Prospects for controlling future pandemics of influenza.

Pandemic influenza remains one of the most serious threats to global public health and continued global vigilance to monitor emerging threats is crucial. Of the weapons available to control a pandemic, vaccination is potentially the most powerful, but there are currently serious limitations to timely availability of vaccine supply in an emergency. Many novel influenza vaccines are in development, some of which have the potential to deliver the massive quantities of vaccine that would be required in a pandemic in a short period of time. However, for the foreseeable future, it is likely that the principal vaccine that will be deployed in a pandemic will be an inactivated egg-derived vaccine of the kind that has been available for several decades. This review will focus on the practical hurdles that need to be surmounted to deliver large amounts of safe and effective pandemic vaccine to the general public. There needs to be a continued focus on improvement to the vaccine response system that will require close collaboration between influenza and vaccine experts, manufacturers, regulators and public health authorities around the world.