After legions of World War I soldiers died from influenza, the U.S. government deemed this deadly virus a national-security threat and made vaccine research and development a top priority.
Decades after this concerted push finally yielded the first flu vaccine, a sobering report from Michael Osterholm and the University of Minnesota's Center for Infectious Disease Research and Policy has made it clear that the battle against the virus must be rejoined. The nation is relying on an a dated weapon against a constantly evolving pathogen. A new, more effective and longer-lasting vaccine is needed.
The first step to making this daunting medical breakthrough a reality is acknowledging more forthrightly that the current vaccine doesn't work as well as many other immunizations -- such as those given for childhood diseases.
It's still critically important to get the yearly shot, because it's the best safeguard available. But the public deserves an immunization that is 85 to 90 percent effective in all those who get it -- not one that is roughly 60 percent effective in healthy adults ages 18 to 64, as the Minnesota researchers concluded after evaluating research overestimating the shot's effectiveness. The flu vaccine should provide superior protection, not protection that is good enough.
That's why it is so disappointing to see the tepid response to the report by the nation's leading public health organizations. The Minnesota report, issued last month, is likely the most exhaustive review ever of the flu vaccine's effectiveness. In an effort that was equal parts investigative journalism and scientific analysis, researchers pored through more than 12,000 documents, meeting minutes, notes and other papers going back the mid-1930s. It also consulted top experts.
While there has been a burgeoning scientific debate about the vaccine's effectiveness, the rigorous Minnesota review provides a definitive answer. The vaccine "offers substantially more protection for most of the population than being unvaccinated." But the "evidence for consistent high-level protection is elusive for the present generation of vaccines, especially in individuals at risk of medical complications or those 65 years old or older."
This landmark report should have been a headline item at a recent meeting of the Advisory Committee on Immunization Practices (ACIP), which develops national vaccine-use guidelines. Instead, the discussion about the new report was negligible at best, which is intriguing because the Minnesota report suggested that this eminent group's recommendations were good policy but not always backed up by data. Those are fighting words in the scientific world.
At the very least the report merited an in-depth discussion at the meeting late last month. The report shouldn't have changed flu-shot recommendations, but it was a call to action. In an interview Friday, ACIP chair Dr. Jonathan Temte emphasized his organization's deliberative process. Neither Temte nor Dr. Joseph Bresee of the U.S. Centers for Disease Control and Prevention provided a satisfying answer about how or when their organizations might act on the Minnesota analysis to champion a more effective vaccine.
This reluctance is likely rooted in concerns that advocating for better vaccine may cause some to forgo the current annual shot. The public, however, is quite capable of grasping that the current shot works, but that today's technology could yield an even stronger one.
Considerable public support and resources will be needed to develop the next-generation flu vaccine. This important work should begin. Leadership and candor from top experts are the key initial ingredients to make it happen.