Major challenges in providing an effective and timely pandemic vaccine for influenza A(H7N9)

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Osterholm MT, Ballering KS, Kelley NS. JAMA. On line May 9, 2013.

The emergence of avian influenza A(H7N9) virus in humans has public health authorities around the world on high alert for the potential development of a human influenza pandemic. As of May 8, 2013, authorities had identified 131 confirmed cases and 32 deaths among residents of 8 provinces and 2 municipalities in China. The arsenal of public health tools to reduce morbidity and mortality from an influenza pandemic is limited. Options include vaccines, antiviral drugs, and interventions such as respiratory protection and social distancing. According to the World Health Organization (WHO), “Influenza vaccination
is the most important intervention in reducing the impact of influenza, and a key component of the WHO response and preparedness efforts for influenza of pandemic potential, including avian influenza A(H5N1), A(H9N2) and A(H7N9).” However, seasonal and pandemic influenza vaccines have significant limitations,including limited vaccine effectiveness, the inability to identify reliable correlates of protection, and the need to distribute large quantities of vaccine early in the pandemic course.

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