Biden administration officials said Wednesday there are currently no plans to authorize a stockpiled avian influenza vaccine, despite a growing outbreak among livestock in the United States that has infected at least 58 people in seven states. said.
The move means any decisions regarding the bird flu vaccine will likely fall to health officials in the incoming Trump administration, including anti-vaccine activist Robert F., whom Trump has nominated to lead the Department of Health.・There is also a possibility that Kennedy Jr. will lead the party. human services.
The virus has been spreading among dairy cows since the spring, infecting at least 774 herds in 16 states as of Wednesday, according to the Centers for Disease Control and Prevention. Last Friday, the Department of Agriculture stepped up its response to the outbreak and issued a federal order requiring testing of the nation’s milk supply.
The USDA says the testing, scheduled to begin next week in six states, will give farmworkers more confidence in the safety of their livestock and their ability to protect themselves from infection, and help officials determine where herds are infected. He said that this would allow for a more accurate understanding of the situation.
The spread of the virus in mammals in close contact with humans is of concern to public health experts. This is because it gives bird flu more opportunities to jump to humans, allowing it to mutate and spread effectively from person to person.
Most of the bird flu cases in the United States, with the exception of the patient in Missouri and the child in California, have been farm workers who came into contact with infected animals (dairy cows or poultry). A Canadian teenager also suffered severe symptoms and was hospitalized, but had no apparent contact with infected animals.
The federal government has two avian influenza vaccine candidates available in limited quantities in the nation’s Strategic National Stockpile, but they must be approved by the Food and Drug Administration before they can be used.
Health officials said in May that if the virus mutates and makes existing antiviral drugs, such as Tamiflu, less effective, or if the virus appears to be causing severe illness in people, the government will limit vaccinations. He said he would start considering it.
CDC Principal Deputy Director Dr. Nirav Shah said Wednesday that the criteria for vaccine deployment remain the same.
“When you think about respiratory vaccines, the sweet spot is to prevent severe disease and death,” Shah said. “If you look at what’s going on with H5 right now, even in humans, thankfully it’s been mild so far,” he said, using the abbreviation for the influenza virus strain that caused the bird flu outbreak. .
“It’s not a guarantee and it’s subject to change, but the vaccine is going to be as effective as possible in reducing the severity of the disease, so that’s one of the things we’re looking at,” Shah said. he said. He said the administration is not considering developing a vaccine at this time, but that could change if the infection situation changes.
Still, some public health experts believe now is the time to get vaccinated, especially for farmworkers.
Jennifer Nuzzo, director of the Pandemic Center at Brown University School of Public Health, said, “We should wait until farmworkers are hospitalized or die before using the tools we have to protect farmworkers.” I don’t think we should risk our lives.”
balancing act
Shah noted that getting a vaccine approved or deployed is always a critical balancing act for public health agencies, and that even the safest vaccines can have side effects.
When the first signs of the H1N1 swine flu outbreak appeared in the United States in 1976, public health officials quickly launched a nationwide vaccination campaign. However, the shot slightly increased the risk of Guillain-Barre syndrome, a rare condition in which the immune system attacks healthy nerve cells.
Although the epidemic never became widespread, public confidence in influenza vaccinations went back decades.
“It led to analysis and introspection about whether the response to these 13 cases of swine flu was an overreaction,” Shah said. “And indeed, quite a bit of skepticism about the vaccine has emerged.”
Still, Shah said public health agencies are ready to authorize an avian influenza vaccine if necessary, adding that authorities are continuing to test vaccine candidates for the strain.
A spokesperson for the Office of Strategic Preparedness and Response, the agency within the Department of Health that manages the Strategic National Stockpile, said the agency is “filling and finishing” vaccine doses for vaccine candidates that are well-matched to viruses circulating in dairy cows. He said that he is working on this. .
A spokesperson said up to 10 million doses of the vaccine will be ready by the end of the first quarter of next year, enough to vaccinate 5 million people.
An FDA spokesperson said the FDA is “actively working with industry as well as our U.S. federal partners to evaluate potential vaccine candidates, should the need arise for use in people.” ” he said.
When is the right time?
Dr. William Schaffner, an infectious disease expert at Vanderbilt University Medical Center, said there is no need to authorize a vaccine at this time, given there is no evidence of human-to-human transmission or signs that the virus causes severe symptoms. said. people’s illnesses. He said existing tools such as antiviral drugs and personal protective equipment are sufficient for now.
The number of cases is even higher, but Schaffner blames public health officials’ increased efforts to search for the virus through testing and surveillance.
Schaffner said the incoming Trump administration’s anti-vaccine rhetoric will not change his position.
“I think we should be very careful about predicting what the new administration will do,” he said. “The administration will have a lot of good, solid scientific evidence, not just from officials at the CDC and the Food and Drug Administration, but from industry and many public health officials and experts across the country.”
Trump’s transition team did not respond to requests for comment.
Dr. Keith Paulsen, director of the Wisconsin Veterinary Diagnostic Laboratory, also said there is no need to approve the vaccine at this time.
“We need to continue to advocate based on science and data and make informed decisions or do what’s best at the intersection of science, economics and political science,” Paulsen said.
Nuzzo, of Brown University’s School of Public Health, said antiviral drugs are important for people who have been exposed to or infected with the virus, but their effectiveness is limited by the very short time frame in which they must be administered. said. He also said the country’s testing strategy is not timely enough to adequately protect farmers.
He said vaccines can protect farmworkers from potentially serious illness.
But Paulsen said one problem officials may face is finding farmworkers willing to get vaccinated, noting that some may be distrustful of vaccinations. .
“I’m going to start with seasonal influenza and only move on to H5N1 influenza if we find that people are transmitting the virus or have severe symptoms,” Paulsen said. “That’s not happening.”
