H1N1 vaccine: Make now or later?


People worldwide are still getting sick with the new H1N1 flu virus, but health officials are now looking ahead to the next big question: whether to start producing a vaccine against the new strain for this fall's flu season.

The great unknown is whether the virus, also known as swine flu, will evolve into a more virulent form as it moves to the Southern Hemisphere and its winter flu seasons during our summer.

But producers can't wait until July or August, when that will become clear. They must make decisions on what to produce now. Already, companies are working on a seasonal flu vaccine for the fall that does not include the H1N1 strain. Which strains are to be included in those vaccines, or whether a new vaccine is needed, is decided by manufacturers with guidance mainly from the Centers for Disease Control and Prevention and the World Health Organization.

The CDC has made no decision on asking manufacturers to produce a swine flu vaccine, says Richard Besser, acting director of the CDC.

WHO, which is a major purchaser of flu vaccine for developing nations through UNICEF and other agencies, is pondering whether to push for production of next year's already-chosen seasonal flu strains or the newly evolved H1N1 strain, though there isn't yet enough evidence to make the decision, says Marie-Paule Kieny, WHO's director of the Initiative for Vaccine Research.

To help it decide, WHO has scheduled a teleconference May 14 with the International Federation of Pharmaceutical Manufacturers & Associations and all other manufacturers that make influenza vaccine to discuss production.

For now, WHO recommends that "all manufacturers put everything in place to be able to start manufacturing vaccine" for this new strain, Kieny says.

CDC also is "taking those initial steps that are very important and necessary should a vaccine need to be made," Besser says.

U.S. vaccine production capability got a boost Wednesday with an announcement that the Food and Drug Administration had approved a new vaccine factory in Swiftwater, Pa., owned by Sanofi Pasteur.

As of Wednesday, WHO had confirmed 1,658 cases of H1N1 flu in 23 countries, including 30 deaths. In the USA, the CDC has confirmed 642 cases in 41 states, with two deaths.

Schools across the USA began reopening Wednesday after the CDC announced that those with infected students didn't need to close. As of Wednesday, 143 schools had reopened, but 589 schools, representing 369,237 students, remained closed, according to the U.S. Department of Education.

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