Flu expert urges pre-vaccination against possible pandemic strains/ AP

Helen Branswell reports on "a bold proposal on how to circumvent too-slow production and too-little output of influenza vaccine during a pandemic."

You saw it here and here first, when I blogged about what pandemic "experts" talk about when they don't have a pandemic: so-called "pre-pandemic" vaccinations.  It would be a great idea if we knew the strain that was to infect us in future, except that we don't.  The experts hope that maybe they will guess right, and the pre-pandemic vaccine selected will provide some immunity when that bad old pandemic finally shows up.  Or at least it might reduce the number of shots we need from two to one, doubling vaccine coverage. 

(Oh damn, I forgot--the 2009 swine flu vaccine only needed one shot, even without preexisting immunity.  That weakens the justification for pre-pandemic vaccine, since reducing the number of vaccine doses was the primary rationale for pre-pandemic vaccination.   Maybe if the "experts" don't talk about it, the public won't see how flimsy the justification is for these inoculations.)

Dr. Klaus Stohr, former head of the World Health Organization's global influenza program, is suggesting the world consider pre-vaccinating people, giving them protection against strains that could emerge from nature to trigger future pandemics.

In an opinion piece published Thursday in the journal Nature, Stohr argues pre-pandemic immunization may be one of the few solutions to a vexing problem — there is no way to make pandemic vaccine fast enough and in large enough quantities when it is needed to have an impact on the toll the outbreak takes.

Stohr is now vice-president of influenza strategy for Novartis Vaccines and Diagnostics, the world's No. 2 flu vaccine producer and a company which stands to gain significantly if his proposal were to take off.

Still, he insisted that he — not Novartis — is making the proposal because the pandemic response model needs to be fixed and the available options are limited.

"I'm not saying it's simple. I'm not saying it's inexpensive. I'm only saying that there is no other solution I can see," Stohr said in an interview Wednesday...

Michael Osterholm, who heads the Center for Infectious Diseases Research and Policy at the University of Minnesota, doesn't believe Stohr's proposal is the answer. For one thing, he said, most countries that had H1N1 vaccine couldn't persuade even a third of their citizens to take the shot. Poor uptake even in the midst of an outbreak throws into doubt how willing people would be to get vaccinated against viruses they might never encounter.

"The idea that we could somehow go out and vaccinate large populations with vaccine in a pre-priming environment — particularly with adjuvants, which were shown throughout the course of this pandemic to be a deterrent to people receiving vaccine because of safety concerns — is just way off the mark," Osterholm said...

"Even if you had a similar subtype vaccine, there's no guarantee whatsoever there'd be any protection against a similar subtype that emerges as the pandemic strain," Osterholm said.