![]() ![]() This threat is now being demonstrated, not by influenza but through the ongoing COVID-19 pandemic, and the world is currently racing to develop a vaccine for a pathogen where no vaccine has ever existed. While the estimated attributable excess mortality due to the last three pandemics was far less than that of the 1918 pandemic, the threat of a severe pandemic caused by a respiratory viral infection remains. Since 1918, three less severe influenza pandemics have occurred: A(H2N2) in 1957 “Asian influenza”, A(H3N2) in 1968 “Hong Kong Influenza” and A(H1N1)pdm09 in 2009. It was not until the early 1930s that influenza A viruses were first isolated. At that time, neither a vaccine nor conventional antibiotics to treat secondary bacterial infections were available and the causative agent remained unknown for many years. The year 2018 marked 100 years since the onset of “Spanish flu” which spread around the globe in three waves, estimated to have infected one third of the global population and to have killed up to 50 million people. Continued efforts are needed to ensure the sustainability of this production and to conduct research for vaccines that are faster to produce and more broadly protective taking into account lessons learned from COVID-19 vaccine development. It is important to note that two doses of pandemic vaccine are likely to be required to elicit an adequate immune response. A moderate-case scenario is also presented of 4.15 billion doses of pandemic vaccine in 12 months. ![]() Further, pandemic vaccines would not be immediately available and could take four to six months for first supplies with several more months needed to reach maximum capacity. However, this figure should be interpreted with caution as it presents a best-case scenario with several assumptions which may impact supply. Results of the current survey show that estimated annual seasonal influenza vaccine production capacity changed little since 2015 increasing from 1.47 billion to 1.48 billion doses with potential maximum annual influenza pandemic vaccine production capacity increasing from 6.37 billion to 8.31 billion doses. This study compares global capacity for production of influenza vaccines in 2019 with estimates from previous surveys provides an overview of countries with established production facilities presents vaccine production by type and manufacturing process and discusses limitations to these estimates. ![]() Through the Global Action Plan for Influenza Vaccines, 2006–2016, WHO promoted an increase in vaccine production capacity and monitors the landscape through periodically surveying influenza vaccine manufacturers. Understanding how much vaccine could be produced, in which regions of the world and in what timeframe is critical to informing influenza pandemic preparedness. While research towards developing universal influenza vaccines is ongoing, the current strategy for vaccine supply in a pandemic relies on seasonal influenza vaccine production to be switched over to pandemic vaccines. Vaccines will be an important element in mitigating the impact of an influenza pandemic. ![]()
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