A viewpoint on H7N9 vaccination

Michael Osterholm is the director of the Center for Infectious Disease Research and Policy (CIDRAP) at the University of Minnesota, a professor in the School of Public Health, and an adjunct professor in the University of Minnesota Medical School. He is a recognized authority in the field of epidemiology and, in the past, he had criticized the lack of international preparedness for an influenza pandemic. In an article published on the Journal of the American Medical Association, he and his colleagues examine several issues regarding the development of vaccines against the potential threat represented by the emergence of the avian influenza A(H7N9) virus.
One of these issues is the estimated effectiveness of a vaccine, which Osterholm and colleagues think will likely be moderate against this novel strain, if the current epidemiologic pattern persists. Also, in order to provide protection, an H7N9 vaccine will probably require a higher concentration of antigen than seasonal vaccines, or an adjuvant. Or maybe both. Another issue is the global capacity for manufacturing a proper influenza vaccine, which is estimated to be less than 15% of the global need and mainly unavailable until six or more months after production begins. Osterholm and colleagues also think that an eventual H7N9 vaccine should require a different regulatory process compared with the 2009 pandemic vaccine.
In conclusion, the authors believe that the global public health community is still unprepared to properly face the challenge of a pandemic influenza and much more efforts should be made to develop new vaccines that protect most individuals from multiple strains of influenza.