A universal flu vaccine that protects against all strains may be within reach in the next five years, replacing annual shots developed for specifics flu viruses, the chief of the National Institutes of Health predicts.
Francis Collins told USA TODAY’s Editorial Board on Tuesday that he is “guardedly optimistic” about development of a long-term shot to replace the one “you’d have to renew every year.”
About 200,000 people are hospitalized with the flu every year, and an estimated 3,000 to 49,000 die, making the flu one of the chief causes of preventable death in the USA.
Collins cited the long-term flu shot in a wide-ranging discussion of many advances coming from NIH research. Amid budget debates now underway in Washington, D.C. that could also trim NIH’s $31billion budget, he made the case for research investments that improve the nation’s health.
A universal flu vaccine “seemed completely out of reach only a few years ago,” Collins said. That’s because flu viruses mutate yearly, causing small changes in surface coatings, which make old vaccines obsolete.
Flu vaccine
Recently however, scientists have found “there are parts of the viral coat that don’t change …. If you designed a vaccine to go after the constant part of the virus, you’d be protected against all strains,” Collins said.
A universal flu vaccine is “not a question of whether, but when,” says Arnold Monto, of the University of Michigan. “I think five years is a bit ambitious, given where we are now.”
Scientists around the world are working on the problem. In February, researchers in the United Kingdom reported preliminary success developing a universal flu vaccine in humans.
Collins pointed to other advances springing from investment in biomedical research:
• Alzheimer’s studies suggest inflammation, rather than brain-tangling proteins, triggers many cases of the dementia that afflicts more than 5million, according to NIH.
• Diabetes research is finding that exercise and nutrition coaching is more effective at checking symptoms than drug treatment.
•HIV studies suggest screening everyone in the country for HIV could lead to early treatment to prevent some of the 56,000 new cases each year.
“We might be able to end this epidemic,” Collins said. Given that the lifetime cost of HIV/AIDS treatment is $1million — a total of $56billion to treat just the newly infected each year — universal screening “begins to look cost-effective.” He cautioned there is no proposal for such screening.
NIH already runs pilot programs to test and treat high-risk people in Washington, D.C. and the Bronx, N.Y., says Anthony Fauci, head of NIH’s National Institute of Allergy and Infectious Diseases. “Scientifically, we know it works.”
A volunteer in a medical study who had an unusual reaction to the flu virus could hold the key to developing a vaccine that protects against all pandemic strains of the infection, scientists say.
Tests on a group of people who had either been infected with or vaccinated against the flu revealed one participant who produced a “super-antibody” that could fight off every strain of influenza A, the virus responsible for mass outbreaks of the illness.
The person produced too little of the super-antibody to make them immune to the flu, but scientists believe they can boost its effect, and use it to make vaccines against the virus.
In preliminary tests, researchers showed that injecting mice and ferrets with the super-antibody protected the animals against doses of influenza that would normally be lethal. The study appears in the journal, Science.
“What we can do now is mass-produce this super-antibody and give it as a therapeutic,” said Antonio Lanzavecchia, director of the Institute for Research in Biomedicine in Bellinzone, Switzerland.
“This could be developed to treat any influenza A infection and prevent any possible new pandemic that will come out. We expect it will block not only the strains that circulate in humans but also those that are present in animals,” he added.
Steve Gamblin, a co-author of the study and structural biologist at the Medical Research Council’s National Institute for Medical Research in north London, said that, if proven to work safely, the antibody might be given directly to hospital staff and other frontline workers to protect them against flu pandemics.
In the longer term, scientists hope to create a vaccine that makes the body launch its own devastating attack on influenza by producing a surge of super-antibodies.
Traditional flu vaccines make the body produce antibodies that target proteins called haemagglutinins on the surface of the influenza virus. But these antibodies focus their attack on the tips of the proteins, which change as the virus mutates. Because the virus evolves so rapidly, flu vaccines have to be reformulated every season.
The super-antibody is different because it latches on to a part of the stem of the haemagglutinin that is shared by all influenza A strains and appears not to mutate. Lanzavecchia calls it the virus’s “Achilles heel”.
A universal flu vaccine could transform public health by making seasonal jabs obsolete and reducing the impact of fresh outbreaks, including those that spread from animals to humans, like the recent strain of swine flu.
Sir John Skehel, another co-author of the study at the National Institute for Medical Research, said: “Every year millions of people are infected with influenza A viruses and, although the majority of infections are mild, those in vulnerable groups, such as the very old or the very young, may be worse affected and more likely to die or be hospitalised.
“As we saw with the 2009 pandemic, a comparatively mild strain of influenza can place a significant burden on emergency services. Having a universal treatment which can be given in emergency circumstances would be an invaluable asset.”