Rethinking Influenza

2 October 2009  Vol 326, Issue 5949, Pages 1-188

Policy Forum
Public Health:
Rethinking Influenza
Rino Rappuoli,1,* Giuseppe Del Giudice,1 Gary J. Nabel,2 Albert D. M. E. Osterhaus,3 Robin Robinson,4 David Salisbury,5 Klaus Stöhr,6 John J. Treanor7

Today, we are better prepared to face the H1N1 influenza A 2009 virus than we were for any other previous pandemic. Although the present manufacturing capacity is unlikely to have all the vaccines needed before the peak of the next wave of cases, the potential output of vaccine manufacturing has increased from 400 to 900 million (1). A vaccine will be produced in Europe with modern cell culture technology instead of eggs. A large facility for cell culture production under construction in the United States is expected to improve the current limited production capacity. Although vaccines against avian H5N1 are not highly immunogenic, this shortcoming can be overcome by using adjuvants or reverting to using whole-virus vaccines (2–5).

1 Novartis Vaccines and Diagnostics Srl, 53100 Siena, Italy.
2 Vaccine Research Center, National Institute of Allergy and infectious Diseases, NIH, Bethesda, MD 20892–3005, USA.
3 Erasmus University, 3015E Rotterdam, Netherlands.
4 U.S. Department of Health and Human Services (HHS), Washington, DC 20201, USA.
5 World Health Organization (WHO), Strategic Advisory Group of Experts (SAGE) on Immunization, 1211 Geneva 27, Switzerland.
6 Novartis Vaccines and Diagnostics, Inc., Cambridge, MA 02139, USA.
7 University of Rochester, Rochester, NY 14642, USA.

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