Fears of ‘colliding epidemics’ fuel campaign to increase flu vaccines

Efforts to increase flu vaccination rates to prevent “collision epidemics” are hampered by limited supply as manufacturers struggle to meet demand.

Germany ordered 26 million flu shots before the European winter, and Health Minister Jens Spahn said the country “had never had so many.” The UK government said it was aiming to vaccinate 30 million people this year, more than double the 2019 figure.

However, manufacturers say they have not been able to meet increased demand in such a short time. Seqirus, one of the top three flu jab producers globally, along with Sanofi and GlaxoSmithKline, estimated that world production had only increased by 1-2 percent.

“If we get an overlay of Sars-Cov-2 [the virus responsible for Covid-19] and influenza, that could be a disaster, ”said Rebecca Jane Cox, professor of medical virology at the University of Bergen. “The question will be how hard the Northern Hemisphere will be affected by the flu now.”

Cheryl Cohen, associate professor of epidemiology at the University of the Witwatersrand in South Africa, said: “The spectrum of colliding epidemics is a concern. If the two epidemics overlapped, it would obviously be really worrying. ”

The World Health Organization has warned of difficulties some countries face in obtaining flu vaccines as supplies run out. “Whoever has an additional flu vaccine, please let us know,” Ann Moen, the group’s head of flu preparedness and response, said at a conference last month.

The 1.5 million doses that Turkey expects to receive this year will be insufficient, according to the country’s pharmacists association. “With Covid-19 we believe it takes three to four times more,” said Erdogan Colak, president of the group. This claim is refuted by the government of Turkey.

Concerns about the two respiratory illnesses compounding each other, and the impact on health systems, have prompted governments to move quickly to begin stringent influenza vaccination programs in place of what were previously voluntary campaigns and not imposed.

John McCauley, director of the global flu center at the Crick Institute in London, said he “would be remiss” if governments did not increase flu vaccines this year. The flu vaccine had prevented 15 to 52 per cent of cases in the UK over the past five years, according to research from the University of Oxford. The wide range is due to the fact that, in some years, the vaccine is less adapted to circulating strains, which are constantly mutating.

Up to 650,000 people die from influenza each year worldwide, according to the WHO, compared with more than 1 million from Covid-19 so far this year.

Last year, before the coronavirus increased demand for flu vaccines, Seqirus estimated that governments and health agencies would buy 650 million doses of vaccines in 2020, at a cost of $ 5 billion.

After the Australian government asked more of its population to get the flu vaccine, vaccine imports rose to a record 18 million doses, up from an average of 8 million doses in 2012-2017.

But as demand increases, supply has only increased marginally. “Manufacturers can extend their campaign to a certain extent, but with such a short notice there is a limit to what we can do,” said Beverly Taylor, director of influenza science affairs at Seqirus. Companies would typically need a 12-18 month notice for any large-scale manufacturing expansion.

“Some governments have offered things before there was enough supply. They should have checked it first, ”he added.

GSK said it was “looking for every opportunity to produce and distribute more flu vaccine doses for 2020 and the next few years, but expects that demand will continue to exceed manufacturing capacity.” He said it was “very difficult to quickly adjust manufacturing capacity to accommodate changes in demand.”

Experts also noted that influenza levels have been exceptionally low so far this year in the southern hemisphere, which typically peaks from June to August. The same trend had been observed in other serious respiratory diseases, such as pneumococcus, rotavirus, and respiratory syncytial virus.

Professor Cohen attributed this “unprecedented reduction” in flu cases to measures taken to contain the coronavirus, including the use of masks, hand washing and limits on mass gatherings. And in the case of illnesses like influenza and RSV, of which children are responsible for most of the spread, school closings are believed to have played a role.

“It makes you wonder if masks and social distancing might help in the future,” McCauley said.

However, the relative absence of influenza has posed some challenges. For one thing, scientists like McCauley spend months each year testing new strains of influenza to tailor vaccine production for the following year. Without a lot of influenza in circulation, it is difficult to know if new mutations will be detected, which means that the 2021 vaccines could be less effective.

And some see the lack of flu so far this year as an ominous sign of what could happen. “Could the lack of immunity this year increase the scale of the epidemic next?” Professor Cohen asked.

Flu experts agreed that the priority was to increase production and ensure that the public actually takes the vaccines already purchased. In Germany, for example, up to 8 million unused doses of flu vaccine are destroyed each year.

Additional reporting by Guy Chazan in Berlin and Laura Pitel in Ankara