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To: Sam Citron who wrote (26594)	2/16/2005 6:21:53 PM
From: Henry Niman	Read Replies (2) \| Respond to of 110194

Sam, The entire vaccine area is very much out of whack. Right now the human vaccine is made of 3 viruses, which cost about $1 each. Shots generally go for about $20 and it looks like the shots have marginal benefit for elderly and great benefit for younger people (who get sick and pass the virus to everyone, including elderly). So as far as the general population is concerned, the wrong people get immunized and the number who get the flu goes up instead of down. On the pandemic side, anyone paying attention would want an H5 shot, even if there was no guarantee it would match a future pandemic strain. In fact a vaccine with H5, H7, and H9 would probably be a very hot seller and could theoretically be made for the same $3 for a human vaccine. Moreover, more would probably want a trivalent pandemic shot on an annual basis than a human flu shot. However, right now no one gets a pandemic shot (other than those who will enter a clinical trial) and the general public can just ask why. My guess is that a $20 trivalent pandemic vaccine could be sold in the 100-200 million dose range in the US alone and probably 3-4 times that or more worldwide (especially if eastern Asia is interested). Its really a crazy situation where there is a market to be created, but everyone is thinking on a VERY small scale, which will create anarchy if a pandemic virus emerges and there is enough vaccine for 1% of the population of industrial nations, and much less for the rest of the world.

To: Sam Citron who wrote (26594)	2/16/2005 9:07:43 PM
From: Henry Niman	Read Replies (2) \| Respond to of 110194

Sam, Looks like time for vaccine was yesterday. Tomorrow's NEJM has article on two siblings in Vietnam who died from neurotropic H5N1 with respiratory problems recombinomics.com H5N1 probably in Philippines (meningococcemia and meningitis) and China (meningitis), and who knows where else. Monitoring of bird flu remains a cruel joke, as history gets ready to repeat.