Science, big pharma, and why we don’t have a universal flu shot yet

A one-jab vaccine that protects you from every strain of the flu for life. It’s the Holy Grail.

Researchers around the world have been working towards it for decades.

Yet – we have nothing, except an annual vaccine that cuts your chances of getting sick by between 30 and 60 per cent.

Which raises the question: why do we continue to fail?

The answer, experts say: because it’s harder to make a universal flu vaccine than it is to put a person on the moon.

And, perhaps, because there is less money in it than you would think.

Ten years ago, University of Adelaide flu researcher Dr Mohammed Alsharifi thought he was 10 years away from developing a universal flu vaccine.

“You publish big papers in big journals, you address the scientific questions, you are done,” he said this week. “And then you try to take it from bench to practice, and all these other issues come in.”

The vaccine works in animals, but his team is still working on how to manufacture at large scale, so it remains on the lab bench.

Dr Alsharifi’s story is a perfect example of the extreme difficulty of manufacturing a universal flu vaccine.

In 2012, there were more than 170 different influenza vaccines undergoing clinical trials around the world. Not a single one of those has turned into a commercially-available vaccine.

“I have a solution,” Dr Alsharifi says. “But to go all the way, it will require a lot of funding. And there is limited funding available – unless you have big pharma on your side.”

A flu virus is covered in jutting proteins called antigens. Our immune system learns the shape of those antigens and produces antibodies to block them.

But the flu’s genetic code mutates constantly. These mutations change the shape of the antigens. This is why you need a new vaccine every year.

That’s not all. The flu’s genetic code is made of eight segments. If two different strains of the flu end up in the body of a single animal, the segments can swap, producing a new virus to which no one is immune – a pandemic strain.

Making a vaccine that can resist both these tricks is harder than putting a man on the moon, says Professor Peter Doherty, who won a Nobel Prize in 1996 for discoveries about the immune system.

“Our immune system is about 350 million years old, and it’s been evolving since then. With a universal vaccine, you have to do better than nature. And that’s tough,” he says.

To one-up nature, Dr Alsharifi’s vaccine – and many others around the world – focuses on T cells, warriors our immune system uses to kill infected cells.

Influenza can mutate, but there are some fundamental bits of itself it can never change. If you could train a T cell to spot those conserved parts, you could build a universal vaccine.

About 400 Australians living on the Sunshine Coast received a T cell flu vaccine in the first step of a clinical trial this flu season. Another T cell vaccine is being designed at the Doherty Institute in Melbourne.

“We are much closer than we were 15 years ago,” says Professor Katherine Kedzierska, head of that effort.

One thing might speed progress: money. More money for research, testing, and manufacturing.

But the companies with the biggest resources – the giants that already make and sell flu virus – have a “huge disincentive to promote or accelerate new technologies and better vaccines,” a group of leading scientists argued in a sceptical 2012 report from the Minnesota-based Centre for Infectious Disease Research and Policy.

It takes years and billions of dollars to develop a universal vaccine. It might only be given once a decade. You’d have to spend billions more setting up new manufacturing facilities.

It makes more economic sense to sell huge numbers of a cheaper vaccine every year, the report argues.

Economic hardheads agree.

“The economic incentive for CSL to develop a universal vaccine… just is not there,” InvestSMART analyist Graham Witcomb wrote in a client note in May. “We do consider a universal vaccine to be a threat to CSL’s vaccine business.”

Seqirus, the arm of CSL that manufactures the flu vaccine, vehemently disagrees. “It’s about as far away from the truth as you flying to the moon,” says the company’s senior vice-president of research, Russell Basser. “If we were sitting on the answer to a universal flu vaccine, we would make a fortune.”

Seqirus have invested in a global project to map the immune system. The map will then help them chart a course to a universal vaccine, Mr Basser said.

It is a one step back, two steps forward approach, but Mr Basser said there was a realisation from leaders in the field there was still so much we don’t understand about the flu or the immune system.

What about the universal flu vaccines undergoing clinical trials right now?

“I wish them well,” Mr Besser said. “I just think it’s not going to be that easy.”