# 477
Long time readers of this blog know that while I support vaccine research and development, I also harbor extreme reservations as to whether we will be able to develop and distribute a pandemic vaccine effectively in the near future. This personal bias come from my own experiences in 1976 with the Swine Flu inoculation program, and from the information I've managed to gather over the past few years on our current resources.
Apparently, I'm not alone.
Long Road Ahead In Developing Effective Avian Flu Vaccination Strategy, Expert Says
Science Daily — The near inevitability that influenza will explode into a pandemic in the coming few years has kept researchers searching for a way to prevent the worst effects of infection. The ultimate prize is a highly effective vaccine that could be produced and deployed rapidly.
But developing a vaccine against one of the most talked about types of influenza - the H5, or avian flu - is proving to be more vexing than first thought.
"Making a vaccine for H5 is more difficult than anticipated, even beyond the necessity of making it on the fly," said Harry Greenberg, MD, the Joseph D. Grant Professor at the Stanford University School of Medicine. "At every level there are difficulties."
This article goes on to illustrate several problems inherent in the manufacturing and production of an H5N1 vaccine. The first being that the virus, being deadly to birds, also kills the eggs used to culture the vaccine. The new cell replication technology, now on the drawing boards, would eliminate this problem, but for now all commercial vaccines are created using the decades old egg culture technique.
The second problem has been the amount of antigen required to provoke an immune response. For an H5N1 vaccine, two shots a month apart may be required, and some for of adjuvant may be needed to increase the shot's effectiveness.
There are other problems of course. Those of manufacturing, distribution, prioritization. Logistical problems that we ran into 30 years ago, and would likely see again.
Had we started ten years ago, or even five years ago, we might be on the threshold of being able to deliver a pandemic vaccine quickly and effectively. We knew, back then, that another pandemic would come some day. It simply wasn't a priority.
If we are granted a few more years, and the H5N1 virus (or some other novel influenza) doesn't rear its ugly head, we might be in a position to deliver such a vaccine. That is why I fully support the idea of research. We may still have time.
It is an unusual position, being both optimistic and pessimistic on the issues of a vaccine. I believe it is ultimately the route through which we can defeat influenza pandemics, but I also believe we are years away from that reality.
