Editorial: Why isn't there a better flu vaccine?

Article by: EDITORIAL BOARD
Updated: September 11, 2012 - 9:02 PM

Complacency is dangerous when fighting new strains.

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Flu shot.

Photo: Richard Sennott, Star Tribune

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The appearance of a swine flu strain able to make pigs and people sick prompted a sharp debate in Minnesota and elsewhere this summer over whether to shut down state fair barns.

Regrettably, what failed to materialize in its aftermath is a related and even more important debate over medicine's main weapon against influenza: the annual flu shot.

Why is the vaccine still manufactured with slow, 1940s technology? And why isn't there a better vaccine available -- one that would strengthen the protection it provides and not require yearly shots to guard against new strains of the virus?

To be sure, the vaccine remains the most specific way to fight influenza, a highly contagious airborne virus that is linked to an average of 23,000 deaths a year. While there's growing evidence that the vaccine doesn't confer as much protection as previously thought, particularly in the elderly, the shot is still a healthy precaution that's recommended for just about everyone.

This summer's swine flu served notice that complacency is dangerous public policy when it comes to vaccine development. Its ability to move from pigs to humans raised concerns that the virus had undergone dangerous changes and that it could have the ability to become widespread, perhaps even more so if it changed again after it infected humans.

So far, the virus doesn't appear to be as easily transmissible among people as feared. Nor does the strain typically appear to cause severe illness, though it has been linked to one death in Ohio. It's also worth noting that the four cases of flu linked to the Minnesota State Fair are a different strain of flu than the one that sickened about 300 people at other Midwest agricultural fairs.

But if the new strains prove to be something more dangerous as transmission continues between humans and pigs this fall, it's unlikely that a vaccine would be available soon to protect the public. This year's flu shot provides protection against other circulating strains, but not the particular variants linked to fairs.

Although public officials and pharmaceutical firms have worked together to increase flu shot supplies and advance manufacturing techniques, the reality is that the vaccine production is still reliant on a time-consuming and decades-old technique using eggs.

"We would be lucky to have a vaccine available for the general public by next spring,'' said University of Minnesota infectious disease expert Michael Osterholm.

Osterholm has been at the forefront of scientists calling for an improved flu vaccine. Some farsighted public officials, such as former Florida Democratic Sen. Bob Graham, have also spotlighted this. Graham, now the chairman of the WMD Center, believes an improved vaccine is critical preparation against man-made bioterrorism, as well as that which occurs when the virus mutates on its own to become more virulent.

These pleas for action, as well as previous influenza scares involving bird flu, have unfortunately failed to galvanize the broader political leadership needed to secure public funding for an improved vaccine, and to help people understand why it's needed. This would be a huge and expensive undertaking, but given influenza's global danger, it should be a top public health priority.

Instead, medical research is at risk in the haste to cut government spending heedless of the consequences. Influenza is endlessly evolving as it circles the globe each year. To keep up, influenza vaccine development must become one of continuous improvement.

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EARLY SHIPMENTS

Flu shots still are the main protection against influenza. This year, vaccine shipments began arriving as early as July, according to the Minnesota Department of Health (MDH). Clinics and pharmacies may already be offering the shot. MDH also won an award for its FluSafe project that encouraged hospital and nursing home workers to get vaccinated.

To see vaccination rates for top facilities, go here.