Universal Flu Vaccine on the Way?

What if patients didn’t have to get their annual flu vaccine anymore and could still be protected from influenza? What if pharmacies didn’t have the mad rush of patients wanting the annual ritual shot against the flu? Is it possible for a flu vaccine to cover patients against all flu strains and have it last more than one year? Scientists are working hard to answer those questions.

The traditional routine for developing the flu vaccine involves the World Health Organization (WHO) and the US Food and Drug Administration (FDA). Basically, they sit down and decide months before each flu season which strains of the pesky virus they think will be the worst offenders for that particular flu season. Then the vaccine goes into production mode, which takes several months. And then the annual shot is finally produced, protecting patients against the 3 strains of the flu we all thought would be the worst offenders for that particular flu season.

The result is a guessing game by world health officials attempting to predict which flu strains will be problematic long before the critical flu season starts. They usually do a pretty good job considering the nature of their target. But the flu vaccine isn’t a sure thing. According to a meta-analysis from The Lancet, the flu shot is only about 59% effective for adults between the ages of 18 to 65 during their study period. That is pretty good considering the development process, but it is by no means guaranteed protection for patients.

But what if there was a way to increase the protection against the flu and have a vaccine last multiple years instead of the usual annual shot? Well, according to an article in the Orlando Sentinel, a couple of companies are working to develop a type of universal multi-seasonal flu vaccine. This new type of flu vaccine would cover patients against all types of flu strains and the vaccine would protect patients for several years.

The science behind it is simpler than you would expect. There are proteins within the flu virus that are unchanged among the different strains of the virus. Vaccines could potentially target these proteins and protect patients against any flu strain in existence. Another option is to develop a DNA-based vaccine. Whatever the method of development, patients wouldn’t have to worry about a yearly vaccine or depend on world health officials to guess the correct strains that will be problematic in any given flu season.

But are these scientific breakthroughs really possible and when can we expect this new vaccine? Well, National Institutes of Health (NIH) Director Francis Collins said this past summer that a universal flu vaccine could come as early as 2016 according to the Orlando Sentinel article. A drug company based in Israel could have a vaccine ready as early as 2014. But some scientists still think we are at least ten years away from a viable universal vaccine against the flu. The point though is that it is coming.

And while I would welcome a medical breakthrough that would allow patients to skip the annual ritual of getting a flu vaccine, I can’t help but wonder what such a scientific breakthrough would mean for community pharmacy. Keep in mind that flu vaccinations are a solid source of revenue (albeit seasonally) for many pharmacies across the country and the world. If a universal vaccine for the flu were to hit the market, we would no longer have that steady annual foot traffic every fall and winter for the flu vaccine. Would this be another nail in the coffin for community pharmacies everywhere?

Vaccine administration—and specifically flu shot administration—has become the best example of a wide spread clinical service in the community pharmacy setting. It is a source of profit for pharmacies, it is easy to develop and implement the service on a wide scale, and it doesn’t require expensive or complicated equipment or excessive space. Pharmacists can easily turn counseling rooms into vaccination centers and provide this valuable service for patients. But a multi-year flu vaccine would cause a great decline in the year to year administration volumes for vaccines in pharmacies.

Pharmacies count on flu vaccine administration to boost their script counts late in the year. It is one of the few decent revenue and profit sources left for community pharmacy. It is a service that mail order pharmacies can’t steal away from local pharmacies. And while focusing on profits instead of praising the new vaccine as an important advance in medicine may seem callous, I think the impact of this development on pharmacy is important. If one more source of profits is eliminated or reduced pharmacies may be further pushed towards closing their doors. Profits are already razor thin at many pharmacies including the local independents. They may be the least capable of handling another profit source being eliminated or reduced.

I’m curious to see if this so called universal flu vaccine will ever become a reality. It would be nice to be better protected from the seasonal flu and not have to get an annual flu vaccine. But I’m also curious how such a breakthrough in public health would impact community pharmacies. I wouldn’t miss the crazy days running around trying to give a dozen flu shots on top of all my other work as a pharmacist. But I recognize that all of those vaccine administrations do help me maintain employment and some level of profitability for the pharmacy. What will happen if this service we gladly provide for patients decreases dramatically because of a universal vaccine hitting the market? Will community pharmacy be able to handle this change? What do you think?