# 2321
From CIDRAP (Center for Infectious Disease Research & Policy) News we get an excellent summary of the CBO's (Congressional Budget Office) recent report entitled U.S. Policy Regarding Pandemic-Influenza Vaccines (PDF file).
Essentially the CBO is recommending that more research be put towards developing and approving adjuvants - additives to vaccines that enhance the body's immune response - in order to lower the amount of antigen required to make an effective vaccine.
If successful, this would go a long way towards helping us meet the goal of being able to produce enough pandemic vaccine for the entire nation within six months of a pandemic outbreak.
As always, I've just reproduced a snippet of this CIDRAP article. It is well worth reading in its entirety.
Report suggests refocusing US pandemic vaccine efforts
Lisa Schnirring and Robert Roos
Staff Writers
Sep 22, 2008 (CIDRAP News) – The Congressional Budget Office (CBO) suggests in a new report that an increased focus on the development of vaccine adjuvants could save the US government money while improving the nation's preparedness for an influenza pandemic.
Noting that the government has been spending large amounts to increase egg-based flu vaccine production capacity and develop cell-based production capacity, the CBO says it might be wise to shift some funds into the development of adjuvants (chemicals that reduce the amount of vaccine needed to generate an immune response).
"The arithmetic of pandemic vaccination changes dramatically . . . if adjuvanted vaccines are developed and approved," says the report. If adjuvants fulfill their promise, it adds, the egg-based and cell-based production facilities now available or under construction would be enough to meet HHS's goal of vaccinating every US resident within 6 months of the start of a pandemic.
The CBO published its findings on Sep 15. The 52-page report gauges progress the Department of Health and Human Services (HHS) has made since 2005, when it outlined two main vaccine goals in its pandemic plan: to increase production capacity by 2011 to vaccinate the entire US population within 6 months of a pandemic onset and to stockpile enough vaccine to inoculate 20 million people shortly after a pandemic begins.
The Congressional Budget Office's Director has a blog summary as well, which may be viewed here.
But adjuvants are not without controversy, as Maryn Mckenna explained in Part 4 (The promise and problems of adjuvants) of her award winning series The Pandemic Vaccine Puzzle.
While adjuvants hold the greatest promise for dose-sparing, they also provoke trepidation because they are by definition immune-system activators. While many have been tested over the years, few have entered the market, because they proved too reactogenic to be acceptable to consumers or safe.
Only one set of adjuvants, aluminum salts or alum (aluminum hydroxide, aluminum phosphate, and potassium aluminum sulfate), is licensed in the United States. Aluminum adjuvants and MF59, an oil-in-water emulsion that contains squalene (an oil found in some fish oils), are licensed in Europe (see Bibliography: Petrovsky 2007).
Mayrn McKenna, author of Beating Back The Devil, and editor of the Superbug (MRSA) blog, is one of the most respected science writers in the the business.
For a full overview of the pandemic vaccine issue, I can think of no better resource than Maryn's 7 part series.
Part 1: Flu research: a legacy of neglect
Part 2: Vaccine production capacity falls far short
Part 3: H5N1 poses major immunologic challenges
Part 4: The promise and problems of adjuvants
Part 5: What role for prepandemic vaccination?
Part 6: Looking to novel vaccine technologies
Part 7: Time for a vaccine 'Manhattan Project'?
Bibliography
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