On Wednesday, officials from the Biden administration stated that there are currently no plans to approve the use of a stockpiled bird flu vaccine, despite a growing outbreak among livestock in the U.S. and at least 58 cases in humans across seven states. The decision means that any potential authorization of a bird flu vaccine may be left to the incoming Trump administration’s health officials, possibly under the leadership of Robert F. Kennedy Jr., who has been chosen by Trump to head the Department of Health and Human Services.
The bird flu virus has been spreading among dairy cows since spring and has affected over 774 herds in 16 states as of Wednesday, according to the Centers for Disease Control and Prevention. Last Friday, the Agriculture Department heightened its response to the outbreak by issuing a federal order mandating testing of the national milk supply. This testing, set to commence in six states next week, aims to provide farmworkers with greater confidence in their animals’ safety and their own protection from infection, while also helping officials identify infected herds.
The virus’s transmission among mammals in close contact with humans is worrying for public health experts, as it increases the likelihood of the bird flu jumping to people and potentially evolving to spread efficiently between individuals. Nearly all reported bird flu cases in the U.S. have been in farmworkers who had contact with infected animals, except for one patient in Missouri and a child in California. Additionally, a teenager in Canada who became seriously ill and was hospitalized had no clear contact with infected animals.
The federal government has two potential bird flu vaccines stored in the Strategic National Stockpile, pending authorization from the Food and Drug Administration. Health officials had previously indicated that vaccination would be considered if the virus mutated in ways that rendered existing antivirals less effective or if it caused severe illness in people.
Dr. Nirav Shah, the CDC’s principal deputy director, reiterated on Wednesday that the criteria for deploying a vaccine remains focused on preventing severe disease and death. While there is no current plan to administer a vaccine, Shah acknowledged that this stance could change depending on the outbreak’s evolution.
Despite some public health experts advocating for immediate vaccination, particularly among farmworkers, Shah emphasized that the decision to authorize and distribute vaccines involves a delicate balance. He highlighted that even the safest vaccine can carry potential side effects, underscoring the complexities involved in making such decisions during public health crises.
In the United States, a nationwide vaccination campaign was quickly initiated by public health officials. However, the vaccine caused a slight increase in the risk of Guillain-Barre syndrome, a rare condition where the immune system attacks healthy nerve cells. While the outbreak did not spread widely, it significantly undermined public trust in flu shots for many years.
This led to a critical analysis of the response to a small number of swine flu cases, prompting introspection on whether it was an overreaction. This incident also fueled a high level of skepticism towards vaccines. Despite this, public health agencies remain ready to authorize a vaccine for bird flu if necessary. They are continuously testing different strains against potential vaccine candidates.
A spokesperson from the Administration for Strategic Preparedness and Response, a branch of the Department of Health and Human Services responsible for managing the Strategic National Stockpile, stated that they have been working on preparing vaccine doses that match the virus found in dairy cows. By the end of the first quarter of next year, around 10 million doses will be available, enough to vaccinate 5 million people.
The FDA spokesperson mentioned that the agency is actively collaborating with federal partners and industry to evaluate potential vaccine candidates in case there is a need for their use in humans. Dr. William Schaffner, an infectious diseases expert at Vanderbilt University Medical Center, emphasized that there is currently no need to authorize a vaccine as there is no evidence of human-to-human transmission or severe disease caused by the virus. He believes that existing tools such as antivirals and protective equipment are sufficient at this time.
Regarding the potential need for a vaccine, both Dr. Schaffner and Dr. Keith Poulsen, director of the Wisconsin Veterinary Diagnostic Laboratory, stressed the importance of making informed decisions based on scientific data. Dr. Jennifer Nuzzo from Brown University School of Public Health highlighted the limitations of antivirals due to a narrow window of effectiveness and emphasized the need for timely testing to protect farmworkers. Dr. Poulsen expressed concerns about potential vaccine hesitancy among farmworkers.
In conclusion, while there are considerations for authorizing a vaccine for specific strains of flu, experts emphasize the importance of evidence-based decision-making and effective communication to address public health needs.
In a recent statement, Poulsen emphasized, “I want to clarify that the reports of me being seriously ill are untrue.” He firmly denied any such claims, asserting that such rumors have no basis in reality.
