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The first successful trial of a vaccine to protect against avian influenza was reported last month by Anthony S. Fauci, MD, director of the National Institute of Allergy and Infectious Diseases (NIAID). The news is highly significant: This is a first step toward devising an adequate response to the threat of an influenza pandemic touched off by a mutated bird flu virus.
The study did have significant limitations: The number of subjects was few and the dosage needed to demonstrate an immune response was large. And producing enough of the vaccine to meet a global threat using current, egg-based manufacturing technology will be daunting-perhaps impossible.
Nevertheless, federal officials consider the vaccine so promising that the government has purchased the two million doses made so far by Sanofi Aventis and plans to buy as much more as it can get its hands on. Rapid approval by the Food and Drug Administration of the vaccine is expected, and requests for proposals have gone out to vaccine manufacturers. What needs to follow, say Fauci and spokespersons for the World Health Organization, is further research, a greatly expanded vaccine production program, and a stockpile of medications such as oseltamivir (Tamiflu) that can be used to fight an epidemic.