BENEATH ALL of the anger and frustration surrounding the current flu vaccine supply problem is a simple fact - as we gear up to fight a new flu strain in our first pandemic winter in 40 years, we employ a really old technology to make flu vaccines. The nation needs to find a better option.
The basic way we make flu vaccines has changed little since the 1950’s. It relies on hen’s eggs. Each year, a seasonal flu vaccine is developed to cover three strains of flu that are circulating. And, each year the flu viruses change a little bit, requiring the production of a new vaccine annually. Manufacturers use separate eggs to brew vaccine to cover each strain, so that means that one dose of vaccine requires at least three eggs to produce. This method has sufficed in most years; indeed, there’s a surplus of flu vaccine at the end of most flu seasons.
But the egg process is too slow to allow for quick response to a pandemic. The 2009 H1N1 virus - widely known as the swine flu - appeared too late to be included in the seasonal vaccine production process, so a separate production process had to be started to cover it. This process cannot be hurried up - which makes it all the more ironic that critics of the H1N1 vaccine maintain that it’s being “rushed’’ through production.
The Centers for Disease Control and Prevention (CDC) and other federal agencies deserve credit for making a gutsy decision to undertake a complicated vaccine development process in response to H1N1, knowing full well the limitations of that process would make obtaining enough vaccine very difficult. The agency chose, for good reasons, to rely on the tried-and-true egg method rather than experimenting with some untested alternative method. But predictably, the situation has revealed serious gaps in our ability to follow through and make a vaccine quickly enough to prevent flu once it has begun to spread.
Hopefully, a policy that supports continued funding for accelerated development of new production methods will follow in the wake of this pandemic. In the face of great fiscal challenges in the future, there’s a risk that we will not see the need for continued investment in this type of research once the present crisis abates. That would be a mistake. There is great potential for developing vaccines through cell cultures in the future, which would make the process more efficient and speedy. Over time, the US Department of Health and Human Services has spent $2 billion in the search for new production technologies, but more public investment is necessary. Vaccines are the best protection we have against the flu, so it’s vital to get them to the public quickly.
At a press conference last Friday, CDC Director Tom Frieden said that no matter how often or loud we yell, it’s not going to make the virus and the eggs cooperate and speed the flu vaccine production process to our liking. He’s right. Which is why it’s so crucial to find a faster way to grow vaccines.
Tom Lyons, a health communications consultant, is a former director of public health strategy and communication for the Massachusetts Department of Public Health. 
