The United States vaccine supply: challenges in preparing for an avian influenza pandemic.

Since influenza may be prevented by vaccine, development and successful implementation of public health programs to prevent spread of a potential avian influenza strain relies upon vaccination as a strategic cornerstone. Although both the Department of Health and Human Services (HHS)† and the World Health Organization (WHO) highlight the role of influenza vaccination as the core of an effective prevention and control strategy, should there be an avian influenza pandemic there is (at the time of this symposium) currently no available vaccine with demonstrated efficacy against the H5N1 strain. Indeed, the recent focus upon preparation for an avian influenza pandemic highlights many of the weaknesses that are generalizable to the entire vaccine development and supply system. This paper will provide general background on the fragility of the current vaccine development and production infrastructure in the United States and identify specific challenges for vaccine suppliers in preparing for a potential influenza pandemic. VACCINE DEVELOPMENT AND PRODUCTION CONSIDERATIONS