2009 H1N1 Swine Flu: Is It Really Worth Making A Vaccine?

At least two medical doctors think that it isn't, and have said so publicly. They feel that the "research has shown" that the new flu isn't going to be very virulent, and question the wisdom of spending $1.5 billion developing a vaccine that "may never be used". I suspect that few of you will be surprised to learn that both these doctors are also Republican members of Congress. Representatives Phil Gingrey and Paul Broun (both of Georgia) made their views known during floor speeches in the House yesterday.

I was not aware that any research had been published that demonstrates that we know anything about how this disease will behave when the normal flu season rolls around this fall. I have not been keeping up with the situation to the same extent that Revere(s) have, but I do know that as of May 1st, we didn't know for sure how virulent swine flu is now. This makes me suspect that the two Distinguished Gentlemen from Georgia are either poorly informed or are making things up on the fly.

Nevertheless, it's possible that the stopped clock rule applies in this instance, and the Representatives are correct in arguing that this is a relatively mild flu. Does that necessarily mean that the it's not worth making a vaccine? Given a current US population of about 300 million, that works out to about $5 a person. Speaking for myself, I think that's a small price to pay if there's even a slight chance that the new flu strain could cause a large number of deaths.

Let's put this in perspective two different ways:

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The six aircraft in the picture above are F-18 Hornets assigned to the US Navy's aerobatic team - the Blue Angels. The low-end cost of a Hornet is currently $29 million. The Blue Angels do not fly aircraft that are fresh off the assembly line, but even at $25 million a pop, the 6 airplanes in the picture come in at a cost of about 50 cents per American. That's just for the aircraft, not the pilots time, training, the fuel, the repair costs, the spare airplanes, or anything else involved in the operation of the Blues.

I really enjoy watching the Blue Angels perform, but I don't think they're even 1/10th as important to our country as a vaccine that we might never need, but might wind up needing really badly.

The F-22 Raptor is another US-made fighter jet. This one's been in the news recently because the Defense Secretary decided to halt production of the jet once 187 have been built. The same Representative Phil Gingrey that thinks that $1.5 billion is too much to spend on a flu vaccine disagrees with the Defense Secretary and with the Air Force Secretary and Chief of Staff. He wants at least another 20 to be built - 16 more than the Air Force is asking for.

At well over $125 million a plane, Gingrey is asking for at least $6.67 from every American - that's significantly more than the $5 that the vaccine would cost. The vaccine would potentially benefit every American. Given that the Air Force says that they don't need the extra 16 planes, it's not quite as clear that every American is likely to benefit from the manufacture of those planes.

Since we still don't know a lot about H1N1/2009, it's hard to give a purely financial answer to the question I raised in the title of this post. If this flu ultimately winds up being no worse than the typical seasonal flu, the financial benefits of a vaccine might not equal the $1.5 billion spent. On the other hand, if this comes back in the fall as anything even remotely close to some prior pandemics, the $1.5 billion will seem like a drop in the bucket. If we really don't know which of the two is going to be the case, or even how likely either scenario actually is, spending the money seems like the smart choice to me. But then I'd rather risk a small financial loss than a massive loss of life. (I'm funny that way.)

If we spend the $1.5 billion, there is a real risk that we will not actually need the finished product. In fact, if we're lucky, that will be what happens. Phil Gingrey thinks that $5 per person is too much to spend for something that we might not need - but given that he thinks that $6.67 per person should be spent to buy planes that the Air Force says they definitely don't need, I think I'd be more comfortable trusting the CDC's judgement on this one.

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I agree with your economic point but only on the assumption that production of a swine flu vaccine is compatible with production of the seasonal flu vaccine.

The danger is that an additional cost of producing the swine flu vaccine would be to reduce the amount or effectiveness of the seasonal flu vaccine. If this is the case then there is a delicate balancing act to be performed because the seasonal flu could kill a more people if we don't produce enough vaccine for it.

As I understand it, there are many different flu virus strains in existence. They change all the time. Hence, there is a need for a new set of vaccines each year. There is also a finite world capacity to produce vaccines. Every year, there is a discussion about which strains should be targeted with that yearâs vaccine. Wouldnât the new swine flu just fall into that same bucket, and be evaluated along with the rest? Are we past the typical decision window for deciding on new vaccines? Other than being discovered late in the flu season, is there anything to distinguish this strain from other known strains?

Thanks.

Is there any concern that if the swine flu comes back for a second round in the fall, it could have mutated to the point where any vaccine that goes into development now would become ineffective?

From a very recent story on NPR, there is apparently serious consideration for making both the seasonal vaccine that would have been made this year anyway, AND a separate vaccine for H1N1/2009. There wasn't much discussion of manufacturing capacity, but the implication was that it was do-able in the time available, provided the H1N1/2009 grows well for manufacturing purposes. Even then, they suggested that there might be only limited amounts of H1N1/2009 vaccine available by the time Fall flu season starts.

Supposedly, vaccine development work is ongoing, but there has been no decision yet whether to really try to produce H1N1/2009 vaccine for this year. One factor that may help decide is that they will observe what H1N1/2009 does in the Southern hemisphere, where their flu season is just beginning.

They also discussed that H1N1/2009 might require two shots (prime + boost). Seasonal flu is generally similar (though non-identical) from year to year. Accordingly, seasonal vaccines are usually effective after only one dose. Our exposure to previous seasonal strains generally obviates the need for a booster dose.

The concern is that H1N1/2009 may be different enough that two separate vaccine doses will be needed for most people. Thus, we might be asked to get a total of 3 shots at three different times: one for seasonal and two for H1N1/2009.

Do we really need a vaccine for H1N1/2009, given that it's starting to seem no more virulent than seasonal flu? Well, first keep in mind that seasonal flu kills an average of 36,0000 people in the US each year, so even if H1N1/2009 is no worse, it's still far from trivial. Second, I understand that in most or all previous pandemics, going back to 1918, the pandemic strain first appeared in the Spring, and caused relatively mild disease. When it came back the following Fall, it was apparently more virulent, causing a more severe flu season than normal. Unfortunately, there's no way to predict if this strain will do the same (unless the So. hemisphere data helps?).

Given all that, I agree with Mike Dunford that making H1N1/2009 vaccine is a very good idea. Of course, the swine flu debacle from the 70's may cause many to refuse it this time. But, as someone interviewed on the NPR piece pointed out, if we have it, we can always choose not to use it if it's not needed. That's much better than needing it but not having it!

We need to be cautious but not hysterical. Only three flu strains in the last 100 years have occurred where humans had no resistance. one of them was the 1918 flu that started out as a mild virus. Look what happened. We should develop a vaccine absolutely, just in case the beginning of the next flu season becomes a full blow H1N1 pandemic.

Seen one flu pandemic, you've seen one flu pandemic. The virus people say this often because no one really knows what a flu pandemic will look like until it happens.

It would be prudent to at least make a few million doses of vaccine. In a real pandemic, the at high risk population includes health care workers since they get a lot of cases daily. Do you really want your entire health care system to stop because everyone is out with the flu? There is also the fear factor. When people were dying in hospital in Mexico of an unknown virus, the docs and staff were in a state of panic.

The cost is chicken feed. How much have we spent to bail out Wall Street and the banks. At least a trillion bucks, maybe 2 trillion. The government hasn't exactly been too transparent on this. A billion bucks won't even come close to paying the bonuses for executives who bankrupted their companies.

There is enough capacity to do it. When the avian virus showed up, a lot of money went into increasing the throughput. We now have cell based production systems as well as the egg ones.

Those representatives are just being the new GOP. Which is becoming known as the party of NO. No ideas, No leadership, No brains, No to anything the Dems want to do.

There is an additional argument in favour of developing the vaccine. There is little real experience in how quickly and effectively the vaccine industry can roll out a vaccine in large quantities for what amounts to an additional (and possibly more dangerous) flu season. The effort to make and distribute the vaccine will act as a test of something analogous to the system's 'surge capacity'. There is a need to know what happens when these sorts of additional demands are placed on the system, and it's better to learn that sooner rather than later.

Those representatives are just being the new GOP. Which is becoming known as the party of NO. No ideas, No leadership, No brains, No to anything the Dems want to do.

New since 1994, you mean?

I am not concerned with the cost, as WE, the individual, pay for the shot when we go to the doctor or drugstore or whatever to get the shot during the flu season. If there is more than one flu shot - so what? There are already options when we go for our flu shot, the pneumonia shot is also available. So, if there would have to be 2 flu shots it is our choice on what to get. My issue, is that the seasonal flu shot only lasts a few months - this new H1N1 seems to last longer into the year - it is already the middle of June out here in Arizona - our flu season should be over, yet we are still loaded with the flu. The seasonal flu shot that would possibly be given for this flu would already be becoming less and less effective if it had been given in October. This flu seems to act differently and stays active in hotter weather - so we will need a longer acting shot, or a booster shot .

1.5 Billion feeds 1.5 Million starving people, who could die over the coming year. Swine flu has killed maybe 150-300 people tops. Get some perspective people...you're all paranoid...

BTW ~ what they are worried about is if it mutates. If it mutates the vaccine is no good...& by the time you get a vaccine developed for the mutated one, it's all over (if it was something that humans have no resistance to).

I've posted more articles on disease causes than enough in the last while. Just check yesterday's posts if you doubt it. That said, monitoring news incoming on various media tells me that the Indians are on the right track : there is no way they have the resources to expend chasing a chimera rather than using preventative measures to maintain optimum health.
I even run into posts referencing back to a previous episode of mass inoculation which turned out to be more beneficial to suppliers than citizens : a scam where the 'cure' was verifiably worse than the disease. There are even references to Baxter violating developmental safety protocols so badly that the 'vaccine' became an agent of transmission.

'The cost of the vaccine is chicken feed.'
Oh my. I should laugh because that is so apt. Check out my links on chicken feces fed to cattle, arsenic in chicken feed and more.Corporate farming is only one component of this mess - but it's a hummer. Bluebloggin started me down this road, I believe...but there's no end in sight.