Swine Flu Vaccine - Priorities Wrong?

In the current edition of Nature (30 July 2009) there is a short correspondence from Italian immunologists on the subject of a swine flu vaccine.

I think it conveys an important message.

In the piece entitled "Flu: vaccinate to cut risk of chimaeric virus emerging", Ilaria Capua & Giovanni Cattoli from the Istituto Zooprofilattico Sperimentale delle Venezie in Italy, make the suggestion that any decisions on priority distribution of swine flu vaccine should take into account areas at higher risk of the emergence of a reassortment virus. This is a virus containing an assortment of genes from various different viruses and can occur in geographic locations where different human and animal viruses are simultaneously present

There is a risk of generating novel influenza A viruses through reassortment of the eight genes that result in antigenic shift, which would give rise to strains to which the human population has no immunity. For example, reassortment occurred between avian and human influenza viruses to create the human pandemic viruses of 1957 and 1968

Developing countries are breeding grounds for these types of reassortment viruses due to inadequate security and safety measures. Based on this, the authors indicate that along with the vaccination of risk patients and healthcare workers, emphasis should be placed on vaccinating populations in developing countries.

Fast-tracking vaccination of humans against pandemic influenza in developing countries where zoonotic flu in poultry is endemic would help prevent reassortment between naoH1N1 or other novel pandemic influenza strains and avian influenza viruses. That would deflect the unpredictable and serious consequences of viral reassortment to humankind worldwide.

So it is vital that we think on a bigger scale here. Undoubtedly each government has prioritised the vaccination of it's own citizens (here in Ireland they are apparently buying two doses per person), however the global community needs to think outside the box and firstly prevent the emergence of reassortment viruses. This constitutes a far greater risk to the human race and must be addressed immediately.