Vaccination strategy for H5N1.

[The Duchess of Zeon]

This is a question for Valdemar and the other knowledgeable people:

1. As I understand it, we currently are producing (albeit in very limited quantities) a vaccine for H5N1 in its current form as an avian virus which can infect humans but not spread from human-to-human contact.

This may not, however, be fully effective against any mutation of H5N1 which allows for human-to-human contact.

2. The Spanish Influenza is genetically very, very similiar to H5N1, and of course was capable of being spread from human-to-human contact (obviously).


This leads to a thought I had--I know that vaccines for some variants of the flu can provide limited protection for other variants of the flu. Now, it seems to me that the protection factor could be potentially gotten fairly high if we vaccinated people against both H5N1 in its current form and the Spanish Influenza (which because of the recreation of that virus it should be possible to produce a vaccine against it).

Is this a correct assumption, or am I off-base there? Also, would the number of side-effects from a double-vaccination against H5N1/Spanish Influenza outweight the potential number of lives that could save should H5N1 transition to a human-to-human virus?

[Darth Servo]

The only way to truly know is to try it. Anyone care to volunteer?

Vaccination is a matter of degrees, not a black and white situation. Thats why back in the days of Jenner when vaccination was invented, cow pox provided protection against small pox.

A lot depends on the mutation itself, where its located in the various genes, how MANY mutations occur. Basically, the more similar to the original, the more effective the vaccine will be.

[Admiral Valdemar]

This is a question for Valdemar and the other knowledgeable people:

1. As I understand it, we currently are producing (albeit in very limited quantities) a vaccine for H5N1 in its current form as an avian virus which can infect humans but not spread from human-to-human contact.

This may not, however, be fully effective against any mutation of H5N1 which allows for human-to-human contact.

It would be totally useless, that's why the vaccine is not being issued and is really only experimental.

2. The Spanish Influenza is genetically very, very similiar to H5N1, and of course was capable of being spread from human-to-human contact (obviously).

Yes and no. While humanity has dealt with the H1 and H3 subtypes in the past (the 1918 pandemic was H1N1 and the subsequent outbreaks in the following decades from the "Asian Flu" to "Swine Flu" were all either H2 or H3), we have never had anything to do with H5 before. It is entirely new to us, and that means no real inherent immunity.

This leads to a thought I had--I know that vaccines for some variants of the flu can provide limited protection for other variants of the flu. Now, it seems to me that the protection factor could be potentially gotten fairly high if we vaccinated people against both H5N1 in its current form and the Spanish Influenza (which because of the recreation of that virus it should be possible to produce a vaccine against it).

Vaccinating against H1N1 won't do any good, just waste tax money and detract from efforts that could help alleviate suffering and infection. I have heard people ask why we don't keep mass vaccinating against standard annual flu to stop any "mixing bowl" goings on from occurring, though that really is only an issue in pigs right now.

Is this a correct assumption, or am I off-base there? Also, would the number of side-effects from a double-vaccination against H5N1/Spanish Influenza outweight the potential number of lives that could save should H5N1 transition to a human-to-human virus?

Until we have a vaccine that can deal with H5N1, the point is moot. Vaccines against H1N1 are of no consequence because the virus is not a threat to us and hasn't attacked the populace in literally years, we also have adequate innate resistance to it. However, the problem resides in the fact that we simply cannot predict what the human-to-human strain of the current Avian Flu will be. This is the same with any flu virus, even the annual flu vaccinations are based on best guesses and with H5N1 killing off the eggs used to work at getting a vaccine and the fact that it is seemingly mutating into what the 1918 variant was just prior to the pandemic of that year, things are decidedly difficult. It doesn't help that we still don't know how the 1918 flu variant killed people within hours in many instances and who were perfectly healthy.

What concerns me is the public now seeing this as no longer a fringe story put on the news now and then concerning the Far East and are now buying up Tamiflu like nonbody's business. Even better, we're already seeing Tamiflu resistance in certain areas. So those that are buying online to produce their own safe stocks of anti-virals through lack of trust for the gov't are really probably wasting money right now. But then anti-virals are always quite unimpressive and with something that is second only to HIV in terms of genetic volatility, resistance is inevitable (I expect people using Tamiflu willy-nilly before even having an outbreak, thus starting another antibiotics like resistance problem again).

[The Duchess of Zeon]

< snip >

Alright, thanks for clarifying that.

Until we have a vaccine that can deal with H5N1, the point is moot. Vaccines against H1N1 are of no consequence because the virus is not a threat to us and hasn't attacked the populace in literally years, we also have adequate innate resistance to it. However, the problem resides in the fact that we simply cannot predict what the human-to-human strain of the current Avian Flu will be. This is the same with any flu virus, even the annual flu vaccinations are based on best guesses and with H5N1 killing off the eggs used to work at getting a vaccine and the fact that it is seemingly mutating into what the 1918 variant was just prior to the pandemic of that year, things are decidedly difficult. It doesn't help that we still don't know how the 1918 flu variant killed people within hours in many instances and who were perfectly healthy.

What's your opinion on the theory that the 1918 flu killed primarily people infected with latent TB, the evidence being the seeming extreme drop in TB rates during the 20's, which only picked up again in the 1930s?

Do you forsee a particular concentration of mass death in those who suffer from chronic diseases which weaken the immune system?

[Admiral Valdemar]

What's your opinion on the theory that the 1918 flu killed primarily people infected with latent TB, the evidence being the seeming extreme drop in TB rates during the 20's, which only picked up again in the 1930s?

I'm undecided on that. While interesting, I don't think it's a true deciding factor in the lethality of the virus which still went after perfectly healthy people without any sign of TB in their system from what I've read, though it was (and still is now it's becoming drug resistant) a very common bacterium. Though subsequent pandemics were lessened in impact thanks to antibiotics being better available to fight off secondary infections that were usually the main cause of death. Besides, this clear and present danger is a whole new threat next to previous pandemics. When we get data on how the bug killed people so well, then we can see how much help it may have had from other microbes or conditions.

Do you forsee a particular concentration of mass death in those who suffer from chronic diseases which weaken the immune system?

That depends on what it mutates into. The 1918 incident may have been helped by TB and other illnesses acting as catalysts or opportunity infections at the time, however, the virus was seemingly capable of causing rampant infection itself anyway in the young and what we typically see annually is something that only ever affects the very young or old with compromised immune systems. If there's going to be a set of people who get hit hardest, it will be those living amongst livestock in poor conditions like in most of the Far East where these outbreaks have come about or who have something like AIDS or pneumonia.

[The Duchess of Zeon]

If there's going to be a set of people who get hit hardest, it will be those living amongst livestock in poor conditions like in most of the Far East where these outbreaks have come about or who have something like AIDS or pneumonia.

Would you say then that it's quite probably that a worldwide pandemic would see at least tens of millions of deaths in Sub-Saharan Africa alone, roughly corresponding with the numbers of AIDS sufferers?

[Admiral Valdemar]

Would you say then that it's quite probably that a worldwide pandemic would see at least tens of millions of deaths in Sub-Saharan Africa alone, roughly corresponding with the numbers of AIDS sufferers?

I see that as a distinct possibility, yes, since the virus is well travelled and anything that can potentially harm healthy adults is more than a death knell to the immunocompromised.