participating States

Patricia Milligan
Senior Level Advisor for Emergency Preparedness

The Department of Health and Human Services, acting on behalf of the NRC, last month issued a procurement order for 14 million tablets of potassium iodide to replenish out-of-date supplies. This drug, also known by its chemical symbol KI, is used to protect the thyroid against radioactive iodine should a nuclear power plant accident occur, and is part of NRC’s program to help states and localities with their emergency response plans.

The NRC first offered KI tablets to states with residents living within the 10-mile emergency protection zone of a nuclear power plant in 2001. The agency recommends that states consider including KI in their emergency preparedness plans and provides it to those states that ask for it. Currently, 25 states have requested and received the pills.

The NRC’s policy is to offer KI to states once every six years to replace pills that may have passed their shelf life. The recent order is the third wave of replenishing KI. While this matter has been subject of some social media attention as perhaps indicative of some imminent threat, supplying KI is nothing new. Including KI in emergency plans is a decades old precaution. However, this is the first time the NRC has used the HHS medical procurement service to order KI. The NRC decided to go through HHS this time in order to leverage federal buying power and reduce costs.

Here are some other facts about KI:

• KI protects the thyroid from iodine-131, a radioisotope that would likely be released into the air during a nuclear power plant accident. It does not protect against all forms of radiation and is to be taken in addition to other protective measures, such as sheltering.

• Residents living near nuclear plants should take KI only when directed by local authorities during an incident – it is not a daily supplement to build up immunity, as some have advertised on the Internet. In fact, daily use can be harmful.

If you live within 10 miles of a nuclear power plant and want to inquire about obtaining KI and/or disposing of expired KI, contact your state health authorities.

Author: Moderator

Public Affairs Officer for the U.S. Nuclear Regulatory Commission

29 thoughts on “Going Shopping To Replace Potassium Iodide for Participating States”

  1. Is that not similar to Fukushima, they were reporting to the government and yet the public was been told the plant was safe while it was melting down in shambles. It was so bad that workers could not get close to many areas to evaluate the plants condition. The public was under the impression that the plant was under control and safe.The nuclear industry in Japan told the public that the plant is under control cold shut down, Again what about the sailors on the US ship that they did not warn, they new it was not safe yet they did not warn them, there must have been many Japanies worker that were on ships all so responding from the sea to attack the problems.
    They should of evacuated Tokyo, thought about it and did not, yet they new at least 3 plants were melting down after blowing up and 5 pools of spent and fresh fuel was compromised, they also had a plant close to this one that may also blow up with its pools. On top of this there may be more earth quacks to shake these ravaged plants. Why did they not evacuate Tokyo and surrounding area, it looks like they will never try to evacuate a high populated area no mater what the risk is.After seeing this response I have no confidence that the public will be warned in time.

  2. What is the chances that the public will be notified in time, in Japan TEPCO denied that the plant was melting down at the time. On some pro-nuke sites they claim that there was little threat, so anyone in charge with similar views and do not want to be blamed for causing a faults alarm are not likely going to sound an alert until it gets extremely bad. The alert will probably go up a chain that will take time to make a discussion, In Japan some didn’t over ride purchasing authority to buy needed equipment to fight the emergency. I have no confidence in the public being given notice in time to evacuate, if there was no earthquake and tsunami would the evacuation been ordered in time.

  3. There is another option to simple replacement of existing KI sources. The bulk of the requirement is for adult doses, and these could be replaced with no tablets.

    Exposure to radioiodine is a hazard only for children. There is direct evidence from medical use of radioiodine to demonstrate that it does not cause any accelerated level of harm in adults.
    Thyroid Cancer after Diagnostic Administration of Iodine-131“careful examination of over 34,000 patients who received substantial radiation doses to their thyroid glands from I-131 did not reveal a radiation-related risk of thyroid cancer.”
    There is indirect evidence from Chernobyl’s effects on thyroid disease by age cohort that people over the age of about 10 are not affected.

    It is well-established by now that having protective measures do not make people feel safer. Instead they escalate the perception of risk and make people feel more anxious. Therefore, measures intended for protection which do not have any demonstrated benefit should be discontinued for the public good.

  4. The development and implementation of protective actions, including KI distribution, is the responsibility of the states for their own populations. Each state has its own plan in place for distribution.

    Patricia Milligan

  5. How does the NRC plan to distribute the KI AFTER an accident. Seems logistically impossible. Or is the NRC going to hand these out to every house now? If so are they delivered? Or do people have to drive somewhere and pick them up. Any plans for the homeless, or are they just collateral damage?

  6. That’s sound like more a bureaucratic Govspeak rather than an agency that purportedly want to increase its rapport with it’s client and funding base.

  7. That 10 mile zone would be easily “shifted” because of winds aloft and or the earths terrain, depending upon weather conditions downwind from a reactor! Far better to plan on say a 20 mile circle, especially where prevailing winds are well known; after all who wants to be lacking KI pills if they are 10.05 miles away, the wind is blowing hard and they just happen to be directly downwind…

  8. yes they should get first priority, but we should cover all the areas until the plants are shutdown. Apparently per reply below the spent fuel pools don’t generate Rad iodine even if they go on fire, so once the plant is shut down and the fuel sits a while, those geographical areas don’t need the protection as much, but I would keep on hand anyway since we can have another Fukushima in another part of the country or world. Kampai!

  9. I agree, its good to have, I keep some on hand in my shelter in place, and my “to go” box. But it think it could be spread farther than 10 miles, especially because it is so cheap and protect against the biggest initial threat. In what they spend in QE money right now, you could have raised your purchase to 6 times that amount with what they spend in QE in 8 minutes.

  10. Right, my doctor gave me a prescription over the phone without seeing me, and without providing dosing data, because the stuff is so harmless. Cost $300. Real value around $20, but if you need it, priceless.

    It should not be regulated by prescription, and should be widely available, KI is WAY more likely to hurt people, and does not need a prescription.

  11. Is this not just a waste of money as KI tablets are inherently stable and do not lose their effectiveness over time, and the only reason is exaggerated regulations about shelf-life?

    What have NRC done to educate the legislators about this?

  12. The population closest (within the 10 mile EPZ) to the nuclear power plant are at greatest risk of exposure to radiation and radioactive materials. The purpose of radiological emergency preparedness is to protect people from the effects of radiation exposure after an accident at a nuclear power plant. Evacuation is the most effective protective measure in the event of a radiological emergency because it protects the whole body (including the thyroid gland and other organs) from all radionuclides and all exposure pathways. However, in situations when evacuation is not feasible, in-place sheltering is substituted as an effective protective action. In addition, administering potassium iodide is a reasonable, prudent, and inexpensive supplement to both evacuation and sheltering. When the population is evacuated out of the area, and potentially contaminated foodstuffs are interdicted, the risk from further radioactive iodine exposure to the thyroid gland is essentially eliminated.

    Patrica Milligan

  13. The NRC recommends that all states consider KI for inclusion into its plans. Protective action decisions are the responsibility of state and local authorities. The states that have decided not to include KI have decided that it is not appropriate for their emergency plans at this time.

    Radioiodines are a concern only during a reactor accident that occurs during reactor operation. It is not a concern when a reactor is shut down or a spent fuel pool due to the fact they have a short half-life (eight days or less) and have decayed away.

    Patricia Milligan

  14. We haven’t purchased all the tablets yet, but we have budgeted $3.49 million for 14 million tablets.

    Child dose is 65 mg. Adult dose is 130 mg. Infant dose is 16 mg. Toddler dose is 32 mg. The recommendation is 2 doses over two days. For an infant, that would be ½ tablet, for a toddler that would be 1 tablet, for a child that would be 2 tablets for an adult that would be 4 tablets

    Patricia Milligan

  15. From the FDA website: http://www.fda.gov/Drugs/EmergencyPreparedness/BioterrorismandDrugPreparedness/ucm130337.htm
    “Prussian blue is available only by prescription and should be given only under the supervision of a physician after assessing your medical condition. It is only effective to treat contamination with radioactive cesium or thallium. The dose and duration of treatment depends on the amount of contamination a person is exposed to. Therefore, this drug should be given only when the physician has determined your need for it.”

    Patricia Milligan

  16. This is how the NRC describes the use of KI during a nuclear power plant accident in our fact sheet on emergency preparedness:

    (A) protective action in the 10-mile EPZ involves KI, a compound that helps prevent the thyroid from absorbing radioactive iodine, one of several radioactive materials that could be present in a release from a nuclear power plant accident. If taken within the appropriate time and at the appropriate dosage, KI blocks the radioactive iodine from being absorbed by the thyroid gland and reduces the risk of thyroid cancers and other diseases. KI does not protect against any other inhaled radioactive materials, nor will it offer protection from external exposure to radiation.


  17. Cool good work ! Who should not take Pottasium Iodine ? Are some people more likely to have an alllergic reaction than others? In an emergency many folks put there childrens survivail before their own. So if a adult over forty need take care of a child what are the odds an aleregic reaction would prevent that? Some might like the best plan to you know have surviving decendants. So what ‘s your best guess? maybe 1 in 1000 adults over forty have adverse effects to the recomended Pottasium Iodine tablets. Should weight or age be considered in dose?
    Is there any Prussian blue on order ? If not why then?
    Pepto Pink on order?
    Scrub down procedure reccomendations?
    Thank you Patricia Milligan in advance for sharing your expertise.

  18. I’d suggest that those living near NPP reactors located on fault lines be given priority since their NPP reactors are threatened by Nature even more than other land based reactors…

  19. Is there any thoughts for NRC to provide Prussian Blue for Cesium removal? The supply chain on this looks like a vastly overpriced monopoly, and this is exactly the type of situation in which government intervention could be extremely effective, as much as we hate anything “socialist”, some socialized Prussian Blue at a reasonable cost could be a great idea. As plants get older, there is no doubt more accidents will happen.

  20. Why is it that only 25 states ask for the KI? The way it is worded in the article, it is implied that the NRC simply hands out the KI to the states for free. If that is the case, why doesn’t every state required KI. In fact, why isn’t every state REQUIRED to stock KI.

    Lastly, is RadioIodine primarily a concern only during a meltdown of a reactor, or is it a similar problem on a spent fuel pool, say a fire or a terrorist attack. Thanks

  21. Did your procurement through HHS actually save money, with administrative fees, what was the cost of procurement per million tablets? how many pills are needed per person per accident (I know this varies, but you must have a median estimate)

  22. I think the NRC should do a much better job of explaining KI to citizens. It is often presented as a radiation protection pill. That gives people a false sense of security. They can now turn their brain off and not worry, not prepare a proper shelter in place kit.

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