Should viral vaccines be made for profit?

This past week the vaccine against influenza made world news when the British government suspendend the manufacturing license of a Liverpool factory that produces the vaccine. The factory is owned by Chiron, which had hoped to sell influenza vaccine produced there in the U.S. As a consequence, the U.S. will fall about 48 million doses short of the 100 million doses of vaccine that should have been available this winter. Another producer of influenza vaccine, Aventis, will supply 54 million doses to the U.S. A very different influenza vaccine is produced by MedImmune – a live virus preparation sprayed into the nose – but only 1-2 million doses of that vaccine will be available.

As Dr. Robert Webster of St. Jude’s has said, “This is unacceptable in the United States. It is a bloody scandal”. Why is the U.S. caught in this position? Because vaccine manufacturing is a for-profit industry. Although this approach has been successful in the past, it is no longer viable.

Thirty years ago, there were numerous manufacturers of influenza vaccine – as many as 25. Today there are just three. There are no manufacturers of the poliovaccine in the U.S. – our supply of inactivated poliovirus vaccine is provided by Aventis. The lack of plentiful virus vaccine manufacturers can be readily explained: vaccine manufacturing is a risky business with low profit margins. Vaccines are expensive to develop and produce, and litigation over side effects further increases the cost.

The solution to this problem, to which I have subscribed for many years, is to transfer viral vaccine development and manufacturing from the private sector to the U.S. government. Vaccine institutes could be established throughout the U.S. where the manufacture of influenza, poliovirus, and other vaccines could be carried out. These vaccines would be sold by the government at low cost, not only to the U.S. but to other countries who require them. What better way to propagate global goodwill than to sustain life, rather than terminating it?

The U.S. has already taken a small step towards this plan by establishing the Vaccine Research Center. However, I envision a much broader initiative where such centers not only develop new vaccines, but manufacture and distribute existing products such as the influenza virus vaccine.

My colleagues have criticized this plan because it prevents scientific innovation. I do not believe a government run vaccine facility need be devoid of scientific creativity. The National Institutes of Health is an example of a government research facility that conducts outstanding scientific research. The key is to attract the best scientists, and provide them with a flexible, stimulating, and scholarly atmosphere in which to exercise their talents.

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