Flu vaccine: This is CDC Clinic Chief Nurse Lee Ann Jean-Louis extracting Influenza Virus Vaccine, Fluzone® from a 5 ml. vial.
Courtesy CDC/Jim Gathany
Did you know back in February scientist and medical professionals selected the influenza virus strains for the upcoming flu season? Now that it is July the pharmaceutical companies are well into manufacturing, purification and testing the vaccine. Meanwhile, it is winter and flu season in the southern hemisphere and the virus is busy mutating. The big question on everyone’s mind is will it mutate so much that the northern hemisphere vaccine will be ineffective?
I agree with Dr. Steven Salzberg remarks in his recent Nature commentary…

"The current system, in which most of the world’s vaccine supply is grown in chicken eggs, is an antiquated, inefficient method requiring six months or more to ramp up production, which in turn means that the vaccine strains must be chosen far in advance of each flu season. More crucially it sometimes prevents the use of the optimal strain, as it did in 2007."

Influenza (the flu) is a serious disease
Each year in the United States, on average:

• 5% to 20% of the population gets the flu;
• More than 200,000 people are hospitalized from flu complications, and;
• About 36,000 people die from flu.

Some vaccine problems in the past
In recent years the match between the vaccine viruses and those identified during the flu season has usually been good. In 16 of the last 20 U.S. influenza seasons, including the 2007-08 season, the viruses in the influenza vaccine have been well matched to the predominant circulating viruses. Since 1988, there has only been one season (1997-98) when there was very low cross-reaction between the viruses in the vaccine and the predominate circulating virus and three seasons (1992-93, 2003-04, and 2007-08) when there was low cross-reaction (CDC). So after last year’s miscalculation the committee picked three new strains for the vaccine this year. One is a current southern hemisphere vaccine virus which they expect will still be present next year. In addition, they predict a second new Type A strain, known as H1N1/Brisbane/59, to also hit, along with a newer Type B/Florida strain.

Dr. Salzberg feels last year’s miscalculation was a failure…

"The harm was thus twofold; people fell ill and their trust in the vaccine system was undermined. This failure could have been predicted, if not prevented, through a more open system of vaccine design, a stronger culture of sharing in the influenza research community and a serious commitment to new technologies for production. The habits of the vaccine community must change for the sake of public health."

He goes on to suggest…

"The process of choosing flu-vaccine strains needs to be much more open. Other scientists, such as those in evolutionary biology with expertise in sequence analysis, could meaningfully contribute to the selection. At present, external scientists cannot review the data that went into the decision, nor can they suggest other types of data that might improve it."

Even with all of these miscalculations, I still feel getting the vaccine is worth the risk. But that doesn’t mean the process shouldn’t be improved. So once again I will be vaccinated and I will make sure my family is too—but what can we do as citizens to improve this process? What will you do?

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