This year’s deadly flu made the quest for a universal flu shot more urgent

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Currently, at least 40 different candidates are being developed for the universal flu vaccine, but a flu season without flu is still far away.
The goal is to create a vaccine that can protect people against a wide range of flu viruses for at least a year or more. Doing this would mean not having to guess which strains will be circulating the following year. The most widely effective vaccines could reduce the number of sick people. Some universal flu candidates are already being tested on people, and companies that discover how to make a universal flu vaccine can make a lot of money.
A flu season without flu is still far away
They also solve a big public health problem because the flu can be serious and even deadly. This year, the flu sent a record number of people to the hospital and killed at least 114 children in the US alone. UU Children, the elderly, the immunocompromised and even the apparently healthy run the risk of contracting the seasonal flu viruses that we expected. If a pandemic virus arose unexpectedly, even more people could die. The Spanish flu of 1918 killed 50 million people, for example. The relatively mild swine flu pandemic in 2009 killed more than 280,000.
This year's devastating flu season "just underscored the urgency," says Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, or NIAID. "We have to get away from this problem of having to run every year and pursue what, hopefully, correctly, we will predict will be the flu that will attack us."
Unfortunately, we simply do not know which parts of the influenza virus to target with a universal vaccine to obtain broad and lasting protection. So last week, Fauci and NIAID summarized key research questions to answer on the way to a universal flu vaccine. That kind of basic science requires money, and in fiscal year 2017, the NIAID spent only about $ 64 million on universal research for the flu vaccine, reports Bloomberg. (For the scale, that's about two-thirds of a single F-35 fighter plane).
"I do not control the money," says Fauci. "I do science." There could be more funds on the way: Sen. Ed Markey (D-MA) recently introduced an act that would boost universal funding of the $ 1 billion flu vaccine in five years, according to Bloomberg. If they get extra money, says Fauci, "that will be money well spent." If we do not get additional money, I'm still going to prioritize it. "
"That will be money well spent."
To understand why it is so difficult to develop a universal flu vaccine, it is helpful to know a little about how the seasonal flu vaccine works. At this time, seasonal flu vaccines target ice cream cone proteins that cover the coat of the flu virus. Most of the immune response is directed against the scoop of ice cream on top of the protein, instead of its conical stem. But the taste of that scoop can change quickly, so the seasonal flu vaccine must be reformulated annually.
The strategy leaves vaccine manufacturers unprepared and struggling if an unexpected virus emerges, such as the H1N1 swine flu pandemic in 2009, which peaked before the vaccines were ready. "You're trying to predict the future," says Florian Krammer, a professor of microbiology at the Icahn School of Medicine in Mount Sinai. "And from time to time, we get this wrong prediction."
At this time, the contestant who leads the clinical trials race is a company based in the United Kingdom called Vaccitech. He is developing a flu vaccine that drives a person's immune system to take out their large weapons, such as killer T cells, instead of antibodies to fight the flu. And he's currently testing his flu vaccine on people to see if it works. The effort has attracted $ 27 million in funds from venture capital groups, including Alphabet & # 39; s GV (formerly Google Ventures), but it will take more to continue. "The aim of this study is to show some preliminary evidence of effectiveness so that we can raise more money, so that we can afford to conduct a phase III trial," says Sarah Gilbert, Vaccitech, professor of vaccinology at the University of Oxford. "We are years away, but so are everyone else."
"We are years away, but so are everyone else."
The next is a Wisconsin-based company called FluGen, which has genetically modified a flu virus that can infect cells, but can not multiply within them. This prevents the virus from spreading through the body or to other people. "It's like a cockroach motel," says the company's chief executive, Boyd Clark. "It can be controlled, but it can not be verified." The theory is that vaccination with a strain of genetically modified influenza virus generates an immune response large enough to protect people against other similar strains as well. It's similar to FluMist vaccines that use live, but weakened, flu viruses, but it looks more like a wild-type virus, explains FluGen virologist Pamuk Bilsel. The real test is scheduled for this summer: the team plans to test whether vaccinating with a strain of the H3N2 flu virus that circulated in 2007 protects the study participants against another H3N2 strain that circulated in 2013.
Then there are the teams still in the first safety trials or are about to start them. Two of them point to the sugar cone part of that surface protein, instead of the spoonful of ice cream that changes rapidly. At Mount Sinai, Krammer and his colleagues are working with pharmaceutical giant GlaxoSmithKline to develop a series of vaccines that combine the same cone with new and exotic flavors. Theoretically, this series of vaccines should teach the immune system to attack the cone, regardless of the taste of the ice cream at the top. The vaccines are in preliminary studies in people to make sure they are safe and to discover how the immune system responds.
"It will be a long time before there is a universal vaccine authorized against influenza."
The NIAID Vaccine Research Center also has a candidate who should be entering the first trials in humans at the end of 2018. His strategy is to create a vaccine made with ice cream cones, without the ice cream ball. While the Vaccine Research Center has also partnered with "medium-sized biotech and large pharmaceutical companies," it will not say which ones.
Last, but not least, Ted Ross of the University of Georgia, whose team developed an algorithm that analyzes influenza viruses to reconstruct a type of Franken protein made from parts of different varieties. This should teach the immune system to fight a wider range of strains, even if those strains evolve. His team is working with leading vaccine manufacturer Sanofi Pasteur, and plans to bring the first of these vaccines to early human trials in 2019, says Ross.
"It's already a pretty busy field."
"It's already a pretty busy field," says Krammer. But the biggest obstacle is not competition between teams. "It's more about getting the funds and getting the acceptance," says Krammer. "We are fighting more with that than among us."
Even those companies that go through the long and expensive human testing process may not be able to qualify their vaccines as "universal," says Gilbert de Vaccitech. That's because of the way the regulatory process works. The first step will be to show that a possible universal vaccine works against seasonal flu. Then comes the process of showing that it works against pandemic viruses. "It will be a long time before there is a universal vaccine approved against influenza," says Gilbert. "And it's not going to be cheap to get there."

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