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Quandary over which vaccine to make

AS swine flu cases topped 6,600 worldwide, vaccine makers and other experts met yesterday at the World Health Organization in Geneva to discuss the tough decisions that must be made quickly to fight the evolving virus.

Pharmaceutical companies are ready to begin making a swine flu vaccine - but as the virus constantly mutates questions abound: How much should be produced? How will it be distributed? Who should get it?

The expert group's recommendations will be passed to WHO Director-General Margaret Chan, who is expected to issue advice to vaccine manufacturers and the World Health Assembly next week.

But some feel the main decision has already been made.

"It's a foregone conclusion," said David Fedson, a vaccines expert and former professor of medicine at the University of Virginia. "If we don't invest in an H1N1 vaccine, then possibly we could have a reappearance of this virus in a mild, moderate, or catastrophic form and we would have absolutely nothing."

Most flu vaccine companies can make only one vaccine at a time: seasonal flu vaccine or pandemic vaccine. Production takes months, and it is impossible to switch halfway through if health officials make a mistake.

Vaccine makers can make limited amounts of both seasonal flu vaccine and pandemic vaccine - though not at the same time.

Seasonal flu kills up to 500,000 people a year. At the moment, health officials aren't sure how deadly swine flu is and whether they will need more seasonal flu vaccine or swine flu vaccine. And if the swine flu mutates, scientists aren't sure how effective a vaccine made now from the current strain will remain.

WHO estimates that up to 2 billion doses of swine flu vaccine could be produced every year, though the first batches wouldn't be available for four to six months.

As of yesterday, at least 33 countries reported more than 6,600 cases of swine flu worldwide, with 69 deaths.


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