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Pre-pandemic vaccines are essential to ensuring equitable protection against influenza, says Klaus Stöhr of pharmaceutical company Novartis.

Our current approach of vaccinating after an outbreak leaves 80 per cent of the world's population — mostly in developing countries — unprotected in the face of a new pandemic, claims Stöhr.

In December last year the number of vaccines available against influenza A(H1N1) or 'swine flu' was enough to cover just ten per cent of the global population, despite production operating at maximum capacity for the previous six months.

Stöhr says the 1.3 billion doses estimated to be produced by June this year would have been "far too little too late if the worst forecasts had played out".

Stöhr calls for pre-pandemic immunisation to be adopted as the most effective strategy to combat the shortfall. "Vaccinating 20 per cent of a population before a pandemic would prevent as many cases as vaccinating 60 per cent after the first wave has struck", he says.

According to Stöhr, the strategy would be cost effective because pre-pandemic vaccines can be administered alongside routine seasonal vaccines, or added to existing child-immunisation programmes.

But he warns that since there is no way of predicting which strain of influenza which hit next, pre-pandemic vaccines would need to contain "a cocktail of strains". 

Public health decision-makers are not contemplating pre-pandemic immunisation, partly because it would take years to implement and partly because of the politics associated with spending money on a medical threat that is not yet a reality.

Stöhr calls for serious consideration of the practicalities and cost-effectiveness of this alternative approach because without it, we cannot ensure global equitable access to influenza vaccines. 

Link to full article in Nature