Monday, February 19, 2018

Collateral Campaigns, Universal Flu Vaccine, Health Communication


Launched in October 1994, with 123.9 million visitors from Nov 2017 to Jan 2018, including 23.33 million monthly unique visitors (www.similarweb.com), Wired is not only a “historical” online technology magazine, but it is still one of the most authoritative. It is rare that Wired dedicates one of its main articles to a health theme,  yet, on Feb 1,  the magazine published a full piece entirely devoted to flu vaccines. This article is part of a wider media campaign on next-generation flu vaccines, which are expected  - as the story goes - to meet the challenges posed by ongoing virus mutations.
Why are media so interested in flu vaccines? The search for the universal flu vaccine is not at all novel, although new approaches are in the pipeline. This flu season has been one of the worst of the last decade, and this could be a possible explanation. However, the actual reason is probably more mundane; quite simply, 2018 is the 100th anniversary of the 1918 influenza pandemics. Anniversaries prompt ideas, initiatives, and, ultimately, business.
On  January 15thVaccitech, an Oxford University spin-out company developing a universal flu vaccine, announced  to have been granted with £20m by two major venture capital firms, GV (the venture capital arm of Alphabet, the parent company of Google), and Sequoia Capital China, the fifth yuan-denominated fund, which has in its portfolio internet giant Alibaba.  On January 19th, Vaccitech announced to be about to start a phase 2 trial for a universal flu vaccine.
Many other teams are working on next-generation flu vaccines, including the Palese Laboratory in the Department of Microbiology at Icahn School of Medicine at Mount Sinai in New York, supported by GlaxoSmithKline and Gates Foundation;  and the American biotech firm, FluGen, which was awarded on October 2017 with $14.4 million by the U.S. Department of Defense to enter human trial with RedeeFlu, an experimental flu vaccine.
The most challenging enterprise, is, however, the Universal Influenza Vaccine Initiative (UIVI), launched by the Human Vaccines Project, “a global nonprofit that brings together leading stakeholders across academia, industry, governments and nonprofits”,  funded inter alia  by The Robert Wood Johnson Foundation, the Vanderbilt University Medical Center, the J. Craig Venter Institute, and drug companies such as GlaxoSmithKlineJanssenPfizerSanofi Pasteur, and still others. The Universal Influenza Vaccine Initiative is more ambitious than any other project previously mentioned because it aims “to harness the human immune system to prevent and control disease in ways previously considered unimaginable (…) Decoding the human immune system holds the key to the development of such new and improved vaccines. Deciphering the human immunome, the universal and common elements of the B and T cell receptors that make up the adaptive immune system, will facilitate germline targeting and structure-assisted vaccine discovery”.  The UIVI proposes itself as the new Human Genome Project, the greatest scientific enterprise for the next decade. This is also echoed by Michael Osterholm - director of the Center for Infectious Disease Research and Policy (CIDRAP) at the University of Minnesota, and influential public health and a biosecurity  scientist – who argues that universal  flu vaccine needs an initiative similar to the Manhattan Project, the U.S. atomic bomb programme during World War II.
This editor has not the scientific expertise necessary to evaluate whether we truly need a new Manhattan Project (admittedly, it is not the most reassuring comparison one could use). The recent history is full of attempts to build great scientific enterprises; sometimes they succeed, other times they just generate bombastic “collateral campaigns,” to evoke Musil’s novel, “The Man Without Qualities.” One thing is for sure; the current universal flu vaccine campaign makes one wonders about scientists’ communication skills. Using the 100th anniversary of the 1918 influenza pandemics to raise public awareness is laudable but doing it by overturning years and years of health communication policies is crazy. Since October 2017, when news about universal flu vaccine started spreading, web searches on “universal flu vaccine have been going up and fluctuating in parallel with queries on “flu vaccine effectiveness” and on “flu shot side effects.”  For ages, people have been told that vaccines are always effective – although medical literate people knew that things were more nuanced than  naive popularizations  - now nonchalant articles and broadcasts are informing everybody, almost casually,  that “flu vaccine is only about 10 percent to 30 percent effective”. The least that could happen is that those who vaccinated themselves, feel deceived, and those who did not, find their doubts fully confirmed.  

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