NIH/CDC working on 2nd avian flu vaccine

At the National Immunization Conference in Atlanta, HHS secretary Michael Leavitt announced today that the development of a second avian flu vaccine has begun, this one on a more recent isolate of the virus. CBSNews.com has the story.

The 'original' vaccine is based on a 2004 sample of avian flu from Vietnam. The U.S. government has already spent $250 million for 8 million doses through contracts with Sanofi Pasteur and Chiron, the story notes. The cycle of vaccine development announced today involves a 2005 isolate from Indonesia. As we've written previously, the question no one can answer is how effective (if at all) earlier vaccines will be against the eventual 'pandemic' strain of avian flu, whenever (or if ever) it arrives.

Ultimately, there's agreement in the scientific community that the only vaccine sure to be effective against a pandemic strain is one developed only after it arrives, requiring a minimum 6-month wait for any vaccine and all but certain supply shortages. At this point, the hope is that these vaccines currently in production will provide some measure of protection in the meantime, if necessary.

The question for public health experts and health economists is whether a semi-annual, $250 million payout for vaccines that may or may not be effective is a sound use of resources as part of preparations for a pandemic. For bioethicists, in addition to the host of issues relating to the allocation of scarce resources, etc., this announcement adds a new wrinkle to consider: If/when a pandemic arrives, it's now possible that several 'generations' of vaccine will be available, with newer generations progressively more effective against the virus than earlier ones. How should this be handled? A national triage system? A roll of the dice based on which manufacturer your physician/hospital/state purchases vaccine from?