"AVIAN INFLUENZA: Preaching Against the Pandemic"

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"In a pandemic, antiviral drugs like Tamiflu can't be more than a stopgap; only vaccines offer long-term protection. As for supply, for the next 5 years at least, the world is stuck with the nine major flu vaccine companies, which produce just 300 million doses annually using chicken eggs, a process that's difficult to scale up quickly. They could all switch to making pandemic vaccine in an emergency--but they would need to produce billions of doses instead of 300 million.

"The only way to increase supply dramatically, Fedson says, is to produce vaccines that use far less antigen, or viral proteins, per dose. For the annual influenza vaccine, which protects against three different strains, manufacturers use 45 micrograms of antigen, 15 for each strain. To vaccinate 3 billion people during a pandemic--and assuming everyone will need two shots--the amount of antigen per shot would have to come down 20-fold, to about 2 micrograms. Studies have suggested that such small doses may be effective when coupled with a so-called adjuvant, such as alum, to rev up the immune system."