# 1195
Today, in a press release from the WHO (World Health Organization) we are told that the amount of pandemic vaccine that we could produce will be dramatically greater in the coming years. That's the good news.
The bad news is that capacity is still 3 years away.
Right now, we have the global capacity to produce 500 million doses of trivalent vaccine, or theoretically as much as 1.5 billion doses of mono-valent vaccine. That assumes that EVERYTHING goes perfectly. Some years, we have problems just producing the standard seasonal flu vaccine in sufficient quantity.
First, the WHO Press Release, then some discussion:
Projected supply of pandemic influenza vaccine sharply increases
23 OCTOBER 2007 | GENEVA -- Recent scientific advances and increased vaccine manufacturing capacity have prompted experts to increase their projections of how many pandemic influenza vaccine courses can be made available in the coming years.
Related links
:: Global pandemic influenza action plan to increase vaccine supply [pdf 510kb]
Last spring, the World Health Organization (WHO) and vaccine manufacturers said that about 100 million courses of pandemic influenza vaccine based on the H5N1 avian influenza strain could be produced immediately with standard technology. Experts now anticipate that global production capacity will rise to 4.5 billion pandemic immunization courses per year in 2010.
"With influenza vaccine production capacity on the rise, we are beginning to be in a much better position vis-à-vis the threat of an influenza pandemic," Dr Marie-Paule Kieny, Director of the Initiative for Vaccine Research at WHO, said today. "However, although this is significant progress, it is still far from the 6.7 billion immunization courses that would be needed in a six month period to protect the whole world."
"Accelerated preparedness activities must continue, backed by political impetus and financial support, to further bridge the still substantial gap between supply and demand," she said.
This year, manufacturers have been able to step up production capacity of trivalent (three viral strains) seasonal influenza vaccines to an estimated 565 million doses, from 350 million doses produced in 2006, according to the International Federation of Pharmaceutical Manufacturers & Associations. According to experts working in this field, the yearly production capacity for seasonal influenza vaccine is expected to rise to 1 billion doses in 2010, provided corresponding demand exists.
This would help manufacturers to be able to deliver around 4.5 billion pandemic influenza vaccine courses because a pandemic vaccine would need about eight times less antigen, the substance that stimulates an immune response. Vaccine production capacity is linked to the amount of antigen that has to be used to make each dose of the vaccine. Scientists have recently discovered they can reduce the amount of antigen used to produce pandemic influenza vaccines by using water-in-oil substances that enhance the immune response.
The progress was reported Friday at the first meeting of a WHO Advisory Group on pandemic influenza vaccine production and supply.
The Global Action Plan Advisory Group, an independent, international committee of 10 members, met at WHO headquarters one year after eight new strategies to increase pandemic influenza vaccine were identified and published in the WHO Global pandemic influenza action plan to increase vaccine supply.
At the Advisory Group meeting, other progress on the Global Action Plan was discussed. WHO reported it is setting up a training hub that would serve as a source of technology transfer to developing countries.
The Advisory Group also discussed a new business plan which assessed options for further increasing vaccine production capacity and reviewed priority next steps. The three most valuable options include continuing to promote seasonal influenza vaccine programmes, supporting the industry to sustain production capacity beyond seasonal demand and enabling some vaccine production facilities to change, at the onset of a pandemic, from producing inactivated vaccines to live attenuated vaccines. Due to the higher yields obtained with live attenuated influenza vaccine technology, facility conversion could, by 2012, bridge the expected supply-demand gap and produce enough vaccine to protect the global population within six months of the declaration of a pandemic.
For further information, please contact:
Hayatee Hasan
Department of Immunization, Vaccines and Biologicals
WHO, Geneva
Admittedly, if these projections come to fruition, this is good news.
The ability to create 4.5 billion doses of vaccine depend, however, on the use of an oil-and-water adjuvant to increase the recipient's immune response. While generally considered safe, there are some people who worry about its long-term effects on the immune system.
But even if the adjuvant is proved safe, it isn't a panacea for a pandemic. The ability to produce billions of doses of vaccine, and the ability to dispense it to billions of people, are two decidedly different things.
There are logistical problems, including the packaging and shipping of billions of doses around the world. There will be political and cultural barriers. Immunizing the world's 6-plus billion people in six months time, as alluded to as being possible by 2012, would require more than just having the vaccine available.
While I welcome any advance in our vaccine manufacturing technology, I'll have to see a vaccine produced and 6.6 billion people inoculated in six months time (during, btw, a raging pandemic) before I'll believe it's possible.
Color me skeptical.
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