Panel, Conference Presentation
Making Influenza History: The Quest for a Universal Vaccine
Milken InstituteMichael Specter, Rick Bright, Anthony Fauci, Bruce Gellin, Margaret Hamburg, Casey Wright
- Experts predict a universal flu vaccine will be more durable and protective than current options, though its development is an iterative, stepwise process unlikely to yield results in the near term, with clinical trials potentially requiring a decade if execution is perfect.
- Scientific progress relies on stabilizing the hemagglutinin stem using cryo-EM technology and presenting it on self-assembling nanoparticles, while future delivery may shift from egg-based systems to synthetic mRNA platforms capable of local printing and self-administration via patches.
- The timeline for a universal vaccine involves specific steps: first covering all H1 group one iterations, then all group one iterations, and finally all H3 group two iterations, potentially reducing vaccination frequency to once every five to ten years compared to the current annual requirement.
- Current pandemic risks are severe, with estimates suggesting a 1918-style outbreak could cause 33 million deaths within six months, undermine civic life, and incur trillions in economic costs, while seasonal influenza already costs $361 billion annually.
- Significant barriers exist including fragmented industry efforts among 40 companies, regulatory and manufacturing uncertainties, a lack of funding for necessary research, and a market disincentive where companies avoid high-risk products with low sales volume despite potential $400 million R&D costs.
- To overcome complacency and "Original Antigenic Sin" (imprinting), strategies include vaccinating infants at six months, combining vaccines with mRNA-encoded monoclonal antibodies for immediate passive immunity, and establishing new incentives for publishing null or negative data to accelerate breakthroughs.
- A new coordinated entity is deemed necessary to unify disparate funding streams from philanthropy and the US Congress, with specific proposals like the Ed Markey bill seeking $1 billion over five years ($200 million annually) to attract cross-disciplinary talent and de-risk development.
- Future success depends on shifting from a "U-shaped curve" of crisis-driven attention to sustained accountability, utilizing financial mechanisms like guaranteed purchases to align industry goals with public health needs, and leveraging global collaboration to share nucleic acid sequences and research findings rapidly.