It’s time to attempt a summary of the different considerations for vaccination strategies.
With the current state of science, vaccines are still the best bet for influenza control. However, there are numerous considerations such as:
Antigen:
For a vaccine to work, one needs to choose the antigen carefully. With current technology we are not able to make a vaccine stable enough to work as the flu virus mutates every year, hence the need for a new vaccine and fresh vaccinations every year. In a pandemic, with the current strategy, we would need to wait for a pandemic strain to emerge and rush to make the vaccine.
In the context of H5N1, there is the additional problem that production is complicated by the fact that the virus kills the fertilized chicken eggs normally used to make the seasonal vaccine, so we need an extra reverse engineering process to create a harmless antigen before you can manufacture the vaccine.
Current vaccines are what we call ‘sub-unit’ vaccines, ie not the whole virus, but portions of it is used to stimulate immunity. This was because in the early days of flu vaccine development, the use of the whole virus was found to be very toxic to kids. (However, according to Webster, we now know how to avoid that by recomination technology to modify the antigen.) The choice of what sub-unit becomes the holy grail of flu vaccine manufacture.
Efficacy:
Vaccines against H5N1 have been developed and found to have very low immunogenicity, so that one would need at least 2 if not 3 doses and a total of about 3–9x the amount of antigen needed to produce an antibody response.
(NB - efficacy in most studies is still based on measuring antibody response, however, there is concern that this may not reflect real immunity, and some studies now measure T cell response instead or in addition to antibodies. This is good but it also means a higher bar for a vaccine to be declared a commercial ‘success’ and hence longer time to availability.)
In the context of a pandemic, we can think of efficacy both as preventing infection and as reduction of symptoms or mortality. That is, a vaccine that reduces mortality not as good as one that prevents infection completely but better than nothing.
Ultimately, ‘real’ efficacy can only be demonstrated by exposing a subject to the H5N1 virus and determining the degree of protection. One cannot, of course, do this on human subjects at this point, but even studies on ferrets are complicated by the fact that they require BSL3+ facilities and correspondingly trained personnel, thus limiting the speed/cost of such studies as compared to our usual seasonal vaccine.
Antigen sparing strategies:
Given that current world production capacity is only 300 million doses a year, if the amount of antigen needed for a pandemic vaccine is several times more, it would mean even fewer people can realistically be vaccinated within a reasonable time. Therefore, any technique that would reduce the dose of antigen needed would be useful.
One way is the use of adjuvants, chemicals added to the vaccine that stimulate the immune system to produce a stronger response for the same dose of antigen. One adjuvant that has been well-tried and save is alum (aluminium hydroxide). The problem is current studies with H5N1 vaccines and alum do not give very encouraging results.
Other adjuvants are being tested by various vaccine companies. These so called ‘proprietary’ adjuvants are mainly plant oils which some scientists consider suspect as far as safety is concerned. This is because what you are doing is trying to over-stimulate a person’s immune system. With people whose immune system is NOT underactive, you run the danger of overstimulating to produce adverse reactions, the main worry being autoimmune diseases.
The only ‘proprietary’ adjuvant that has been used commercially is MF59, which is used in one flu vaccine approved in a few European countries for the elderly, the rationale being elderly people have sluggish immune responses and require extra stimulation. This adjuvant is not FDA approved and is considered controversial by some because of allegations of its connection to Gulf War Syndrome by way of an ‘experimental’ anthrax vaccine given to military personnel. While there is no clear conclusion to the controversy, suffice it to say that INDEPENDENT safety studies ie conducted by scientists COMPLETELY un-connected to Chiron, the manufacturer, are glaringly lacking.
Go here for the MF59 story.
Nevertheless, it is currently the darling of vaccine-optimists. However, even assuming the GWS controversy can be ignored, to the extent that it is currently used (or supposed to be used) only in the elderly, there would (or at least should) still be necessity for new safety profiles to be done for younger age groups especially children. All this is going to take time, to get through the regulatory hurdles to manufacture.
Apart from adjuvants, another way is to use whole viruses instead of sub-unit vaccines. Webster certainly thinks that;s the best way to go, especially for a pre-pandemic vaccine. He suggests using reverse genetics to create a recombinant H5N3 vaccine (which would not kill you). Whole virus vaccines also have the advantage of requiring only one dose. The combination of whole virus with alum is also seen as probably the best way to go by some senior WHO researchers.
pre-pandemic vs pandemic vaccine:
Because of current limited production capacity and the possible need for 2 or 3 dosese, it would be extremely difficult to have enough vaccine (even if all technological and regulatory hurdles are out of the way) and enough people vaccinated in time to affect the outcome of a pandemic. Therefore, consideration is being given to a pre-pandemic vaccine, ie a vaccine to be produced and stockpiled now and given prior to (or as soon as a pandemic starts). It would not provide enough immunity for the above reasons but one would hope that partial immunity may reduce total impact, plus it could be used to ‘prime’ the population so that only 1 dose would be necessary with the actual pandemic strain.
This notion carries its own difficulties. The biggest one is safety. Because you are vaccinating people against a pandemic that has not happened yet, ie a hypothetical risk rather than actual risk, and because you are aiming at a large proportion of the population if not all, and the target is most likely to be young working age people, the most valuable members of society, the safety bar has to be set much higher than normal vaccines.
The next problem is cost or specifically who is going to pay for it? Unless there is definite financial commitment in the form of orders or contracts from governments, vaccine companies are not likely to sink millions or billions of dollars and make large quantities. But even if governments pay for them now, and the product is successfully made, they have a limited shelf-life as with vaccines in general. If a pandemic does not happen and the stockpiles of pre-pandemic vaccines have expired, the money could be wasted. (This is a simplified description, the commercial issues are a lot more complex when you add in companies who want to vaccinate their staff to protect their business.)
Re-examining the efficacy issue: the (relative) efficacy of a pre-pandemic vaccine is determined by how close it is to the ultimate pandemic strain. Make the vaccine too late, we won’t have enough. Make it too soon, the virus might have mutated significantly so that the vaccine is no longer useful.
Safety:
This is partly addressed in the above posts. It is also closely tied to liability issues.
Since we are talking about a vaccine that is potentially to be given to almost everyone, even a slight risk of side effects can become thousands of deaths when given to enough people. Safety profile studies are only as good as the models used, and no model is good enough to pick up side effects on that scale. That’s why manufacturers are unwilling to take such risks unless they are given protection against litigation. While I do not support giving them a blank check in general, in the context of a pandemic, it may be necessary to offer such incentives. (The US legislative changes made to accomodate this however go way beyond such necessity as revere has been commenting on Effect Measure ‘Frist Responder’ May 9.
Regulatory issues:
The closer the vaccine is to currently appoved ones, the easier it is to get it approved and licensed. Novel adjuvants not currently approved is likely to take years, for example. Similar concerns probably apply to cell-culture, DNA or other novel techniques.
In term of likelihood to license, the ones nearest the front of the queue (I am guessing so anyone who knows please correct me if I am wrong) would be alum adjuvanted inactivated sub-unit vaccines, if they can make one that works. Next would be using MF59 as adjuvant, for example, but even that as I said may have to overcome objections for use in younger age groups. The fact that it has not gained FDA approval after all these years says something.
So when you see a new technique being reported in the press, don’t get excited too quickly. These processes take a lot of time, for the right reasons IMO.
Production capacity:
Current production capacity of 300 million doses is for production of our normal seasonal vaccine, assuming no need for modification of production process, which is highly unlikely. Manufacturing vaccines require huge investments to expand capacity, and companies consider that worthwhile only if they can be reasonably sure of a continuing market for their product for a substantial number of years.
Building new plants for a pandemic that may or may not happen, to make vaccines that governments have not committed to yet (that non-commitment is partly because there is no demonstrably good product, sort of an egg&chicken situation, a true if unfortunate analogy), using techniques that have not been well tested for smaller scale production, is simply not financial viable.
That is why some have suggested that we boost annual uptake of seasonal flu vaccine drastically and ultimately to close to 100%, to create an ongoing commercially viable capacity. Personally, I don’t see that happening in a big way anytime soon because of the costs involved.
Delivery:
What is the percentage of population that needs to be vaccinated to make a difference to the pandemic outcome? How much resources, manpower, logistics are needed to make that happen, especially in a pandemic? Ferguson in his model where he enthuses about the possibility of containment assumed 90% coverage.
That is fairy tale as far as I am concerned.
Adjuvents
Since adding alum to 30 microgram doses (two) marginally increased responses, adding alum to 15 microgram doses had no effect, and adding alum to 7.5 microgram doses reduced the immune stimulation effect, it might be quicker and easier to flip coins to determine the best dosage / alum combo.
Priority:
Current vaccine policy aims at reducing deaths in the most vulnerable age groups ie older people. A pandemic vaccine would need to have different priorities especially if the elderly are not at highest risk. Priority will be different depending on your outcome, as we have discussed on other threads. Generally you would vaccinate high risk groups to reduce total deaths, and vaccinate young people including kids to reduce overall impact on infrastructure etc.
<anon_22 goes off for coffee break to replenish brain juice>
niman, I agree. But then, I am not sitting in the decision making chair.
You’ve certainly earned a coffee break. In RacterWorld, first priority would be given to first responders and their families.
In summary, anybody who tells you that ‘we won’t have a pandemic vaccine till 6 months into a pandemic’, as is frequently heard, is being extremely economical with the truth.
Hi annon 22.
We have had it clearly illustrated for us, at every turn in the past six months, that we know very little about the influenza virus, genotype as well as phenotypic expression.
I have not seen any solid, irrefutable evidence that any influenza vaccine works; whether it is for mild seasonal influenza’s or H5N1.
Is it possible to produce an effective vaccine against a highly mutagenic virus? Yes Can an reasonably effective vaccine be produced for H5N1 in the next five years…Not likely, unless the resulting vaccine is released without testing or validation as to effectiveness.
Given a hypothetical effective vaccine, do we have the production capability avaliable to produce enough vaccine to protect 50 % of the world’s population in five years at full capacity…No.
Therefore, although this discussion is needed and essential to further discoveries with respect to H5N1, I believe we must concentrate on effective measures in the short term because I believe that may be all the time we have left.
Tom, “I have not seen any solid, irrefutable evidence that any influenza vaccine works”
I wouldn’t go so far. I don’t have the data at hand and I don’t intend for this thread for that discussion, but I do disagree. We can talk about that some other time.
Tom DVM – at 11:57
We can (and must) multitask. ;-) We can do long and short term together.
Dem,
I’ve been told that multi-tasking makes your IQ fall 20 points. ;>)
Annon 22. If those who state there will not be vaccine for at least 6 months are being “extremely economical with the truth”… then when exactly do you think the vaccine will be produced and more importantly how many doses do you expect to have.
The facts as they are today indicate that it is highly unlikely that the general public will get any vaccine for the first two years of the pandemic. Having it avaliable for a miniscule minority is of little interest to me.
It also may be true that vaccinating the young helps with reducing death ratres better than just vaccinating the old: link
Melanie – at 12:01
That’s why you delegate. ;-)
Tom, “when exactly do you think the vaccine will be produced and more importantly how many doses do you expect to have.”
That’s not for me to guess.
“Having it avaliable for a miniscule minority is of little interest to me.”
It is of interest to ME, for many reasons. Any progress is better than no progress in general, that minority may be the crucial minority as far as society is concerned, etc etc.
When I think of a pandemic these days, all I see is mitigation. There will not be a silver bullet, period. So I am interested in anything that makes a marginal difference.
A few percentage points here and there, if we do enough, we might make a difference.
Otherwise I might as well quit right now, and I’m not about to do that.
Anon 22. That’s fine with me but your statement at 11:56 is completely out of line.
which statement is completely out of line?
Anon 22. “In summary, anybody who tells you that ‘we won’t have a pandemic vaccine till 6 months into a pandemic’, as is frequently heard, is being extremely economical with the truth.”
For what it’s worth. I don’t think we are going to have vaccine for two years into a pandemic…and that leaves out whether the experimental vaccine that will be given will be of any use whatsoever.
If you have a shred of evidence otherwise, I would like to see it.
I don’t have any evidence for 6 months, 2 years, or any figure of that nature. The point that I was making was that that statement ‘we won’t have a pandemic vaccine till 6 months into a pandemic’ is an over-simplifications of a complex issue. That’s all. Don’t read too much into it.
BTW I’m not trying to present any evidence, any position supporting or not supporting vaccines etc. I am only summarizing the considerations, as I stated in my first post, putting together issues in one place for those whom this might be useful.
Tom DVM is not convinced vaccines are a viable strategy. You won’t convince him easily. That’s fine… others equally convinced it’s our best hope.
Nice summing up, anon_22… very helpful. Other issues include the ehtical onres involved with vaccine priority are equally complex. I don’t believe there’s a consensus, even in Toronto, where the SARS experience drives the process a little deeper.
Source: HealthDay: Experts Argue Over Allocation of Bird Flu Vaccine
If and when a bird flu pandemic occurs, experts estimate there will be only enough vaccine to protect one in every 10 Americans.
Now, an essay in the May 12 issue of Science is heating up the debate on who that lucky 10 percent should be.
Countering the federal government’s policy of placing the elderly near the top of the list, two medical ethicists from the National Institutes of Health (NIH) say that after doling out the vaccine to essential health workers, people between 13 and 40 years of age should be next in line to receive the shot.
“What we are arguing is that younger people have more of their life to lead, and they ought to get higher priority,” explained Dr. Ezekiel Emanuel, chairman of the department of bioethics at The Clinical Center, which is part of the NIH.
He and co-author Dr. Alan Wertheimer stress that their opinion piece does not represent any official stance on the issue by the NIH, but they do hope it widens the debate on what could one day prove to be a very divisive issue.
The H5N1 avian flu virus continues to spread worldwide, infecting more than 200 people so far in bird-to-human transmissions and killing half that number, mostly in Asia. The big fear for health officials everywhere is that the virus could someday mutate so it passes easily from human to human. Just such an event sparked the 1918 flu pandemic, which killed more than 50 million people worldwide.
Two U.S. bodies — the National Vaccine Advisory Committee (NVAC) and the Advisory Committee on Immunization Policy (ACIP) — have helped craft the nation’s flu vaccine allocation strategy in the event of a pandemic. Everyone on the panels agreed that vaccine production staff and health-care workers should get top priority for any vaccine. Then were people at high risk for death or hospitalization due to preexisting health conditions, as well as pregnant women, and a few key government leaders.
The question of who should be next was tougher.
“You have to decide what the number one priority is, and we felt that that priority was saving lives and decreasing hospitalizations,” said ACIP chairman Dr. Jon Abramson, who is also chairman of the department of pediatrics at Wake Forest University Baptist Medical Center, in Winston-Salem, N.C.
According to Abramson, that means doling out vaccine to those people deemed at highest risk of dying should they become infected. With the lone exception of the 1918 pandemic — in which young adults were most at risk — “it is mainly the elderly and those with underlying cardiopulmonary and other chronic conditions that are most at risk” in flu pandemics, he said.
With that in mind, NVAC/ACIP submitted their allocation plan prioritizing the elderly to the White House, which accepted it. “We’ve never been asked to come back and rethink it,” Abramson said.
But Emanuel hopes that might change. In their essay, he and Wertheimer say that while the focus on “saving the most lives” does have merit, other considerations come into play. “On reflection, most people have the intuition that you should save children and young adults,” Emanuel noted.
This reasoning is based, in part, on something called the “life-cycle principle.” That states that people in late middle- and old-age have already had the opportunity to live through most of life’s stages of growth and experience, while adolescents and young adults are only beginning to do so.
Then there’s a concept the ethicists call “investment.”
“People in their late teens/early 20s should get priority because [society] has already invested a lot in them, and they are just on the cusp of leading their lives,” Emanuel said. It’s precisely for these reasons that the death of a young person always seems more tragic to us vs. the death of someone much older.”
In their essay, Emanuel and Wertheimer posit a new set of priorities for the flu vaccine: health workers first, then Americans aged 13–40, based on the principles outlined above.
Emanuel pointed out that “saving the most lives” hasn’t always been paramount when it came to allocating scarce, potentially lifesaving resources. In the Titanic’s lifeboats, it was “women and children first,” he said, and transplanted organs usually go to the sickest patients first, not those who are most likely to survive after transplant.
He said both he and Wertheimer are older than the 40-year-old cut-off, and he understands that many older people would want the vaccine, too.
“It’s not as if I feel my life is over,” he said, “but we have to give priority. If you ask me if I would take the vaccine or give it to my 16-year-old kid, it doesn’t take me a millisecond for me to say ‘Oh, my kid’s first.’ “
But another ethicist said Emanuel and Wertheimer’s position has flaws.
“Part of the dilemma in developing vaccine-rationing policy is that we just don’t know who’s likely to be the most vulnerable — the young, the old or the in-between,” said Dr. G. Caleb Alexander, an assistant professor of medicine at the University of Chicago’s MacLean Center for Medical Ethics.
He said that “support for their argument has to hinge to some degree, on how vulnerable different populations of individuals are to the pandemic. The less vulnerable this young and middle-aged group are, the less sense the proposed policy makes.”
For example, what if a virulent flu virus was killing 80 percent of infected elderly, but just 20 percent of infected 13-to-40-year-olds? “Would they still really hold that we should be allocating these precious vaccines to people who have just one-fourth the likelihood of dying?” Alexander said.
Abramson said the official U.S. allocation policy does contain built-in flexibility. “If you’re basing it on lives saved and hospitalizations, then as you get into the epidemic and you find that 20-year-olds are the ones dying, then absolutely you change [the policy] — that’s already in our recommendation,” he said. “You adjust, you reprioritize.”
But he said the policy as it stands now is based on a sense of “equity”: Outside of health-care workers, no one group should get priority because of age or any other factor, other than their vulnerability to the virus. He said ethicists were included on the NVAC/ACIP panels and were familiar with Emanuel and Wertheimer’s position, but “none of them bought that argument.”
Still, the University of Chicago’s Alexander said raising the public’s awareness of the complexities of vaccine-distribution policies is important. For that reason, he said, the two NIH ethicists “deserve high praise for helping to move the debate about pandemic preparation and vaccine allocation to the public arena, highlighting the tough calls that may have to be made in the event of a flu pandemic.”
This was posted on our internal website today…from the Wall Street Journal. Requires a subscription which I can’t get from my work PC, but someone out there may be able to either post the URL or copy/paste the whole story…it’s only 5 short paragraphs. I’ll also post on the News thread…
Seems to me that some time back, it had been pretty much decided that these two drugs did not work against H5N1…
Generics Work Against Bird Flu
By Nicholas Zamiska
05/11/2006 The Wall Street Journal (Copyright © 2006, Dow Jones & Company, Inc.)
Hmm…I really thought I had something there. Dem already posted this on today’s News thread…I’m so shtupit!!!
I posted this this morning on the ‘Gaps in Preparedness’ thread, the vaccination discussion has moved (thanks anon_22!) and so…
As for vaccinating children (which I’m all for), what about their parents? Is the definition of ‘young’ not those under 30? Although some people wait a little to have kids, many are parents in their 20′s(and some even earlier). If the children are vaccinated and the young parents are not, who will care for all of the orphans?
WASHINGTON (AP) — Who should get the first flu vaccine during a worldwide outbreak — the 60-year-old grandmother with a weak heart and lungs or the healthy 4-year-old with decades ahead of her?
Government guidelines put the ill grandmother at the head of that line, for now… CNN
These are discussions that are best done in advance. Good to have them now.
The other advantage of vacinating kids is we know they are carriers. Face it. Anyone who has/has had/been around young children knows they just breed germs. I can say that with affection as my little petri-dishes are always bringing surprises home for all in our family to share. It’s too early to say who would be better protected from dying as we don’t know who will be most susceptible to H5N1 (or some other strain possibly). But vacinating kids may be one way to slow the spread.
I think the CDC models would suggest those aged 16–30 should have first priority followed by children aged 15 and under, to reduce overall pandemic impact.
Could I raise my hand and put in just one sentence in favour of protecting those who will supply the electricity, water, sewage and communications that will underlie the continuing operation of vaccine plants, hospitals—and some degree of societal order?
Nikolai, of course. :-)
Has the data so far collected shown that the young (anyone under 50 to me) are more likely to get the flu, as in the 1918 flu, or is it still conjecture?
31120,
If you go to the demographics page and scroll to the outcome and age group link, you can see the age distribution for yourself.
Has the data so far collected shown that the young (anyone under 50 to me) are more likely to get the flu, as in the 1918 flu, or is it still conjecture?
The only extended data is from SE Asia, and the median age is 14 or so; whether it’s from current exposure, egg collecting, vulnerability, lack of previous exposure or what is unknown.
Everything else about what might or might not happen is an educated guess.
Actually, reviewing the data, it looks like the age has crept up; the 16–20 range looks closer to the median.
By the time this virus reassorts, recombines or mutates itself into becoming fully adapted to humans, age distributions may change signigicantly.
As DemFromCt has said it is all speculation but from H5N1’s history we can surmise that we should expect the unexpected.
Let’s also keep in mind the possibility of recombination between the H5N1 antigen and media contaminants once it is put into production if we move to cell-based production methods.
Recall the SV40 virus from the green monkey kidney cells that was accidentally introduced into the US population via the cell-based polio vaccine 50 some odd years ago.
Our haste to move vaccine to market may again bring reduced surveillence on our methods and procedures allowing introduction of additional pathogens that may encourage further recombination and strengthening of H5N1.
NS1. You are the expert on these matters.I just can’t get my head around the intricacies of viral adaption. I keep an eye out for phenotypic expressions of genotype changes.
Have you read of the hypothesis that the use of chimpanzee (I think) cell cultures of polio vaccines specifically in Africa resulted in the jump of the species barrier from SIV to HIV infection in humans?
TomDVM-
Not an expert, just a curious student today.
Studied the idea extensively concerning retrovirus genetic insertion. Various primates carry retroviral material novel to man. Using cell lines even from other humans promotes the possibility of unwanted recombination during vaccine production. Not all that different from the selection against human receptors when we grow the H5N1 in the chicken eggs, I guess, but a possibility that we need to watch.
SIV to HIV is not so direct as some would have us think. As you know, zoonoses is rampant and the major avenue of human emerging pathogens, but I believe that we also are creating the terrain for these buggers to colonise us.
A retrovirus by nature will attempt to incorporate its genetic sequence into the host cell’s genome, so its not hard to see the potential avenues when we use cell-lines for vaccine production that may be selected for their high mitosis (because they were designed for cancer research originally)?
It looks to me that by the time a vaccine is available in sufficient quanities the virus will have burned itself out [ 1918 three waves in about 18 months] Unless there is some breakthroughs on several fronts a vaccine just isnt a viable option to stem a pandemic.
Then the question of effacy - it appears that the seasonal flu vaccines are not the magic bullets that weve been led to believe from public health and the media. Another thread addressed the percentages/age groups.
Why not concentrate on effective treatments to add to the Tamiflu arsenal. We seem to have the technology/knowledge already beat in this arena. Why are we putting all our eggs in the vaccine basket with so manty problems to over come?
janetn Thanks. I couldn’t agree with you more!!!
One thing about H5N1 though. Whether it disappears for the moment or becomes a pandemic strain and knocks hell out of us, it is here to stay, not just for the length of a pandemic but for the foreseeable future…
…that’s exactly what happened after 1918 but NS1 or Monotreme could probably do a better job of explaining the after-effects.
TOM DVM message for you on Cdn Preppers thread
gharris Thanks.
janetn – at 22:09
Why? Because a vaccine (that actually worked) would reduce morbidity and mortality in ways that “get sick, properly identify the illness early, then take proper meds asap, assuming they’re available” would not. That’s a hope, not a guarantee, but a major hope. And more rapid turnaround from non-traditional manufacturing techniques or the fruition of a universal flu vaccine to all types would be a major move forward in disease prevention.
PS I don’t get the either-or idea. Vaccine research doesn’t preclude all the other preps and steps.
More on flu vaccine priorities.
We’ve covered this story, but it’s getting more play now.
DemFromCt. I agree that there is no need for the either/ or but at the moment they are spending all their time on either vaccine or antivirals and nothing on…broadspectrum antibiotics, oral electrolytes, anti-fever and anti-shock drugs or food for that matter.
The either/or is not my approach, it theirs and they are, in my opinion, squandering the limited funds in not taking a more balanced approach to preparations.
If they don’t change direction, I don’t think ethics will play much of a role because their supplies will be so limited as to make the discussion irrelevant.
or respirators or the development of less expensive respirators with fewer bells and whistles.
Any Lets pretend a vaccine is found and distribution has started. What about the length of time it takes for the body to produce antibodies. Many people will be under the impression that the moment they recieve the vaccine they will be safe. Am I thinking correctly? gina
HARN-
Sometimes the body can produce antibodies in 4–7 days, sometimes in two weeks and sometimes not at all as we’ve seen in most dosages of the current H5N1 vaccines under development. Huge doses and multiple injections are necessary to create a proper response.
Maybe we should try to get our bodies to start responding properly before we inject these viral particles.
Tom,
“DemFromCt. I agree that there is no need for the either/ or but at the moment they are spending all their time on either vaccine or antivirals and nothing on…broadspectrum antibiotics, oral electrolytes, anti-fever and anti-shock drugs or food for that matter.”
In a way you are right in that there is insufficient attention being paid to supply of critical medicines and infrastructure problems. We need everyone to say it wherever we can.
However, if I compare what is happening to the speed with which governments or international institutionsa normally work, I must say some good souls have already managed to cut through a lot of BS and things are picking up speed. This is not to defend any deficiencies, but some of these functions fall under different departments in most countries, and at the moment there is still a lot of unevenness in awareness and therefore in priority and in funding.
So anything anyone can do to raise awareness by way of advocacy at any level will help, directly or indirectly. For example, I have spoken to someone who became aware of the magnitude of the problem because their husband’s company’s risk management team has been talking to all employees, which caused the spouse to talk to their school, which caused another parent to start talking to their child’s hospital about critical medicines.
Don’t underestimate the power of the individual to influence; however, to do that one must be careful to be impeccable in our fairness, both because it would enhance our credibility, and also because most of the time you are asking individual officials sitting between a rock and a hard place to push aside their already overwhelming workload and take on extra battles on budget etc. It’s very easy and tempting for them to go for the easy life and say “it’s not my problem.”
a cheap basic respirator could be developed easly if protection from lawsuits was given to companys. all it has to do is move a set volume of air at a set rate and sense when to start the air flow with the tech today it could be done with a microcontroler and a stepper motor driver and stepper motor and a plastic bag. move the set volume when a patient starts to take in a breath and then move the volume in (to help the patient to breath deeper) and then pull it out at a set speed, and start over, if patient will breath on one then it will start after a set time ie. 2 seconds or a set time. the whole thing could be done for $300 or less in large production with of the self parts.
If they don’t change direction, I don’t think ethics will play much of a role because their supplies will be so limited as to make the discussion irrelevant.
Actually, ethics play a bigger role the more rationing is needed. ‘Who gets scarce resource (who, and on what basis?)’ is an ethical issue, far more so than ‘who gets plentiful resource (everyone)’.
DemFromCt.
If you only have enough supplies for one in a thousand or one in ten thousand or one in one hundred thousand then the discussion of ethics is irrelevant in my opinion.
When push comes to shove- it will be the richest and most powerful who get almost all of the vaccine- period. I guess there will be a few “made for TV” poster cases. I would like to draw all of your attentions to the “making your own vaccine” thread???
The idea of making attenuated or killed vaccines in local vaccine factories seems like the only viable course. How else will we ever make 4–8 -or 12 billion doses of vaccine and distribute it??
It appears that this is not going to be a keep your heads down for 18 months and everything will be back to normal situation. (Just if- I am not assuming) If h5N1 goes pandemic and throws up new iterations of itself quite regularly- not only are we going to have to produce 12 billion does of h5N1 vaccine- but we will have to do it annually.
Why don’t we do a “Marshall Plan” and start converting every biohazard facility in the world into vaccine factories?
Hi Clark. It is kind of a funny situation we find ourselves in. Everything is basically standing still like a freeze frame in a movie. Everyone is waiting and waiting and waiting…and talking ourselves out of the inevitable and talking ourselves out of the inevitable etc…
…the point is if this thing pops, if you look at the numbers, we are looking at a one in a thousand or two thousand year event.
As you just said, the only possibility for us to respond in a meaningful way, would be the equivalent of a Marshall plan or a war footing…
…personally, I think effective antivirals and vaccines are more than ten years away. If I turn out to be right, we are going to need one god awful amount of antibiotics etc. amounting to thousands or ten of thousands the amount that is needed today…
…and we are waiting and waiting and waiting.
They are taking a hell of a gamble that I wouldn’t take!!!
TomDVM at 22:46,
As always, I appreciate your posts. You often articulate what I think as well. And Clark, if I may point out to others, you are in New Zealand, a country that lacks a vaccine plant. I also appreciate your posts as I live in a state about the population size of your country. We don’t have a vaccine factory either. In fact, many of our states in the U.S. are similar in population to foreign countries.
The federal government here in the U.S. has been relentlessly telling us that we are basically on our own. And it seems to be successfully lowering our expectations. While there is certainly merit in what has been said, there are some things that government and only government can do: for example, provide funding for vaccine factories. As Revere at Effect Measure pointed out, we spend 9 billion a month in Iraq. That is probably about the funding for 18 vaccine factories each month.
Many people may not realize that the U.S. has only one or at most two vaccine factories at the present time. We cannot even produce enough of our own seasonal influenza vaccine. How many factories would we need to cover the entire population? Well, apparently way more than the expansion of the plant in Pennsylvania and the possible new one being explored by another company. How do we know this? Because TPTB are telling us that we can expect to wait 5+ years before there is enough vaccine to cover everyone even though some ‘partial immunity’ vaccine has already been produced for the select few in line.
Dr. Osterholm at CIDRAP clearly understands our problem and has called for a full court press (my words, not his, but same thought). A previous generation clearly ramped up during WW2 and understood what a full court press means.
I understand that it is wishful thinking to have a vaccine plant in every state. And I understand that there are many hurdles to overcome. But suggesting it illustrates the longing for our government and we, the people, to not accept that most of us will be left to fend on our own when so much more could be done. Yes, Tom, we are waiting and waiting.
Nightowl – at 23:52 TomDVM at 22:46 Hi all.
New Zealand has a deal where we get supplied with vaccine from an Australian vaccine factory. We have all of our eggs in one basket- a very far away basket.
TPTB keep going on about vaccines as if it were rocket science- and that is why we are going to have to wait 1–5 years, if ever. If Robert Webster can make it in his lab- it must be fairly straight forward- just take extreme care. I mean there are McDonalds everywhere- why can’t there be Vaccine plants everywhere? McDonalds churns out Billions of Big Macs- why can’t we churn out billions of vaccines?
The officials tell me to forget about getting a vaccine anytime in the first year. I also realize that it may never happen. Vaccines are my plan D- for all of the reasons that Tom has expressed so beautifully. (my A plan is SIP and prednislone)- ( My plan B is that Tom preps so he can help us all figure out a plan B)
What really bothers me- and it was Northstar’s history of vaccine lessons that alerted me- There is nothing impossible about producing enough vaccine for everybody in a timely fashion. The problem is akin to why the sequences are not being released. Stupid human shortsighted status games. If there is a will, there is a way. But there STILL is no will.
Clark-
There is no will at the highest levels because the expenditures would like create ill will with the masses at the lowest levels.
We are at a turn in humanity where we can clearly see the failure of society to recognise a major problem and take broad action.
NS1 – at 15:50
Hi NS1- I just realized how “concerned”(desperate?)I am about this. I have been an opponent of vaccine and vaccination for my entire adult life. We decided not to vaccinate our two children for anything- and they are both healthy and happy 15 years later. (touch wood)
The reason I am now on a Vaccination thread is I cannot think of any other approach that could work for Joe and Jane WorldInhabitant and their kids. (if a High Path flu pandemic hits us)
The reason I am thinking about killed or attenuated viri vaccine is the idea of DNA vaccine terrifies me more than the H5N1. At least Humanity would emerge from a pandemic- we have always done so- beaten to a pulp- but stronger and wiser.
The thought that our DNA could be altered by a DNA vaccine………..The cure could be far worse thah tne disease
Clark-
You and I share exactly the same concerns.
We have studied the same topics and likely acted in the same manner in many areas.
My highest concern is about what we don’t know:
I’m banking on using a whole panel of modalities to take prepare those I love.
And I’m running from anything that I know in my heart is toxic.
NS1 – at 17:05 I agree- I have a plan A and B- and I am working on plan C, D and E. Anyone out there thought of a plan F, G, H, I, J or K yet?? I am interested.
I’m working on concurrent plans, all plan A.
clark,
“TPTB keep going on about vaccines as if it were rocket science- and that is why we are going to have to wait 1–5 years, if ever. If Robert Webster can make it in his lab- it must be fairly straight forward- just take extreme care. I mean there are McDonalds everywhere- why can’t there be Vaccine plants everywhere? McDonalds churns out Billions of Big Macs- why can’t we churn out billions of vaccines?”
I share your frustration about why we do not have more vaccine plants or capability, otherwise I wouldn’t have spent time investigating the issues and writing this thread. However, some observations may be in order at this point.
First of all, rocket science is rocket science. McDonalds burgers is McDonalds burgers. Flu vaccines are flu vaccines.
And Robert Webster is Robert Webster.
Just because anybody can make McDonald’s burgers does not mean that anybody can make flu vaccines.
Secondly, I read the article ‘The Flu Hunter’ that Northstar and you linked to in the ‘make your own vaccine’ thread. What is most interesting given the level of debate it generated is that there is NO indication that Webster succeeded in making such a vaccine ie producing protective immunity in himself or others against H5N1. If you can find a reference somewhere that says otherwise, please let me know.
Absent of that, one should assume that he did NOT succeed in making an H5N1 vaccine in the way described in the article. Rather the story was more an illustration of the willingness to take risks that makes a great scientist, who btw also need other qualities such as adherence to best practice based on known data, due diligence, public responsibility, etc.
“There is nothing impossible about producing enough vaccine for everybody in a timely fashion. The problem is akin to why the sequences are not being released. Stupid human shortsighted status games. If there is a will, there is a way. But there STILL is no will.”
Northstar and your spirit of enquiry is commendable. However, just because challenging established wisdom is one path towards creative solutions does not necessarily mean that established wisdom is wrong.
So when you say “There is nothing impossible about producing enough vaccine for everybody in a timely fashion.” one can interpret that as an expression of frustration against our current dilemma, in which case I quite sympathize.
Or one can take the statement as a true reflection of reality, in which case the inference would be that someone (presumably yourself or your associates) have investigated this thoroughly and found solutions to ALL the problems blocking this worthy goal. If that is the case, I would implore you for the benefit of the billions of people on this planet to please publish your thesis with all supporting evidence and submit it for peer review so that other scientists can reproduce your results. If you have such findings, I assure you that scientists, governments, and vaccine manufacturers, will be standing in line 10 deep to use your process.
As for whether there is the will, we cannot know that unless we can see inside people’s souls. If we cannot, it may IMO be more ethical to assume innocence until proven guilty.
as for the antigenic problems, is it similar as with normal flu ? I assume that normal flu is much more experienced here and maybe H5N1 is not so advanced in changing the antigenic sites ?
We all may be a bit overwrought with this item of enquiry.
We are generalising when we need specificity and comparing when we need contrast.
Let’s all take a more balanced view of the issue.
Anon-
If we want a vaccine with specificity producing substantial antibodies in a reasonable amount of time, then the maker’s will be needing a accurate sample regardless of the Influenza subtype.
Hi Anon_22 at 2:29
First of all- why is your point of view always- “established wisdom”? It is just your point of view- no more- no less. It is possible to reference just about any point of view with scholarly articles. The truth is out there- it is just in many places at once -(quantum theory)
In a nutshell, the flu virus was isolated and identifed in 1933. McGill and Francis attempted the first flu immunization in 1937. The US army successfully tested whole killed virus vaccine in 1943.
Results:
* Among 6,211 controls, attack rate was 7.11%
* Among 6,263 vaccines, attack rate was 2.22%
* VE thus 69%
(Francis, Salk, Pearson, Brown: J Clin Invest. 1945; 24: 536–546)
In 1976, a couple of recruits died of “swine flu” at Fort Dix.The US Government decided to vaccinate entire US population- which began in September, 1976. The vaccination began within months of the “threat” being identified
Tell me this- why could the US government decide to produce flu vaccine and impliment mass vaccinations of the entire USA population in 1976- But now it is impossible????????
I know that the swine flu was a false alarm, But they said “Lets do it”- and they did.
It is not rocket science.
We are manufacturing about 70,000,000 automobiles every year- plus all the junk that goes with them. If we want something- we can make it. We just don’t seem to want a flu vaccine very much.
and that 1976 vaccine did only cost $135million for 200million people. Even with inflation, that’s still less than 1 billion of today’s money.
Query for the experts and “news trackers” on the Wiki: My dad (the retired virologist) just sent me a packet of info. related to Avian flu. In his letter discussing all this, he mentioned that no one, to his knowledge, has begun to “choose tissue cell lines for culture of the virus or the conditions of growth in culture vessels of say, 5 liters to 500 liters”.
Is this still true? He is still in touch with some researchers in the field and keeps up with the technical literature and hasn’t seen mention of real research in this area yet. Is it being done? He’d like to know who is doing this now, as he is trying to keep up with the research.
bump
clark,
I have very limited internet access at the moment so this will have to be brief. And I may not be able to respond to your questions so I hope you will bear with me. :-)
Just a quick note to say that I never said and I don’t take my point of view as established wisdom. I just question ALL information relating to this important subject to see if we can come up with better solutions than the current collection of very difficult problems. So let’s not get personal again, ok?
It isn’t, really.
If this was an easy subject, there wouldn’t be so many people butting our heads against the wall about it.
:-)
clark,
“We just don’t seem to want a flu vaccine very much.”
That I do agree with you, at least for the seasonal vaccine and up to the current moment.
I believe the problem is a combination of low take-up rate, short product life (one season only), and so on. Manufacturers do not have production capacity for the whole population even in countries with their own plants, because there is no universal uptake of the vaccine. From the point of view of commercial ventures with responsibility to shareholders, they are unwilling to expand those capacities unless there are firm guarantees of close to 100% vaccine uptake. That means contracts signed, sealed, and locked away.
Trouble is governments can’t sell that to the public unless they can prove that the cost vs benefit to collective good justifies it. At the moment it remains too difficult to make that case for the seasonal vaccine.
So to jump from very low production capacity for a relatively low cost easy-to-make seasonal vaccine to the huge investments involved to boost capacity for a pandemic vaccine, where a satisfactory one of licensable quality is still far in the horizon, is a step that, at least in a democracy, would be even harder to sell to taxpayers.
I wish one could make an easy vaccine as clark is suggesting. I just don’t think anyone has connected the dots to make that proposal viable, even if we ignore all cost and political considerations and just look at the science, at least at the moment. That’s not to say we shouldn’t keep trying. But it is also useful to be realistic about it.
InfoLady,
“My dad (the retired virologist) just sent me a packet of info. related to Avian flu. In his letter discussing all this, he mentioned that no one, to his knowledge, has begun to “choose tissue cell lines for culture of the virus or the conditions of growth in culture vessels of say, 5 liters to 500 liters”.
Is this still true? He is still in touch with some researchers in the field and keeps up with the technical literature and hasn’t seen mention of real research in this area yet. Is it being done? He’d like to know who is doing this now, as he is trying to keep up with the research. “
That’s intersting. I don’t know the answers and I would be very interested in more specifics if you can share them. Do you have links or whatever? If it is easier to email your ‘packet of info’ please send it to anon_22 AT hotmail DOT co DOT uk, and I’ll see what I can do to post the stuff. Or if your dad is willing to post and share with us here that would be even better! Thanks..
To get back to clark’s query about 1976 and why they could do it then. One of the biggest obstacles now vs the 1976 is the nature of the virus. H5N1 is no ordinary flu virus as we all know. It kills eggs so has to be reversed engineered, it has a peculiarly low immunogenicity, etc etc.
anon_22 — My dad is “old school” and not much on computers for chat, etc. (My mom is the “email queen” at their house, Dad wants everything printed out to read, etc.) So that packet he sent was in hard copy, of course.
He wouldn’t be willing be be on the forum here, but if there are specific questions people have, I’m sure I can ask him and relay the answers. He did do research and development in influenza vaccines for Wyeth, Eli Lily, etc. so he does have experience in this area.
BTW, he doesn’t think that WHO, the CDC, and other leaders are really stepping up to the plate — sees a major lack of leadership in this area.
Clark. That piece of writing at 6:04 is the best you have ever done…and you have produced some very good writing in the past three months.
It is crystal clear concise and your brief analysis informs completely.
I agree with your comments because you have now given me the context to be able to make an informed decision. Thanks!!
Clark and A22-
We’ve obviously presented an extremely over-simplified version of vaccine manufacture in these past 24 hours.
We each can agree that the sociological dynamic of government to the people is a much more daunting catch than the economic issue. Leaders are concerned about public opinion polls and people are thusly distrusting of leaders’ decisions.
We can also agree that even if a country’s population were to fully concede the need to produce these vaccines, the economic ramp-up time is lengthy.
All for a product that may or may not have a substantial effect based on recent studies on influenza vaccine and mortality statistics . . .
NS1. As you no the first precept is ‘Do no harm’.
If I have a choice between an experimental vaccine produced in my own country or an experimental vaccine produced in China…and make no mistake that is going to be the choice, I will take the experimental vaccine in my own country…
…The only problem with that is that the evidence that I have seen indicates that seasonal influenza vaccines don’t work…probably because of the instability and mutability of the virus…drifting away from the vaccine strain…
…so I won’t be subjecting myself or my family to any vaccines until the data clearly supports their usefulness.
I would rather take my chances, dancing with H5N1.
Hi all
I think that the problem is that nobody in the West is making wholed killed or attenuated virus vaccine. There were adverse reactions- law suits etc etc.- so they are not doing it - too dangerous to their bottom lines-
But- I am guessing that whole killed or attenuated virus is the way to go- I believe that the process is simpler (it was the first process for making flu vaccine)- and the resulting vaccine is more effective. It is just a flu virus that has been killed or disabled, that is then injected, you sniff it or drink it. What could be simpler?
anon_22 – at 13:12 Why not grow the virus on fertilized duck eggs? Or even try to?? Sometimes in a pinch, we get so overwhelmed by panic, that we forget to consider simple solutions. I am not the first to suggest this.
I have been anti-vaccine my entire adult life. I certainly would not automatically take an H5N1 vaccine- OR give it to my kids. But I would love to have the option of being able to.
It comes down to numbers for me. The potential CFR and attack rate of H5N1 are so high- and the very real risks from taking a whole killed or attenuated virus vaccine are so low- You then look at the available data- check your intuition- and make a choice.
Tom DVM – at 15:07 Thanks Tom-
“A team of German researchers two years ago tested a vaccine containing alum and a flu strain in which the virus was “whole killed” — chemically inactivated but not broken into pieces. With as little as 1.9 micrograms, that vaccine provided protection in 80 percent of people.
The problem with that solution is that the dozen companies making 90 percent of the world’s flu shots all use virus that has been broken up by chemical detergents — a treatment that makes the injection less painful than a whole-killed vaccine but also less stimulating to the immune system.
To capture the advantage of a whole-killed vaccine, the vaccine makers would have to change their manufacturing methods, and whether they are willing to do that is a big unanswered question”.
I wonder if most people have foundational elements to develop antibodies (uncoded T cells, et al) at the time that they take a vaccine?
Even a well-designed vaccine only works in a properly, functioning body.
InfoLady – at 09:29
Your Dad could help us so much. A vaccine expert who has been there and done it. Please talk and talk and talk to him. I am interested in all of his thoughts on the situation we all find ourselves in. Please pump him dry!! and tell us what he thinks.
Could you ask him about early flu vaccine manufacture (whole killed or attenuated) and if he thinks that this would be a good approach for H5N1? Ask him how difficult and expensive it would be to set up regional vaccine plants- nothing huge- but more small or medium scaled. Maybe using existing Military, University and Hospital biohazard facilities. Nothing too fancy- In the style of 30 or 40 yearws ago. Low tech.
Ask him about his ideas for mediums to grow the virus on. Could duck eggs work? Are there any stategies to make chicken eggs work (all human flu virus is realated to avian flu).
In your Dads opinion, where should we be looking? What should we not waste our time and money on? ‘What should we do????
InfoLady-
Does your family get a flu vaccination each year? Does your father?
If he lives close to you, maybe we could set a day and time for him to visit you and be interviewed, per se, while you input his answers for the readers?
Would you be open to that idea? Do you think he would?
Anyone want to submit some questions for him now?
if H5N1 kills chicken eggs, what then about pigeons? We all heard the story about imune pigeons. And as far as I know they lay quite alot eggs during a year….. my five cent..
Are the eggs small?
“In the urban environment, because of their year-round food supply, feral pigeons will breed continuously, laying eggs up to six times a year.” http://en.wikipedia.org/wiki/City_pigeon
eggsizes:http://www.internationaldovesociety.com/EggComparison.htm
I’m not sure if that’s enough eggs or enough volume?
is volume important? How many doses do one chicken egg make? Only one or multiple? The solution could be to bread a reststant chiken? In the genetical monotone industrial chicken flocks, there is 100% dieoff. But among wild birds and maybe also some rurual chicken flocks there is some imunity, could we not just use breading? Make a variant of chicken that is genticaly resistant? it will take time but..
Urdar-
Breed a resistent chicken? If we can find what makes a chicken resistent, we can probably use that research with people.
Here in the southern U.S., some cook a dish called Fried Chicken, which is breaded (battered) and then deep fried.
I realy dont know. It just ocured to me that the 100% motality among industrial chikens got something to do with lack of genetic diversity .. A ordinary problem in plants and animals that is heavy produced.. Expose some diferent variants of chikens for H5N1, those who surwive you just breed further on.. We cant do that with people you know :)
Spellcheck should be embeded in the wiki sofware..
Urdar-Norge – at 20:53- I don’t see why not. Others have suggested duck eggs. I wonder if geese eggs might not work.
Your idea of finding or breeding H5N1 resistent laying hens is one of the best ideas I have heard for awhile. What I like is that it is sooooooooo obvious- but I have never heard it suggested before. Sometimes great solutions are so simple that people miss them.
WE live in a culture that is addicted and obsessed with high tech solutions to what are often simple problems. Eggs from H5N1 chickens could be the solution we need. Thank you
Anybody out there who could breed H5N1 resistent laying hens for vaccine manufacturing would have a very could business. Each egg would be precious.
I wonder what will happen about the folks whose religious beliefs preclude vaccination?? Would/could they be forced under Martial Law? I suppose so few people will actually get vaccinations anyway that it likely doesnt matter?
clark,
A short response:
1) I also think whole virus vaccine may be the best choice.
2) I don’t know about duck eggs. I’ll have to look it up.
<anon adds another item to her 38 page to do list>
There’s a couple of conferences coming up this month. I hope to learn a lot more then. :-)
bump
anon_22 – at 23:41 - Thanks for your great reply- I will be really interested in what you find out.
I am an old hippy at heart and like my vaccines (I hate vaccines!), as whole, organic and unprocessed as possible.- Not these new fangled, highly processed, genetically altered vaccines. No sireee- not for me.
I prefer a vaccine made from happy, wild, free range viri that have not been raised in petri dishes. And humanly killed of course.
No bolt guns for clark’s vaccine stock.
InfoLady – at 13:49- any word from your dad??
NS1 – at 00:38- I hoped you would have a laugh!
clark — My father thinks they should be researching and developing this via cell tissue culture, not in eggs at all. Apparently there is no way (according to his calculations) to “grow” enough vaccine in eggs, no matter what the production “ramp up”, and the fact that eggs are problematic with this virus is another hurdle. He was doing this type of research several years ago (ie., cell tissue culture vaccine research) so he is baffled why the current emphasis is still on the egg production route. He also thinks that they need to consider incorporating any proven H5N1 vaccine that is (or soon will be)available into the seasonal flu “mix”, even if it is not totally effective to future mutations. He says that influenza vaccine work must be ongoing, of course, due to the constant mutations of the virus — a system should be put in place NOW to handle the H5N1 (and its future mutations) longterm. In other words, a LOT of scientists, money, facilities, etc. dedicated to this — ramp up what is being done in other influenza research and vaccine development in a major way. He admits he sees no evidence that this is a priorty for the CDC, WHO, NIH, etc., etc.
As for “low-tech” methods — my dad hasn’t really worked much with “low tech” research, even “back when”. (He worked at cutting edge labs and was doing work with AIDS, for example, before it had a name). He is also very strict on lab/research safety, and has always refused to cut corners in that area. He says that you cannot rush the research and development, because you will cause more problems than you will cure. If you want it faster, you need more people working in more places, and hope for a breakthrough that way. So he certainly agrees we need more scientists working on this — but with existing labs (perhaps at universities as well as government and private labs).
NS1 — Yes, my dad and mom get the seasonal flu vaccine. So do I and my family. We know it is not 100% effective, but it does what it does (helps prevent against catching the strains selected for the vaccine).
InfoLady: Thank you so much for posting, and please thank your father for sharing his thoughts. Here are two pieces he might be interested in. The first is DNA vaccine research at St. Jude’s. The second is about conversion of vet vaccine plants.
InfoLady – at 09:06
Thanks for talking to your father, and of course to your father for his help. I just reposted part of an article I found about whole virus as opposed to broken virus vaccines. Could you ask your father to comment? cheers
“A team of German researchers two years ago tested a vaccine containing alum and a flu strain in which the virus was “whole killed” — chemically inactivated but not broken into pieces. With as little as 1.9 micrograms, that vaccine provided protection in 80 percent of people.
The problem with that solution is that the dozen companies making 90 percent of the world’s flu shots all use virus that has been broken up by chemical detergents — a treatment that makes the injection less painful than a whole-killed vaccine but also less stimulating to the immune system.
To capture the advantage of a whole-killed vaccine, the vaccine makers would have to change their manufacturing methods, and whether they are willing to do that is a big unanswered question”
Infolady-
Thanks so much for your response.
That just about says it all. I’m concerned that we are going to be strongly coerced to cut corners, ergo, sacrifice lives, in order to meet the demand.
Any chance that your father will concede to an online interview situation with you as his guide?
Clark — my dad actually sent me that article in the “info. packet” he sent. The whole-killed virus is one strategy, and could work, but the problem is — once again — on the production side. As the article notes, manufacturers of vaccines are not set up (for the most part) to produce this type of vaccine. Same issue with cell tissue production methods. It isn’t that it can’t theoretically be done, it’s who’s going to come up with the money to convert production lines, train workers in new techniques, buy new equipment, etc.
I know it seems silly to us that $$ are the real stumbling block, but for large-scale production you have to put in lots of start-up dollars, even if you aren’t looking to make a profit. Of course, world governments could put money into this, if it were a top priority, like, say, wars. (Sorry if anyone thinks that’s too political, it’s just my humble opinion). Of course, some will say that it would be a gamble of the dollars, because we don’t know that there will be a pandemic. But — again in my opinion — scaling up production of vaccines to combat influenza and a host of other life-threatening diseases in the world seems like a better hand to bet on than the alternative.
InfoLady – at 19:28 That is so cool that he sent you the article! Could you tell him that when I said “low tech”, I didn’t mean unprofessional-All safety precausions and procedures would be first class. I was thinking of using older and proven vaccine techniques that would be easier to set up in far flung places. The equipment would not be bleeding edge, that is all. Tell him that I live in New Zealand and we have no human vaccine making facility here - there are facilities for veterinary vaccines. I am interested in having local vaccine plants- particularly in my country- province and even my city.- but I was worried about the rest of the world as well.
A well maintained older car will take you on a cross country trip just as well as a brand new one. You sacrifice comfort and convenience-
In your Fathers opinion, is there any way that a little country like New Zealand could have it’s own vaccine plant/ plants??? Maybe making whole killed or attenuated virus vaccine?
Thank him profusely for us!!
kindest regards
Closed due to length. Conversation is continued here.