# 3143
It has been a frequent topic in this blog, and has been addressed by many other bloggers as well, that the world’s capacity to produce a pandemic vaccine is inadequate to even begin to provide for the needs of nearly 7 billion people.
Each year, the world produces somewhere around 500 million trivalent doses of influenza vaccine. That’s a vaccine with 3 types of antigen (2 Influenza `A’, 1 Influenza `B’).
While it’s never been done . . . theoretically manufacturing capacity could be ramped up to produce 900 million doses of trivalent vaccine.
At least according to the WHO’s Dr. Marie-Paule Kieny.
Dr Keiny estimates that under ideal conditions, the world could produce between 1 billion and 2 billion monovalent vaccine shots in a year. Dependent of course on how well the virus grows in eggs, and how much antigen is needed to convey immunity.
Once again, that’s never been done.
And to do that, you’d have to sacrifice both seasonal vaccine runs, denying hundreds of millions of people the protection of a seasonal flu vaccination.
That would, undoubtedly, cost a certain number of lives.
The absolute best case, according to the WHO, is that you could produce enough pandemic vaccine in a year’s time for 1/3rd of the world’s population in a year.
Whether you could actually deliver a vaccine to 2 billion people over a year’s time is quite another question, however.
Given the complexities of the situation, and the real possibility that it will require 2 shots to convey a reasonable amount of protection, the actual number could be half that.
Or less.
No matter how you slice it, a large segment of the world’s population won’t see a vaccine during the first year of a pandemic.
Perhaps 70% or more.
Fair? No, but that is the reality.
Over the past few years the United States, along with Canada and a number of other wealthier nations, have contracted with the vaccine manufacturing firms to get `first dibs’ on any pandemic vaccine.
The World Health Organization, on behalf of less wealthy nations, is now asking that some part of the early run of vaccines be allotted to developing countries.
Helen Branswell of the Canadian Press picks up the story. As always with a Branswell article, it is well worth your time to follow the link and read it in its entirety.
Developing countries should share first batches of swine flu vaccine: WHO
By Helen Branswell, Medical Reporter, The Canadian Press
TORONTO - Vaccine makers and countries with standing orders for pandemic flu vaccine will be asked to share with developing countries from the moment the first batches are ready if an H1N1 vaccine is made, the World Health Organization said Wednesday.
The Geneva-based agency's director of initiative for vaccine research said the WHO wants to secure "real time production for the benefit of developing countries" if an H1N1 pandemic is declared.
At least some of the production capacity is already locked up. Canada, the United States, the United Kingdom, Iceland, Malta, the Netherlands, Australia, New Zealand, Sweden and others have contracts that guarantee vaccine production for their citizens when a pandemic occurs.
Dr. Marie-Paule Kieny said the WHO is aware of these advance purchase agreements, as they are called, but believes there is remaining capacity within the industry and wants to snag part of it for developing countries before it is snapped up by other, wealthier countries.
If this new H1N1 strain should gain virulence and become a serious pandemic threat over the next few months, you can expect to see some serious diplomatic wrangling over the world’s finite vaccine supply.
And it could get ugly.
There are just 11 significant vaccine producing countries in the world, that together, produce over 90% of all vaccines. They are: Australia, Canada, France, Germany, Italy, Japan, the Netherlands, the United Kingdom and the United States of America.
Will it become politically untenable to allow substantial quantities of vaccine to be exported from a vaccine producing country before all of its citizens are vaccinated?
And if that happens, will `have-not’ countries cut off the supply of vital goods or services until they receive substantial quantities of vaccine?
As you can see, the problems here go far beyond simply producing a vaccine in a laboratory.
Once you create it, you then have to decide who gets it. And nobody is going to be happy about being at the back of the line.
Expect this to become a major point of contention over the coming months.
