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Federal health officials announced on Wednesday that the United States is prepared with two vaccines in case the strain of avian flu currently affecting dairy cows begins to spread easily among people. These vaccines could be widely distributed within weeks if necessary.
Currently, there is no evidence of H5N1 spreading from person to person, although a dairy worker in Texas who had close contact with infected cattle developed a mild infection and pinkeye in April. Government health officials are preparing for the potential scenario of H5N1 jumping from animals to humans or spreading among humans. The virus has infected at least 36 herds across nine states, raising concerns about possible mutations that could make it more transmissible to humans.
Demetre Daskalakis, director of the National Center for Immunization and Respiratory Diseases, stated that studies suggest the vaccines will provide good cross-protection against the virus strains in cattle outbreaks.
Both vaccine candidates are already in limited quantities in the nation's stockpile, according to officials. The Centers for Disease Control and Prevention (CDC) is also testing blood samples from people previously vaccinated with influenza vaccines to determine their immune response.
Dawn O’Connell, assistant secretary for preparedness and response at the Department of Health and Human Services, mentioned that there are hundreds of thousands of prefilled syringes and vials ready to ship if necessary. The U.S. has been investing in a library of antigens to quickly respond to highly transmissible flu strains.
H5N1 is not easily transmitted between people, but due to its high mortality rate of around 50%, health officials are concerned. There is no indication that the virus is mutating to become more transmissible.
Vivien Dugan, who heads the CDC's influenza division, stated that the government would consider vaccination if there were genetic alterations in the virus affecting existing countermeasures. Currently, the U.S. has antiviral medications in supply, including Tamiflu.
Health officials are monitoring over 100 people, mostly those working with farm animals, for signs of infection. If needed, the federal government could ship out hundreds of thousands of vaccine doses within a few weeks and over 100 million doses within three to four months. O’Connell noted that people may need two doses of the vaccine, meaning 100 million doses would only be enough for 50 million people.
The U.S. is also pursuing a third vaccine based on mRNA technology, similar to Pfizer's and Moderna's COVID-19 vaccines, which could be quicker to manufacture. All three vaccines would require FDA approval before distribution.
Dr. William Schaffner of Vanderbilt University Medical Center emphasized the importance of having vaccine candidates on hand to reduce the time needed for distribution. Despite having vaccine candidates, there are still questions about their effectiveness against infection and severe illness.
The U.S. has contracts with three manufacturers for pandemic influenza vaccines. One of the vaccine candidates is from CSL Seqirus, which has shown promising immune response in a phase 2 study targeting a virus closely related to H5N1.
The government has potential adjuvants that could boost the immune response if needed. Given the amount of vaccine skepticism and fatigue from the COVID-19 pandemic, a vaccine campaign would likely be necessary to persuade people to get vaccinated.