Simulation of what may happen if a highly contagious and lethal airborne pathogen were to occur today. Map: Institute for Disease Modeling
The U.S. won't be ready to face a flu pandemic until it improves its vaccines, health care infrastructure, and coordination with other countries — all of which are top priorities for the White House, a National Security Council official said Monday.
"Influenza is a priority to the White House, and represents both a health security and a national security threat... Today, however, we cannot respond with the speed that we need to.""— Luciana Borio, White House, National Security Council
Current preparedness: Speaking at a symposium hosted by Emory University and the Centers for Disease Control and Prevention, multiple public health officials said they agree the U.S. isn't ready, and needs to improve its yearly seasonal vaccines, which range in effectiveness from below 30% to 70%.
- 85% of seasonal vaccines are now created via an egg-based process that's less expensive but takes 6 months to develop and "is the state of technology, for the 1950s," Borio said. The remaining 15% are made from more expensive but faster producing cell-based or recombinant technologies.
- Food and Drug Administration Commissioner Scott Gottlieb recently told STAT that the early indications show cell-based vaccines had 20% improved efficacy compared with egg-based vaccines for this past season.
- Multiple panelists pointed out drug companies need an incentive to leave their egg-production process.
- Another "concerning" issue, Borio says, is that China is not upholding its international agreements via the World Health Organization to share their viral samples with other countries so a more effective vaccine might be produced.
By the numbers: CDC says the 2017-2018 flu season was particularly bad because it had a prolonged period and the vaccine did not work as well as hoped. As of April 28, there were 30,286 laboratory-confirmed influenza-associated hospitalizations recorded via FluSurv-NET and 163 children had died — 75% of whom were not fully vaccinated, per Borio.
Yes, but: Over the past decade, improvements have been made in flu surveillance, access and distribution of seasonal vaccines, production technologies, new antiviral drugs, a slate of adjuvants that boost the effectiveness of regular flu vaccines, the creation of a Vaccine Finder app and in lowering regulatory hurdles for new treatments, according to multiple panelists.
The holy grail: Panelists said improvements can be made now for seasonal vaccines, but the ultimate goal is a universal vaccine — one that can be given one time to boost the immune system's response to multiple strains of the virus, even newly developing ones.
What's happening now: National Institute of Allergy and Infectious Diseases director Anthony Fauci, who was not part of the symposium, told Axios on Friday that, assuming funding continues and trials go well, "some version of the universal vaccine" should be ready in 4–5 years, with the goal of creating a fully functioning universal vaccine in 10 years.
- Last week, NIAID said they are starting a Phase II clinical trial of one universal vaccine version determined to be safe in its initial trial.
- Bill Gates announced recently he was donating $12 million "to boost the development of a universal flu vaccine."
What's next: Researchers are also looking at new distribution systems via drones, skin patches sent through the mail, or an Uber-like delivery system.
Go deeper: Read what experts say we need to do to prepare for the next pandemic, why the most recent flu season was so bad, and a piece in Wired on why Big Pharma needs incentives to develop new vaccines.