Efforts to extend influenza vaccination charges to forestall “colliding epidemics” are being hampered by a restricted provide, as producers wrestle to fulfill demand.

Germany has ordered 26m flu vaccines forward of the European winter, with well being minister Jens Spahn saying the nation had “by no means had so many”. The UK authorities stated it aimed to vaccinate 30m individuals this 12 months, greater than double the 2019 determine.

Nonetheless, producers say they’ve been unable to fulfill the elevated demand at such quick discover. Seqirus, one of many prime three flu jab producers globally, together with Sanofi and GlaxoSmithKline, estimated that world manufacturing had solely elevated by 1-2 per cent.

“If we get an overlap of Sars-Cov-2 [the virus responsible for Covid-19] and influenza, that may very well be a catastrophe,” stated Rebecca Jane Cox, professor of medical virology at College of Bergen. “The query will likely be how arduous the northern hemisphere goes to be hit by the flu now.”

Cheryl Cohen, affiliate professor in epidemiology at Witwatersrand College in South Africa, stated: “The spectre of colliding epidemics is a priority. Ought to the 2 epidemics be overlaid, that might clearly be actually worrying.”

The World Well being Group has warned of the difficulties confronted by some international locations in acquiring flu vaccines as provides are snapped up. “Whoever has further flu vaccine tell us,” Ann Moen, the group’s head of influenza preparedness and response, stated at a convention final month.

The 1.5m doses that Turkey expects to obtain this 12 months will likely be inadequate, in keeping with the nation’s pharmacists affiliation. “With Covid-19 we predict there’s a necessity for 3 to 4 occasions that,” stated Erdogan Colak, the group’s president. This declare is refuted by Turkey’s authorities.

Individuals wait in line to obtain a flu vaccine at a free cellular clinic in Lakewood, California © Etienne Laurent/EPA-EFE/Shutterstock

Considerations in regards to the two respiratory sicknesses compounding each other — and the impression on well being techniques — has led governments to behave quick to start strict flu inoculation programmes rather than what had been beforehand voluntary and unenforced campaigns.

John McCauley, director of the worldwide influenza centre on the Crick Institute in London, stated it “could be remiss” if governments didn’t improve flu vaccinations this 12 months. Flu vaccine had prevented 15-52 per cent of UK instances over the previous 5 years, in keeping with Oxford college analysis. The big selection is as a result of in some years the vaccine is much less properly matched to the circulating strains, which consistently mutate.

As much as 650,000 individuals die from influenza every year globally, in keeping with the WHO, in contrast with greater than 1m from Covid-19 up to now this 12 months.

A well being employee administers a flu vaccine at a brief vaccination centre in Las Rozas close to Madrid through the second wave of Covid-19 © Pablo Blazquez Dominguez/Getty

Final 12 months, earlier than coronavirus boosted demand for flu vaccines, Seqirus estimated that 650m vaccine doses could be purchased by governments and well being our bodies in 2020, costing $5bn.

After the Australian authorities referred to as on extra of its inhabitants to get the flu jab, imports of vaccinations jumped to a document excessive of 18m doses, up from a median of 8m doses from 2012-2017.

However as demand surges, provide has solely elevated marginally. “Producers can lengthen their marketing campaign up to some extent, however at that quick discover there’s a restrict to what we will do,” stated Beverly Taylor, head of influenza scientific affairs at Seqirus. Firms would usually want 12-18 months’ discover for any large-scale manufacturing scale-up.

“Some governments have provided issues earlier than there was adequate provide. They need to have checked first,” she added.

GSK stated it was “ all alternatives to supply and distribute extra flu vaccine doses for 2020 and the approaching years, however expects demand to proceed to outpace manufacturing capability”. It stated it was “very troublesome to rapidly modify manufacturing capability to match modifications in demand”.

Weekly influenza cases per million people emphasizing 202 relative to the previous five years

Consultants additionally famous that ranges of influenza have been exceptionally low up to now this 12 months within the southern hemisphere — which usually experiences a peak from June to August. The identical pattern had been noticed in different critical respiratory ailments, resembling pneumococcal, rotavirus and respiratory syncytial virus. 

Prof Cohen attributed this “unprecedented discount” in flu instances to measures adopted to include coronavirus, together with the usage of masks, handwashing and limits on mass gatherings. And for sicknesses resembling flu and RSV, for which kids are answerable for a lot of the spreading, college closures are thought to have performed a major position.

“It does make you ponder whether masks and social distancing might assist sooner or later,” famous Mr McCauley.

The relative absence of flu has thrown up just a few challenges, nevertheless. For one, scientists resembling Mr McCauley spend months every year analysing new influenza strains to tailor vaccine manufacturing for the next 12 months. With out a lot influenza in circulation, it’s troublesome to know if new mutations will likely be picked up, which means vaccines from 2021 may very well be much less efficient.

And a few see the dearth of flu up to now this 12 months as an ominous signal of what may be to come back. “Might an absence of immunity this 12 months improve the size of the epidemic subsequent?” Prof Cohen requested.

Flu specialists agreed that the precedence was to extend manufacturing and be certain that the general public truly takes the vaccines already procured. In Germany for instance, as much as 8m unused flu vaccine doses are destroyed every year. 

Further reporting by Man Chazan in Berlin and Laura Pitel in Ankara


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