production capacity

[gsgs]

http://www.genengnews.com/news/bnitem.aspx?name=16627296

http://www.ifpma.org/Influenza/content/pdfs/Presentations/2007_10_01_WHO_meeting_on_Use_of_H5N1_stockpile_vac.pdf

> This means that monovalent pandemic dose capacity could be sufficiant to cover most of
> the global population by 2010

IFPMA, WHO-meeting, October 2007

https://www.idsociety.org/WorkArea/downloadasset.aspx?id=11320

life investment cost for life bulk 3B doses of pandemic vaccine within 6 months of declaration
of a pandemic:

timeframe to serve developing world pandemic demand


year time to 1st dose
time until demand served
base aggressive
--------------------------------------------------------
2007 5y >10y 8m 25m
2008 4y >10y 8m 24m
2009 3y 9y 6m 17m
2010 3y 9y 6m 16m
2011 3y 9y 6m 16m
2012 3y 9y 6m 15m
2013 2y 6y 5m 12m

2007 2013
------------------------------
3 0M 0M 300M 700M
4 20M 50M 600M 1400M
5 60M 160M 900M 2100M
6 90M 250M 1200M 2800M



cumulative prepandemic H5N1-courses

year base aggr
-------------------------------
2008 111 1200
2009 389 3600
2010 623 6300
2011 688 9000
2012 684 11800
2013 967 16400

base case assumes yields of 1/3 of seasonal vaccine, access
to novel adjuvants or alum, and stockpiles need to be regenerated every 2 years.
Aggressive case assumes yields of 80%, access to best adjuvants to all

http://74.125.39.104/search?q=cache:YR4IVDFhSv4J:www.oliverwyman.com/ow/pdf_files/VAC_infl_publ_rpt_10-07.pdf+%22miv+study+group%22+2008&hl=en&ct=clnk&cd=19&ie=UTF-8

>Our estimate is that in a ?best-case? scenario, only 1.2 billion courses (2.4 billion doses)
> could be produced from current capacity within six months, and current stockpiles are limited

> Cell-based inactivated: ...still costs >50% more than egg-based

[Anne]

Re: production capacity

thanks gsgs,
I have a question ..
Immunization request 2 injections to have a "good" immunity.( 21 days between the injections )
What are we supposed to do between this injections ? stay at home to avoid contacts ?

[gsgs]

Re: production capacity

just behave like the other people ?

it also takes 2-3 weeks (I even read 6 weeks or more somewhere)
to build up the immunity by the body, so the question only applies
after the 2nd dose was given after 21 days (if it was given...)


the above were just snippets from a websearch

[Anne]

Re: production capacity

I have not asked the right question.
scenario :
Imagine, just imagine, that a pandemic begins in a remote area.
Imagine that your government is warned and have doses of prepand?mic vaccine ( very lucky )
you receive the first dose of vaccin (very very lucky , you meet the criteria for vaccination and your name is the first of the list.)
the pandemic is spreading very rapidly with plane ( for example )
people fall ill around you.. etc..
what do you are suppose to do with your first injection which don't protect you ?
stay alone, and wait for the second injection ?

just suppositions.

[tropical]

Re: production capacity

Anne:
"...what do you are suppose to do with your first injection which don't protect you ?
stay alone, and wait for the second injection ? "

Correct.

Also with a few packadges of Tamiflu, antibiotics, food, water, etc., in isolation.

[Oracle]

Re: production capacity

The point of immune priming is that you have some immune protective response, so that the first injection of a specific vaccine both reinforces protection and works towards establishing immune memory, necessary to avoid illness from repeat exposures.

Those who are chronically ill and are immune suppressed may not have lasting protection from vaccination (demonstrated recently in a test patient cohort of HIV-positive children treated with seasonal influenza vaccine - short term benefit that quickly decayed with time, when compared against vaccinated controls).

Our vast planetary Achilles heel: the significant number of immune-compromised population; the actively infected and silent carriers of antibiotic drug-resistant TB, Strep and Staph; chronic smokers; drug-addicts and the vast herds of malnourished-sedentary population in both developed and developing nations.

They number about 60% or more of every region. They will not respond adequately to vaccination. They will harbor a pandemic strain for many weeks to months, perhaps years.

Certain patient subpopulations will most likely induce mutations that will give rise to successive waves.

You cannot 'hide' from a pandemic by relying on either just-in-time vaccines or antiviral agents.

[Anne]

Re: production capacity


I ve made a mistake : 21 days is the minimum.. 6 weeks would be better..

correct but a little unrealistic if you are HCW ?

[gsgs]

Re: production capacity

yes, wait for the 2nd dose. One dose alone does also provide some protection, probably.

I don't think we have 60% Achilles heel. The models say
it might work with vaccines,antivirals,NPIs

[AlaskaDenise]

Re: production capacity

.........
.........Certain patient subpopulations will most likely induce mutations that will give rise to successive waves.

You cannot 'hide' from a pandemic .........

Do you think they were the source of the successive wave from 1918 H1N1? or another explanation, e.g., similar to normal seasonal variations?

.

[Oracle]

Re: production capacity

<i>Do you think they were the source of the successive wave from 1918 H1N1? or another explanation, e.g., similar to normal seasonal variations?</i>

If you are speaking of the winter 1919 wave, :unsure:. Many localities (for instance, Singapore) did not report successive wave morbidity, while others not only reported repeat wave in winter-spring 1919, but again in fall-winter 1920 (and patients reported repeat illness in successive waves - New Foundland, England and Wales). The "w-shaped" age-cohort mortality curve returned to it's more typical "v" shape by 1921, when mortality among the youngest and aged once again dominated age-class mortality figures.

Confounding matters, locations that relaxed public health controls prematurely during the worst waves (fall and early 1919) experienced sudden return to peak wave conditions. This suggests that either silent carriers (as much as 1/3 of all infected individuals) or latent-actives seeded these intra-waves.

Repeat waves of the same clade viruses are thought to be due to proficient viral evasion coupled with a high enough density of susceptible individuals to seed and foster the spread of illness - but these occur about a year later in either typical seasonal influenza or pandemic events. This was not the case in the highly compressed waves of Fall 1918 and Winter-Spring 1919.

Not enough viral samples isolated (all were fragmentary, and had to be 'reassembled' with ****-filler from a swine strain circa early 1930s (also suspect, in that has been passed/maintained many times before it was finally sequenced), to be able to fully answer your question.

Taubenberger reported two strain variants. There may have been more; Oxford is said to be still working on recovery of viruses from various preserved sources.

Certainly, there was a much noted, marked shift in reported patient morbidity and mortality between late 1917-early 1918 (progressing through Spring-Summer seasons) and the highly lethal Fall wave. This is another unique aspect of the Spanish Influenza pandemic - it had never been reported previously nor since. The mechanics of this rolling shift are significantly more complex than that of later influenza pandemics.