Fedson David S
Hum Vaccin. 2006 Jan-Feb;2(1):38-42. doi: 10.4161/hv.2.1.2554. Epub 2006 Jan 29.
The avian H5N1 virus continues to evolve and poses an imminent pandemic threat. Pandemic vaccine development, however, has progressed slowly. For it to succeed, it must be based on a public health perspective that reflects the arithmetic of pandemic vaccine demand, especially by countries without vaccine companies. Clinical trials of H5N1 vaccines have been discouraging, and we must understand why the H5N1 virus is so poorly immunogenic. Antigen-sparing pandemic vaccines will be required, and future trials must identify the most effective adjuvant and determine whether whole virus vaccines will be needed. Problems related to intellectual property and concerns about several regulatory issues must be resolved. Public funding for clinical trials must be provided and firm leadership and coordination exercised by national and international (WHO) public health officials. Vaccination for an imminent pandemic requires a global perspective not only for vaccine development but also for vaccine production and distribution.
禽流感H5N1病毒持续演变，构成迫在眉睫的大流行威胁。然而，大流行疫苗的研发进展缓慢。要取得成功，必须基于公共卫生视角，这要反映大流行疫苗需求的计算方法，尤其是没有疫苗生产企业的国家的需求。H5N1疫苗的临床试验结果令人沮丧，我们必须明白为何H5N1病毒的免疫原性如此之低。将需要节约抗原的大流行疫苗，未来的试验必须确定最有效的佐剂，并确定是否需要全病毒疫苗。与知识产权相关的问题以及对若干监管问题的担忧必须得到解决。必须为临床试验提供公共资金，并由国家和国际（世卫组织）公共卫生官员坚定地发挥领导作用并进行协调。针对即将到来的大流行进行疫苗接种不仅在疫苗研发方面，而且在疫苗生产和分发方面都需要全球视角。
