Pandemic Influenza and the Global Vaccine Supply

(See the editorial commentary by Fedson on pages 1562–3) Use of influenza vaccine is increasing, especially in developing countries. Yet most of the world’s influenza vaccine is produced by companies located in 9 developed countries. When the threat of an influenza pandemic appears, the traditional approach to providing interpandemic vaccines will not be able to meet the global demand for pandemic vaccine. Several steps must be taken to address this problem, including the use of reverse genetics to prepare seed strains for vaccine production, the undertaking of clinical studies to define the characteristics of candidate “pandemic-like ” vaccines and vaccination schedules, the development of procedures for global vaccine registration, the expansion of recommendations and reimbursement for interpandemic vaccination, the country-specific reporting of vaccine use and forecasts of future vaccine needs, and the negotiation of political agreements that will ensure the adequate production and equitable distribution of pandemic vaccine throughout the world. In early 1962 long queues attended any clinic in Birmingham offering vaccination, because three patients with smallpox were in the isolation hospital. At this time over 100 people a week were dying [of influenza] … but this caused no great public agitation. T. H. Flewett, 1963 [1] That we have chosen to worry more about anthrax than about the flu is hardl