Abstract

A new influenza pandemic is expected and if caused by the H5N1 virus it could be severe. Antiviral agents will be unavailable to most people and vaccines are regarded as the mainstay of protection. Development of inactivated H5N1 vaccines has been slow because of reluctance by US regulatory authorities to consider adjuvanted formulations and the unwillingness of Western European governments to fund vaccine trials. With effective political leadership, large amounts of live-attenuated and recombinant hemagglutinin pandemic vaccines could be produced quickly in existing facilities using egg-based technologies. New types of influenza vaccines, new technologies for their production and new adjuvants to make them more immunogenic are receiving the attention of scientists and vaccine developers. These technologies could help meet the global demand for pandemic vaccines, but only if they are coupled with improvements in the human infrastructure necessary for pandemic vaccination.

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