As you might recall during your early pandemic preparations several years ago…there was always the big question (almost like a black hole) around the question of when vaccines would be available. As a globe, we have major issues in vaccine production – old technology, limited production capabilities and limited suppliers who are mostly in Europe (70%).
WHO’s Next Move
Influenza experts will meet May 14 to consider whether the WHO should advise manufacturers to launch mass production of an H1N1 vaccine. Whatever they decide to do, they will be taking a calculated risk. Production takes months and it is impossible to switch halfway through if health officials made a mistake. While some countries like the United States may be better prepared than others, American officials say production for next year’s vaccine batch is so advanced they’re nearly finished, whereas the situation for many other countries is unknown. At a news briefing on May 6, Dr. Marie-Paule Kieny of the WHO estimated that the global capacity to produce a vaccine against the H1N1 virus in question to be between 1 billion and 2 billion doses annually. She went on to acknowledge many unknowns about the vaccine issue:
- How well the vaccine virus will grow in eggs?
- What size dose will be required?
- Whether an adjuvant will be needed?
- Whether each person will need one or two doses?
The vaccine decision has a major impact around the world. Vaccine makers can make limited amounts of both seasonal flu vaccine and pandemic vaccine though not at the same time but they cannot make massive quantities of both because that exceeds capacity. The impending decision to make pandemic vaccine will also complicate matters for countries in the southern hemisphere, where the flu season is just starting. The WHO usually makes recommendations about which seasonal flu strains should go into next year’s southern hemisphere flu vaccine in September. But if vaccine manufacturers are already making pandemic vaccine in the fall, that will mean fewer doses of flu vaccine for people in the southern hemisphere.
Once a vaccine decision is made, there are still more questions.
- Until we know how contagious and deadly the virus is, we won’t know how many people actually need to be vaccinated.
- If it remains mild, it is possible many people won’t need a shot – however if H1N1 evolves into a more deadly strain, more vaccine doses may be needed to protect wider swathes of the population.
- Another possible complication is that the pandemic vaccine will be made using the strain available now; whether that will work if the virus mutates isn’t certain.
Vaccine production is unfortunately not a fine science and there is a certain amount of educated speculation that always goes on every year. Decisions are often made on incomplete date and then we all have to live with them. Hopefully this latest encounter with the pandemic threat will further the work to modernize vaccine production. It is long overdue.
Lastly clearly waiting for a vaccine is not an option. It will take many months for the vaccine supply to meet the US demands and several years for the world. Pandemic planning and preparation must continue.
Source ProMed, WHO