Confronting the avian influenza threat: Vaccine development for a potential pandemic

Iain Stephenson*, Karl G. Nicholson, John M. Wood, Maria C. Zambon, Jacqueline M. Katz

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

164 Citations (Scopus)


Sporadic human infection with avian influenza viruses has raised concern that reassortment between human and avian subtypes could generate viruses of pandemic potential. Vaccination is the principal means to combat the impact of influenza. During an influenza pandemic the immune status of the population would differ from that which exists during interpandemic periods. An emerging pandemic virus will create a surge in worldwide vaccine demand and new approaches in immunisation strategies may be needed to ensure optimum protection of unprimed individuals when vaccine antigen may be limited. The manufacture of vaccines from pathogenic avian influenza viruses by traditional methods is not feasible for safety reasons as well as technical issues. Strategies adopted to overcome these issues include the use of reverse genetic systems to generate reassortant strains, the use of baculovirus-expressed haemagglutinin or related non-pathogenic avian influenza strains, and the use of adjuvants to enhance immunogenicity. In clinical trials, conventional surface-antigen influenza virus vaccines produced from avian viruses have proved poorly immunogenic in immunologically naive populations. Adjuvanted or whole-virus preparations may improve immunogenicity and allow sparing of antigen.

Original languageEnglish
Pages (from-to)499-509
Number of pages11
JournalThe Lancet Infectious Diseases
Issue number8
Publication statusPublished - 1 Aug 2004

Bibliographical note

Funding Information:
Iain Stephenson is supported by an appointment to the Emerging Infectious Diseases Fellowship Programme administered by the Association of Public Health Laboratories and funded by the US Centers for Disease Control and Prevention.


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