According to a new draft
influenza plan issued by the U.S. Department of Health and Human Services, the
following actions must be taken now, before a pandemic strain emerges:
Expand manufacturing capacity for influenza vaccine, develop surge capacity
for pandemic vaccine production, and assess potential approaches to optimize
vaccine dose and diversify manufacturing.
Strengthen global surveillance — human and veterinary — leading to earlier
detection of novel influenza strains that infect humans, cause severe disease,
and are capable of person-to-person transmission such that they have a high
probability of international spread and assess the susceptibility of the pandemic
virus to antiviral drugs.
Strengthen U.S. surveillance by expanding to year-round surveillance for influenza
disease and the viral strains that cause it. Develop hospital-based surveillance
for severe respiratory illness (e.g., influenza and other infectious agents)
and identify methods to rapidly expand the current sentinel physician surveillance
system during an influenza pandemic or other health emergency.
Conduct research to better understand the pathogenic and transmission potential
of novel influenza viruses to improve predictions about the strains that could
trigger an outbreak that could lead to a pandemic.
To shorten the timeline to vaccine availability in a pandemic, develop collections
(libraries) of novel influenza strains that may cause a pandemic; prepare
reagents to diagnose infection and evaluate candidate vaccines; and develop
high-growth reference strains that can be used for vaccine production.
For selected novel influenza strains, develop investigational vaccine lots
and perform clinical studies to evaluate immunogenicity, safety, and whether
one or two doses are needed for protection. In the determination of the optimal
vaccine dose, studies also should be performed to assess whether adding an
adjuvant, a substance to enhance the immune response to vaccination, or alternative
vaccine administration approaches will lead to improved protection and/or
the ability to protect more people with the available amount of vaccine virus
and effectively expand the vaccine supply.
Conduct research to develop new influenza vaccines that are highly efficacious,
easier to administer, or directed against a constant portion of the influenza
virus and thus potentially sidestep the need to develop a new vaccine every
year to match the predominant viral strains that are most likely to cause
disease. With this approach, it may be possible to create an influenza vaccine
stockpile in the future.
Continue efforts to expand annual influenza vaccine use and provide appropriate
incentives to strengthen the vaccine delivery system. Increase vaccine use
and encourage manufacturers to increase overall capacity.
Improve capacity to monitor influenza vaccine effectiveness and track vaccine
distribution and coverage.
Periodically assess the appropriateness of the types and quantities of antiviral
drugs included in the Strategic National Stockpile.
Promote planning and provide guidance to groups that will have the lead role
in a pandemic response such as state and local health departments, the public
and private health care organizations, and emergency response groups; and
review, test, and revise the plans, as needed.
Evaluate the potential impacts of interventions to decrease transmission of
infection such as travel advisories, school closings, limiting public gatherings,
and quarantine and isolation.
Develop materials for various audiences that will inform and educate them
about influenza and pandemic influenza.1
