Despite a growing outbreak among U.S. animals and at least 58 human infections in seven states, Biden administration officials stated on Wednesday that they currently have no plans to sanction a stockpiled bird flu vaccine.
Given that Trump has appointed anti-vaccine activist Robert F. Kennedy Jr. to head the Department of Health and Human Services, the decision indicates that any decisions on a bird flu vaccine will probably be left to health officials in the upcoming Trump administration.
As of Wednesday, the Centers for Disease Control and Prevention reported that the virus, which has been circulating in dairy cows since the spring, had affected at least 774 herds across 16 states. In an effort to combat the outbreak, the Department of Agriculture issued a federal order last Friday requiring testing of the country’s milk supply.
According to the USDA, the testing, which is scheduled to start in six states next week, will help officials better understand which herds are contaminated and will also offer farmworkers greater confidence in the safety of their animals and their own capacity to prevent infection.
Public health specialists are concerned about the virus’s spread in mammals that have frequent contact with humans because it provides the bird flu with numerous opportunities to infect humans and may evolve into a virus that can travel efficiently from person to person.
With the exception of a patient in Missouri and a kid in California, farmworkers who have come into contact with sick dairy cows or poultry have been the source of nearly all bird flu cases in the United States. There was no obvious interaction with infected animals for a Canadian teen who became quite ill and had to be admitted to the hospital.
The Food and Drug Administration must approve the two bird flu vaccine candidates before they can be used, but the federal government possesses them in the nation’s Strategic National Stockpile in small amounts.
Health officials stated in May that if the virus changed in a way that would reduce the effectiveness of current antivirals like Tamiflu or if it seemed to be seriously infecting people, the government would start considering vaccination.
The CDC’s principal deputy director, Dr. Nirav Shah, stated on Wednesday that the standards for implementing a vaccine are unchanged.
According to Shah, respiratory vaccinations are particularly effective at averting serious illness and death. He used a shorthand for the influenza virus strain that is causing the avian flu outbreak to say, “When we look at what is currently unfolding with H5, even in the human cases, thankfully what we’ve seen thus far is mild disease.”
According to Shah, that is not a guarantee and could change, but it is one of the things we are watching for since the vaccination would be as successful as possible at lowering the severity of the illness. Although the administration isn’t currently considering a vaccine, he stated that if the outbreak shifts, that may change.
Nonetheless, some public health specialists think that now is the right moment to vaccinate, especially farmworkers.
According to Jennifer Nuzzo, director of the Pandemic Center at Brown University School of Public Health, “I don’t think we should gamble with farmworkers’ lives by waiting for them to be hospitalized or die before using the tools we have to protect them.”
A balancing act
Public health organizations must constantly balance whether to approve or implement a vaccination, Shah said, adding that even the safest vaccines can have adverse effects.
When the first indications of an H1N1 swine flu outbreak appeared in the United States in 1976, public health officials promptly launched a statewide vaccination campaign. However, the shot increased the risk of Guillain-Barre syndrome, a rare disorder in which healthy nerve cells are attacked by the immune system.
Although the pandemic never extended far, it caused a decades-long decline in public confidence in the flu.
According to Shah, it prompted an examination and reflection on whether the reaction to those 13 swine flu cases had been excessive. Indeed, a significant level of vaccine mistrust surfaced.
Shah added that officials regularly test strains of the bird flu against the vaccine candidates and that public health agencies are ready to approve a vaccine if necessary.
HHS has worked to fill and complete vaccination doses of a candidate vaccine that is well-matched to the virus circulating in dairy cows, according to a spokesman for the Administration for Strategic Preparedness and Response, an office inside HHS that oversees the Strategic National Stockpile.
By the end of the first quarter of next year, there will be up to 10 million doses accessible, which is enough to vaccinate 5 million individuals, according to the spokeswoman.
According to an FDA representative, the agency is actively working with business and federal partners in the United States, including assessing possible vaccine candidates in case they need to be used in humans.
When is the right time?
Given the lack of proof of human-to-human transmission or indications that the virus is seriously harming humans, Dr. William Schaffner, an infectious diseases specialist at Vanderbilt University Medical Center, stated that there is now no need to approve a vaccine. According to him, the current tools—such as antivirals and personal protective equipment—are enough.
Schaffner ascribed the increased number of infections to public health officials’ increased efforts to detect the virus through surveillance and testing.
Schaffner stated that the anti-vaccine rhetoric of the incoming Trump administration did not alter his position.
According to him, we should use extreme caution when predicting the actions of the incoming administration. The administration will get a wealth of high-quality, well-supported scientific data from the Food and Drug Administration and the CDC, as well as from industry and several public health officials and specialists nationwide.
A request for comment from the Trump transition team was not answered.
The head of the Wisconsin Veterinary Diagnostic Laboratory, Dr. Keith Poulsen, added that approving a vaccination at this time is not required.
According to Poulsen, we must continue to advocate using facts and research to make well-informed judgments, or we must try our best to bridge the gap between political, economic, and scientific disciplines.
Antivirals are crucial for everyone exposed to or infected with the virus, but their effectiveness is restricted by a very short window of time during which they must be administered, according to Nuzzo of the Brown University School of Public Health. Additionally, she claimed that the nation’s testing method is not quick enough to provide farmworkers with proper protection.
She said that a vaccine may shield farmworkers from the risk of serious disease.
Finding farmworkers who are willing to receive the vaccine, however, could be a problem for officials, according to Poulsen, who also mentioned that some might be wary of the shot.
According to Poulsen, I would begin with seasonal flu and only move on to H5N1 strains if they discover that people are spreading the virus or becoming seriously ill. That hasn’t occurred.
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