Pandemic What-if's - Speed of Appearance Versus Vaccine Availability

Scientific American article cautions against wishful hoping that a slowly adapting virus will be met immediately with adequate volumes of efficacious vaccines

Scientific Amercian today released an article by Maggie Fox covering the current status of H5N1 infections in mammals and people in the U.S., as well as the current status of vaccine developments and stockpiling:

A Bird Flu Vaccine Might Come Too Late to Save Us from H5N1

…the U.S. government is stockpiling H5N1 vaccines. But don’t count on those vaccines saving us if this virus does what flu viruses sometimes do and turns into a pandemic form. It won’t oblige humanity by slowly mutating, giving people a chance to ramp up vaccines quickly.

“It is going to happen fast,” says Ali Khan, dean of the University of Nebraska Medical Center College of Public Health and a veteran of numerous disease outbreaks, from influenza to Ebola.

The world just saw this happen. COVID appeared suddenly and spread globally before alarm bells rang. Even with the new, quick-turn technology of mRNA vaccines, it took just about a year after SARS-CoV-2 started its global spread to get the first doses into arms. By that point, 300,000 people had died in the U.S. and hundreds of thousands more—possibly millions—died around the world before vaccines were fully deployed.

It’s still an open question regarding if, or when H5N1 gains its “pandemic legs” by achieving onward transmission in humans with Ro >1 accompanied by significant morbidity/mortality. However, we cannot count on it being a slow process!

The article goes on to describe many of the practical, scientific, economic, and political limitations we face in building large vaccine stockpiles right now against current H5 strains. However, my biggest concern relates to what appears to be a lack of leadership appetite for even addressing H5 pandemic preparedness at this juncture.

I can only hope that the election a week from now will awaken some clarity. The winning party may face an H5 pandemic (or another agent for that matter) on their watch. Slience is understandable in the heat of a dead-even election campaign. Remaining silent and inactive after the election constitutes public health malpractice. We’ll need a much more robust surveillance and vaccine development planning process for H1N1 ASAP.

John