COVID. Monkeypox. The old-fashioned flu. We’re living in a new era of overlapping viral outbreaks. But as frightening as these diseases might be, at least there are safe, effective and readily-available vaccines for each of them—even if the first COVID vaccines did take a year of frantic work.
There’s at least one viral disease we don’t have a broadly effective vaccine for, however. Bird flu. “Highly pathogenic avian influenza,” or HPAI, in scientific parlance.
And that’s got epidemiologists worried. “I would say that the potential of a HPAI strain to become the next pandemic is small but not zero,” Tony Moody, a professor of Immunology at the Duke Human Vaccine Institute, told Rolling Stone.
The bird flu virus is common in—well, take a guess. Songbirds. Geese. Ducks. And perhaps most troubling: chickens. Of which there are tens of billions all over the world.
Bird flu is all around us all the time. Spreading from bird to bird. Mutating. Evolving. And it occasionally leaps from birds to people through a process called “zoonosis.” If zoonosis ever ramps up, and a lot of people catch bird flu … we could have a new pandemic on our hands. One we might not be able to quickly contain because we declined to pay for vaccines in advance.
Scientists first identified bird flu in geese in Scotland back in 1959. Over the next four decades the virus evolved into the forms of HPAI that are now widespread, H5 and H7.
In 1999, the virus crossed over to people for the first time, in Hong Kong. There was another small outbreak in people in 2003. Symptoms included fever and cough. The worst outcome was respiratory failure. In all, around 400 people died.
These outbreaks were an ominous sign: that a much wider human outbreak—indeed, a pandemic—might be a matter of when, not if.
After the 2003 outbreak, the U.S. Centers for Disease Control and Prevention and U.S. Food and Drug Administration worked with French pharmaceutical firm Sanofi Pasteur to develop a human vaccine for HPAI. In 2007, the feds bought eight million doses of the Sanofi jab and stashed them in warehouses belonging to the U.S. Department of Health and Human Services’ Strategic National Stockpile.
But the doses eventually expired. And today there isn’t any bird flu vaccine in the U.S. stockpile, a Strategic National Stockpile official told Rolling Stone. The problem isn’t just that the doses expire after a few years. The bigger problem is that the HPAI virus, and other highly-pathogenic bird flu viruses, mutate constantly. Just like the human flu does.
“There are many experts who have advocated stockpiling bulk vaccines against all different predictable combinations, or at least ones we have seen,” James Lawler, an infectious disease expert at the University of Nebraska Medical Center, told Rolling Stone. But it’s probably pointless to stash away a bunch of jabs for an old form of the virus.
To stockpile an effective bird flu vaccine for current strains of the virus, and in quantities that would actually matter in the event of a major human outbreak, would require “a big investment,” Lawler said.
How big? Potentially billions of dollars annually as scientists identify the latest strain, industry develops a new vaccine and the government pays for many millions of doses—then everyone repeats the process in a year’s time. “It is a never-ending cycle of chasing virus evolution,” Moody said.
There’s no appetite for it. Consider the precipitous drop-off in federal investment in COVID vaccines. Facing stiff opposition in Congress from anti-vax Republicans, the administration of U.S. president Joe Biden this summer all but gave up on passing big new COVID spending bills and instead signaled the impending “commercialization” of the pandemic.
The feds will stop paying for COVID vaccines around the end of the year. And Big Pharma will start charging individuals a hundred dollars or more per jab. If the government’s not even going to invest in mitigating the current pandemic, don’t count on it spending big to prevent a possible future one.
There’s another way to go at it. Vaccinate birds instead of people. The theory is that, if we inoculate enough domestic geese, chickens and ducks—the birds people are most likely to come in close contact with—we can stave off zoonosis. That is, suppress the virus so it doesn’t make the leap to the human population.
The main problem is the same: the bird flu virus mutates so fast that it’s hard to keep up. But at least the incentives are different.
Human bird flu outbreaks are periodic and, so far, small in scale. When we produce human vaccines for bird flu, we tend not to use them—and they eventually go bad. In other words: Human vaccines for bird flu aren’t a waste, but they might feel like they are.
By contrast, big outbreaks in birds happen all the time. There was a major outbreak in the U.S. in 2014 and 2015 that forced authorities to cull tens of millions of birds worth billions of dollars. Another serious outbreak in birds began in South Carolina this year. When we produce bird vaccines, we can actually use them.
The trick is to develop a bird vaccine that works for a long time even as the virus mutates. Adel Talaat, a professor of pathobiological sciences at the University of Wisconsin-Madison, is developing a so-called “nanovaccine” that blends tiny particles of several different bird flu strains.
Talaat’s theory is that this mix of genetic material will induce broad immunity against current and future strains of HPAI. Talaat told Rolling Stone he hopes to get efficacy data by the end of the year, potentially leading to a license from the U.S. Department of Agriculture to administer the vaccine to domestic flocks.
It’s a start. But there are tens of billions of domestic birds in the world, and every one of them is a potential vector for bird flu—to other birds and to people. Vaccinating some of them is feasible. Vaccinating all of them is impossible.
Realistically given current politics, the best we can probably hope for is partial vaccination of some domestic flocks. Talaat said vaccines such as the one he’s developing “are the only practical hope.” Hopefully they’ll be enough to prevent a human bird flu pandemic for a few more years.
Bird flu is a unique problem. A major human outbreak could infect billions and kill millions. Everyone knows it. And everyone knows how to prevent it: a stockpile of good vaccine, refreshed every year, forever.
But this approach is so expensive that we seem content to save the money … and take our chances. It’s not hard to imagine a day, possibly in the near future, when bird flu is running rampant in the human population—and we regret being so cheap.