Covering U.S. efforts to create a universal flu vaccine

Bara Vaida

About Bara Vaida

Bara Vaida (@barav) is AHCJ's core topic leader on infectious diseases. An independent journalist, she has written extensively about health policy and infectious diseases. Her work has appeared in outlets that include the National Journal, Agence France-Presse, Bloomberg News, McClatchy News Service, MSNBC, NPR, Politico and The Washington Post.

Photo: U.S. Pacific Fleet via Flickr

This year’s severe flu season has increased the spotlight on the development of a “universal” influenza vaccine – a vaccine that would be effective against most strains of the flu.

But that vaccine has been elusive.

In 2011, Francis Collins, director of the National Institutes of Health, told USA Today that he was “guardedly optimistic” a universal flu vaccine would be within reach in five years after scientists identified pieces of the virus that consistently appeared in seasonal and pandemic flu viruses.

Seven years later, however, scientists aren’t even close to a universal vaccine because the science isn’t there, Stat News’ Helen Branswell reported. It turns out that the pieces of the virus identified as being consistent between strains don’t seem to stimulate the immune system enough to create a vaccine target.

“We cannot predict when a more broadly protective influenza vaccine would be publicly available,” National Institute of Allergy and Infectious Disease director Anthony Fauci told the U.S. House Energy and Commerce Committee’s Subcommittee on Oversight and Investigations on March 8. “We expect that progress toward that goal will occur in iterative and progressive steps.”

There are at least three kinds of flu virus – called A, B and C – which stem from the different proteins that contain the virus’s genetic code. Influenza A and B cause seasonal flu. There are almost 200 potential versions of Type A flu viruses that may be circulating the planet. These virus strains mutate quickly, which is why people need a new flu vaccine annually.

The problem is that the current vaccine, at its best, can only reduce the likelihood that someone will be sick enough to seek medical care by about 40 percent to 60 percent. And sometimes, because experts miscalculate which strain is prominent, or the virus mutates, the vaccine is even less effective. There is also evidence that annual flu shots may, in some people, reduce immunity to the flu.

Every six months, global influenza experts gather to try to guess which three or four strains are of most concern and then recommend vaccine composition to target those strains. Most seasonal flu vaccines are made through a decades-old process of growing the flu virus in eggs. It is an inflexible process that takes about six months and means public health officials can’t quickly produce a new vaccine if the virus has mutated.

The severity of this year’s flu season is due in part because one of the strains within the flu vaccine isn’t well matched to the strain causing sickness. The Centers for Disease Control and Prevention says this year’s vaccine, as of early February 2018, reduced the risk of having to seek medical care from the flu by only 36 percent.

Research on improving the seasonal flu vaccine’s effectiveness isn’t occurring in the private sector. The flu vaccine market is a stable, $3 billion industry. Any changes to the flu vaccine manufacturing process would likely cost hundreds of millions of dollars, which companies are reluctant to spend, Fauci told Congress.

That leaves it to the federal government to fund vaccine research. Until recently, developing a universal flu vaccine hasn’t been a top priority. Michael Osterholm, Ph.D., M.P.H., director of the Center for Infectious Disease Research and Policy, says about $75 million is being spent annually on universal flu vaccine research, compared to about $1 billion on an HIV vaccine, writes Henry Miller in the Los Angeles Times.

To jumpstart more flu vaccine research, the NIAID published, in February 2018, a strategic plan for developing a universal flu vaccine. The roadmap includes encouraging research investment into improving the effectiveness of the current seasonal flu vaccine until a universal flu vaccine can be developed.

Journalists interested in covering how the roadmap unfolds should track this year’s Congressional debate on the reauthorization of the Pandemic and All Hazards Preparedness and Response Act. The legislation was first passed in 2006 and aimed to boost federal response to a public health emergency. Funding for the Act, which expires in September 2018, was last authorized in 2013.

Reporters also may want to look into where next-generation vaccines are being developed. Rick Bright, deputy assistant secretary for preparedness and response and director of the Biomedical Advanced Research and Development Authority (BARDA), told the House Energy and Commerce committee there are companies in Connecticut, North Carolina, New York and Pennsylvania, which have received BARDA funding for flu vaccine research.

Other legislators have called for specific funding on the flu vaccine. Democrats Sen. Edward Markey, from Massachusetts, and Rep. Rosa DeLauro, from Connecticut, each introduced legislation that would boost federal research funding on flu vaccines by $1 billion over five years.

For additional resources and reading on the flu vaccine:

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