The almost overnight public concern and media attention over the swine flu outbreak has again turned the attention to pandemic preparedness. Officials continue to encourage preventive actions and precautions, noting that, as of yet, it is still unknown whether current vaccines and antivirals will have any effect against the strain responsible for this outbreak. It is also unknown whether those who received a vaccination during the 1976 US swine flu outbreak will have some protection against the current strain.

There are many questions regarding the outbreak, and there has been pressure on the industry to provide a response. Early focus has been antiviral makers Roche (maker of Tamiflu) and Glaxo (maker of Relenza). With the Department of Homeland Security’s declaration of a national public health emergency, however, the Department of Health and Human Services has been authorized to take rapid action, including the release of 12.5 million courses of Tamiflu from the nation’s stockpile of 50 million.

But will the existence of antivirals derail efforts to start a vaccination program? What will happen if the current viral strain becomes resistant to antivirals? And what about the added burden on vaccine makers to develop vaccines capable of inoculating against drug-resistant strains in addition to the original strain? Does the industry have sufficient capacity to work on a swine flu vaccine in addition to its current campaigns? (The most recent reports claim Novartis has started work on a vaccine based on the genetic code. But without the actual virus in its laboratories, there will be delay before a true vaccine is developed. Even then, the company reportedly will only scale-up production in the case of an actual pandemic.)

The industry has learned much after the seasonal influenza vaccine shortage a few years ago and the ongoing (yet not as rapid) spread of avian influenza infection. Attention has focused on the need to move toward faster, more controlled production methods. Does a too-early response and release of an antiviral that may have some effect on the current outbreak jeopardize these efforts?