'Vaccine makers are ill-prepared for an influenza pandemic'

The Economist provides more information on the flu situation in a new article. I quote:

The production of flu vaccine has developed to cope with seasonal flu. The disease may seem no more than a nuisance to many, but the flu still kills perhaps 500,000 people a year around the world. It is hard to develop a perfect vaccine against seasonal influenza because it is so fleet-footed. There are usually several different strains of influenza active at any time, and these variations evolve......

To help the vaccine manufacturers plan, the WHO issues guidelines every six months listing the three strains of seasonal flu that appear to pose the biggest threat during the relevant hemisphere’s approaching winter. The firms then prepare their genetic cocktails and develop them inside live chicken eggs in sterile conditions. The resulting “trivalent” vaccine provokes the patient’s immune system into producing antibodies, and that primes it for an attack by the worrying strains of flu.....

If a global pandemic is declared and manufacturers are asked to produce a vaccine for H1N1, they are unlikely to be able to respond quickly enough. Firms can produce perhaps a billion doses of seasonal vaccine every year. The details of dosing for a pandemic vaccine are not yet known, but it is clear that even if all the capacity was switched to pandemic flu there would still be a huge global shortfall.....

Switching production also poses risks. A lack of vaccines for seasonal flu guarantees that many unprotected people will die of the otherwise mundane version of influenza. Nor is there any guarantee that, having switched production, a second wave of an H1N1 strain will indeed be deadly. So producing pandemic vaccines as a precaution may turn out to be a waste of resources with deadly results. Or it may save millions of lives. No one knows.

Comment: The article raises the question of how limited vaccine production supply should be allocated to making vaccines, and how the vaccines that are produced should be allocated to people. It also fails to mention that more than one dose might be needed to immunize a person against a new variety of flu. A billion doses of vaccine should be enough to do a lot of good if they are used well.

They are likely to be used to protect the rich, which is not necessarily the best epidemiological use.

Of course, it would be nice to be able to produce more, and improving vaccine production techniques remains a high priority. JAD