If needed, could the U.S. produce an effective bird flu vaccine for humans? : Shot

The federal government has announced that it has taken steps to develop a vaccine to prevent avian influenza should it become a threat to humans.

Shoes Donnell/Getty Images

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Shoes Donnell/Getty Images

The federal government has announced that it has taken steps to develop a vaccine to prevent avian influenza should it become a threat to humans.

Shoes Donnell/Getty Images

Avian influenza, currently circulating among cattle, does not yet appear to be an immediate threat to most people. Scientists say the virus would need to mutate significantly to be infectious. easily transmitted from person to person.

But federal health officials say they have begun work on developing a vaccine to protect people in case a pandemic breaks out.

“We have several preparations in place to give us a head start should a mass vaccination campaign become necessary in the context of the pandemic.” dawn o'connellsaid the assistant secretary for preparedness and response at the Department of Health and Human Services in an interview with NPR this week.

That includes two vaccines made from older but similar strains of the virus that early tests have shown may protect people, O'Connell said. Mr O'Connell said the government also had stocks of adjuvants, substances used to increase the effectiveness of vaccines.

“In fact, we manufactured both candidates in small batches, so we have hundreds of thousands of doses available in prefilled syringes and vials, so we can deploy them fairly quickly,” she said. Ta.

He said the government also has the raw materials to make an additional 10 million doses in the coming weeks and another 125 million doses in about four months.

“You can imagine that getting the first 100 million doses is going to be very important and that will give us a good start and then from there we will ramp up manufacturing and increase production. It will continue,” she said.

Dawn O'Connell, Assistant Secretary of Health and Human Services for Preparedness and Response;

Jim Watson/AFP via Getty Images

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Jim Watson/AFP via Getty Images

Dawn O'Connell, Assistant Secretary of Health and Human Services for Preparedness and Response;

Jim Watson/AFP via Getty Images

No one knows how much risk bird flu poses to humans, so a vaccine may not be necessary.

But outside infectious disease experts are skeptical about the country's preparedness for this potential threat.

“The first thing we have to do is get rid of the fun stories,” he said. michael osterholmwho runs the Center for Infectious Disease Research and Policy and the University of Minnesota.

“I think the estimates of the stockpile that currently exists and the potential for this to be used as a human pathogen for human-to-human transmission are unfortunately overstated,” Osterholm said. .

For example, there is still not enough testing to know how effective the two vaccine candidates actually are, as the virus is likely to change, especially if it becomes a real threat to people. That hasn't been done, Osterholm said.

“I don't really believe that these vaccines will provide much protection,” he said.

And even if an effective vaccine were available, most influenza vaccines are still made with outdated technology that relies on the reproduction of the virus in eggs, which requires little effort to produce in sufficient quantities. It can take months and can be unpredictable. Since everyone will need two doses, the country will need more than 600 million doses.

“Given these restrictions, I think it's really important for the federal government to take a more proactive stance.” Luciana Borio, Senior Fellow in Global Health at the Council on Foreign Relations. “We cannot afford to be falsely complacent. We need to be more humble.”

Borio and others argued that the federal government's overly optimistic assessment sends the wrong message to the public and Congress, where funding is needed to truly ramp up vaccine production.

“I don't think our vaccine business is ready to respond quickly enough,” he said. rick brightUntil 2020, he worked at the Biomedical Advanced Research and Development Authority (BARDA), a federal agency involved in pandemic research.

“There are a lot of gaps in our preparedness response. We don't have a prioritization strategy for who gets vaccinated first. We don't have a distribution plan for when we need to distribute the vaccine.” he said. “So there's a lot of work to be done.”

Bright believes the government should develop a vaccine based on the strain of the virus that recently caused alarm in Texas dairy workers.

“By the time we start a virus-based vaccine candidate in 2020, we are probably four years behind the evolution of the virus,” Bright said. “We would like to update the vaccine candidate virus while we have time.”

Bright said the government should start funding mRNA vaccine development directly.

Bright, Osterholm, Borio and others are concerned that the response shows how little the country has learned from past pandemics like the coronavirus.

“It definitely feels like Groundhog Day,” he said. Jennifer NuzzoDirector of the Brown University Pandemic Center. “We still seem to be stuck in reactive mode. We shouldn’t be waiting for evidence that the virus is devastating us. We should act now to prevent this.”

In an interview with NPR, HHS's O'Connell acknowledged that the country could face problems developing and distributing vaccines. However, it added that in addition to conducting additional trials on one of its vaccine candidates, the pharmaceutical company is also developing an mRNA vaccine. The federal government is also in talks to help with that, she said.

“We have a head start and we're not off to a flat foot start like we were with COVID-19, but that doesn't mean this is going to be simple or easy,” she said. “But I’m glad we have some tools we can leverage.”

In the short term, Nuzzo believes the country should start vaccinating dairy workers as soon as possible.

“We need to protect farm workers and those exposed to raw milk,” Nuzzo said.

Doing so protects the health of workers and could help reduce the chance that the virus can spread more easily between people, Nuzzo said.

During a press briefing Wednesday, Vivian Dugan, director of the Centers for Disease Control and Prevention's influenza division, said dairy workers should He said vaccinations could begin.

Nuzzo and others said they are concerned about the lack of information being released by the federal government about the status of vaccine development and other important issues related to the virus.

“I wish there was more transparency about what's going on, but if we end up asking people to use the vaccine, we want the vaccine to be produced so that people can have confidence in the process. 'Because you have to understand the process.' And we can't do that,' and that was at the last moment,'' Nuzzo said. “We've seen the challenges of doing that during the coronavirus pandemic, and I don't want to see us doing it again.”

Two vaccine companies are already conducting further testing of one of the two vaccine candidates, David Boucher, director of infectious disease control at the federal Office of Strategic Preparedness and Response, said at a briefing Wednesday.