The viruses that cause the flu are numberless, they shift shape quickly and they surge and ebb every year, making influenza a top public health concern in the United States.
Health officials can usually identify the candidates most likely to infect the public, allowing researchers to create vaccines that target the worst potential offenders. Studies have shown that these yearly flu vaccinations are effective 67 percent of the time. But it’s an inexact science, and there are many battles won and lost. The 2017-2018 flu season was the worst in a decade, and the Center for Disease Control says there have already been more than 1,300 flu-related deaths this season in the United States.
Although far from perfect, the process of choosing a flu vaccine is epic.
There are about 100 influenza centers in 100 countries that test thousands upon thousands of flu viruses from patients across the world. Twice a year, the World Health Organization (WHO) hosts a meeting of center directors along with researchers and experts to determine which strains are most worrying.
What viruses worry WHO? It’s the ones that are most lethal and are easily transmitted. But, health officials also must choose viruses that are most likely to respond to a vaccine.
It’s a high stakes and inexact science, yet even a 67 percent success rate saves hundreds of thousands of lives across the world.
The meeting for the Western Hemisphere takes place in February. Then, the race is on for manufacturers to take the viral samples and create safe and effective vaccines for delivery in the fall. It takes at least six months for a large batch of vaccine to be created, tested, manufactured, packaged and delivered. It’s such a tight turnaround that some manufacturers second-guess the WHO and start working with viruses their own private researchers believe will be at the top of the February WHO list.
Scientists have tried for years to create a universal vaccine that could solve the problem once and for all by eradicating all of the viruses that cause the flu. That holy grail has been elusive so far but we may be getting close. The National Institutes of Health have created Collaborative Influenza Vaccine Innovation Centers (CIVICs) to coordinate a nation-wide effort for a universal vaccine, providing millions of dollars in funding and support.
Advances in technology are allowing researchers to get a more intimate look at the complexities of the virus and refine their targets. Government labs, pharmaceutical companies and universities are all vying for the prestige — and potential payout — of being the first to find a vaccine that is effective for all types of flu viruses.
One effort is based in the Icahn School of Medicine at Mount Sinai in New York, where researchers have been able to identify the stalk of a protein that is present on the surface of almost every known flu virus. Called hemagglutinin, it shepherds the virus into host cells.
It also has a unique feature — a ‘stalk,’ which doesn’t vary much at all from virus to virus. With help from the Bill & Melinda Gates Foundation and GlaxoSmithKline, researchers there have created a potential vaccine that is undergoing tests now. If it proves capable of building resistance to all strains of the flu, it could be a major shot in the arm in the battle against what is still often a deadly disease.
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