In Review
FLU WATCHER: “The safety of the H1N1 vaccine should be the same as the regular flu shot—one of the safest medical interventions that we have,” says Treanor, the founder of the New York Influenza Center of Excellence at the University. (Photo: Richard Baker)John Treanor ’79M (MD), a professor of medicine and chief of the Infectious Diseases Division at the Medical Center, spends a lot of his time thinking about the flu.
He’s the founder of the New York Influenza Center of Excellence at the University, part of a network established by the National Institute of Allergy and Infectious Diseases to help protect people against seasonal flu and future flu pandemics.
He and his staff have been keeping a close eye on the developments surrounding the new form of the flu virus known as “novel H1N1.”
Are you surprised by the high level of public concern over novel H1N1? Is it warranted?Concern, but not panic, is definitely warranted, as we expect that the attack rates will be high, and there will be substantial amounts of unpleasant, flu-like illness in younger people. Also, we expect to see higher than usual admissions to pediatric hospitals and intensive care units.
How is this different from the usual seasonal flu?This is most reminiscent of flu years when there has been a major change in the outer coat of the virus, which allows the virus to escape from previous immunity. The expected severity would be somewhere between a true pandemic and a very severe seasonal flu outbreak.
Flu viruses are known to be unstable and changeable. Does H1N1 fit that pattern?The new H1N1 virus is a good example of the many ways that flu viruses change to be able to continue to infect us each year. There can be small changes that are mutations from the previous year and then you can see more widespread outbreaks. Those can bring a primary and then a secondary wave of the illness, which is an example of what we saw last spring and now this fall. That is why we need vaccines every year.
What is it about the very young and young adults that seem to make them more likely targets for H1N1?This is a really intriguing question and, to be honest, no one has a complete explanation. What is not known is the mechanism that is making those over age 60 less susceptible. Susceptibility seems to decrease about age 30 or 40. Some researchers have theories: age-related cellular immunity, for example. Many, many interesting observations exist.
As an expert on vaccines, do you think the turnaround time in developing an H1N1 vaccine was faster than expected?It was about as expected. From the time that a new strain is identified to having a vaccine ready usually takes about six months for seasonal influenza. So, for example, if a new strain is identified in February, then the vaccine can be distributed to physicians in August. The H1N1 virus was identified in late April, and the vaccine was ready in October. A major goal of vaccine development is to do it faster, but it’s not an easy task.
Clinical trials for vaccines are a mystery to most of us. Will improved technology help speed the process for developing new vaccines?Improved technology could reduce the amount of time by a short amount. But better or different technology isn’t the full answer. There’s a very active area of research for alternatives to using hundreds of millions of fertilized eggs to grow flu vaccines, such as cell culture systems. One of these methods may be licensed in the next year or two in the United States. Conceivably, that could be a little faster. The real home run would be to figure out a way to make vaccines that did not have to be administered every year.
Should the public worry about getting the H1N1 vaccine?It’s worth emphasizing that the H1N1 vaccine is identical to the regular flu shot, except it has a new strain, the H1N1 strain. Actually, we change the strains in the flu vaccine every year without doing any clinical trials. There’s just no time. In this case, there have been some clinical studies for the H1N1 vaccine. Those trials were needed to determine the differences between getting one dose or two doses for adults. Now we know you only need one dose. The safety of the H1N1 vaccine should be the same as the regular flu shot—one of the safest medical interventions that we have.
Sharon Dickman is University spokesperson.
