Vaccine specialists discuss strategy in swine-flu battle
GENEVA - As swine flu cases topped 6,600 worldwide, vaccine makers and other specialists met yesterday at the World Health Organization to discuss the tough decisions that must be made quickly to fight the evolving virus.
Pharmaceutical companies are ready to begin making a swine flu vaccine, but as the virus constantly mutates, questions abound: How much should be produced? How will it be distributed? Who should get it?
The group's recommendations will be passed to WHO Director-General Margaret Chan, who is expected to issue advice to vaccine manufacturers and the World Health Assembly next week.
WHO's flu chief said the meeting of industry representatives and independent specialists sought to answer questions including when to recommend to manufacturers that they switch from a seasonal vaccine to one that works against the pandemic strain.
"No big decisions, no announcements," Keiji Fukuda told reporters after the meeting. "These are enormously complicated questions, and they are not something that anyone can make in a single meeting."
But some believe the main decision has already been made.
"It's a foregone conclusion," said David Fedson, a vaccines specialist and former professor of medicine at the University of Virginia. "If we don't invest in an H1N1 [swine flu] vaccine, then possibly we could have a reappearance of this virus in a mild, moderate, or catastrophic form and we would have absolutely nothing."
Most flu vaccine companies can make only one vaccine at a time: seasonal flu vaccine or pandemic vaccine. Production takes months and it is impossible to switch halfway through if health officials make a mistake.
Vaccine makers can make limited amounts of both seasonal flu vaccine and pandemic vaccine - though not at the same time - but they cannot make massive quantities of both because that exceeds manufacturing capacity.
"What is really going to be wrestled with is that seasonal influenza itself has a significant impact on people," Fukuda said. "This is an infection which is estimated to kill some hundreds of thousands of people each year around the world, so there is a real trade-off if you just say we're going to stop making that vaccine."
At the moment, health officials aren't sure how deadly swine flu is, and whether they will need more seasonal flu vaccine or swine flu vaccine. And if the swine flu mutates, scientists aren't sure how effective a vaccine made now from the current strain will remain.