Researchers chase a better fix for the seasonal flu
MEGAN THOMPSON: Shannon Zwanziger was a healthy, 17-year-old high school senior growing up in the southern Minnesota town of Owatonna.
TERRY ZWANZIGER: Beautiful eyes.
Her parents, Gwen and Terry, say she loved skateboarding and playing video games. She wanted to become an artist one day.
TERRY ZWANZIGER: She was young, oh what just ninth grade when she did that…
MEGAN THOMPSON: One day three years ago, Shannon came home from school complaining she felt sick.
TERRY ZWANZIGER: She says I just feel horrible. I got a sore throat.
MEGAN THOMPSON: After four days, Terry took her to the emergency room. The doctor said Shannon had influenza or the flu.
TERRY ZWANZIGER: And he said, 'You just have to ride it out, you know. Go home.'
GWEN ZWANZIGER: Let it run its course.
TERRY ZWANZIGER: Yeah, 'Let it run its course,' that's what he told me.
TERRY ZWANZIGER: We were sitting in the emergency room down there waiting to be seen. Her mom called. So I told her I got to you know took a picture of her, and said I'm taking care of her. That's the last one we have.
MEGAN THOMPSON: Back home, a day-and-a-half later, Gwen was with Shannon when she lost consciousness.
GWEN ZWANZIGER: I knocked on the wall and yelled for Terry to wake up. And then, I laid her down on the floor right here, and Terry came down and called 911.
MEGAN THOMPSON: Paramedics flew Shannon to the Mayo Clinic in Rochester, about 40 miles away. But it was too late. The flu had destroyed her organs.
GWEN ZWANZIGER: We had every reason to believe that she was gonna come back to us.
TERRY ZWANZIGER: Yeah, uh-huh.
GWEN ZWANZIGER: I mean, I had never heard that the flu would kill somebody like her.
MEGAN THOMPSON: Shannon was one of 148 children in the US killed that season by the flu. The number of children who die ranges widely from 37 in 2011 to a high of 288 during the Swine Flu outbreak in 2009. The flu and complications from it kill another 12-to-56 thousand Americans every year — mostly those 65 and older. Between 9 and 60 million Americans get the flu every year costing 10 billion dollars in doctor visits, hospitalizations, and medication.
The Centers for Disease Control and Prevention recommends that everyone older than 6 months get the annual flu shot. Shannon Zwanziger chose not to 2014, but the vaccine was only 19 percent effective that year, so it might not have mattered anyway. And that's the big problem with flu vaccines, says Doctor Anthony Fauci, head of the Infectious Disease division of the National Institutes of Health.
DR. ANTHONY FAUCI: This right here is the influenza virus
MEGAN THOMPSON: the challenge is there are many strains of the virus and they mutate often.
DR. ANTHONY FAUCI: Every year you have to reevaluate whether the vaccine that you made for the prior year is actually now matched to the virus that you predict will be circulating in the coming year. That's totally unique. You don't have to worry about that with polio or with mumps or with measles or anything like that.
MEGAN THOMPSON: Every spring, the CDC and the World Health Organization look at the flu strains circulating in the southern hemisphere to predict which strains might hit the north the next winter. The most common process of manufacturing vaccines- growing them in eggs- has been used for decades and takes about six months.
DR. ANTHONY FAUCI: That's a long time. And that's one of the reasons why it's crying out for us to do something a little bit different. Because once you start it, you hit the gong and you say, 'Go, we're gonna start making a vaccine,' it's very difficult to stop in mid-stream and say, 'Oops, I think we got it wrong.'
MEGAN THOMPSON: Because the many strains can change so quickly, the flu vaccine is only around 20 to 60 percent effective. This compared to the once-a-lifetime polio vaccine, which is 90-100 percent effective, or the measles vaccine which is 93-97 percent effective.
MEGAN THOMPSON: That's why dozens of teams at the NIH in Maryland, across the country and around the world are trying to develop a so-called "universal" flu vaccine, one that would protect against many strains and could last a decade or more.
Microbiologist Peter Palese is leading the research at Mount Sinai's Icahn School of Medicine in New York.
PETER PALESE: Many vaccines are long-lasting, such as measles, mumps, rubella. They're given once, and then, they're we are protected for life. And we hope that we have something similar now for influenza viruses.
MEGAN THOMPSON: As Palese explains, the outside of the flu virus is covered in proteins that look kind of like a lollipop. The top is called the head, and the bottom, the stalk. The head is the part of the virus that the body's immune system tries to fight off and builds an immune response to. It's also the part that changes constantly.
PETER PALESE: The problem is that, two years later from today, when I get infected again, the virus has changed so that my immune response is not effective anymore.
MEGAN THOMPSON: Palese has figured out a way to make a virus with a head that the human immune system just ignores, so instead it fights off the stalk, the part that doesn't change much.
PETER PALESE: So, we want to redirect the immune system to make a protective immune response against the portions of the virus and the areas of the virus which are not changing.
MEGAN THOMPSON: Palese's vaccine is now in the first phase of testing in humans, supported by funding from the gates foundation and the pharmaceutical company GlaxoSmithKline, one of the main producers of the annual vaccine.
Anthony Fauci's research team at the National Institutes of Health has two vaccines, one already in human trials, while a team at Oxford University in England is testing another. The hope is, someone will get there within the decade.
DR. ANTHONY FAUCI: When people ask me, and I get asked this all the time, "What keeps you up at night regarding an infectious disease outbreak?" Clearly very high up there in that short list is another pandemic influenza.
That also worries Michael Osterholm, an epidemiologist and head of the Center for Infectious Disease Research and Policy at the University of Minnesota.
MICHAEL OSTERHOLM: Seasonal flu is the one we deal with all the time, but pandemics is a flu that frankly is the one that scares the hell out of us.
MEGAN THOMPSON: A pandemic flu is a strain that usually jumps from an animal — often a pig or a bird — to a human…a new strain for which humans have no prior immunity. Osterholm says the risk of a pandemic may be increasing, because meat consumption is growing worldwide, and more people are in contact with poultry and pigs.
MICHAEL OSTERHOLM: When pandemic flu hits, it's one where everyone is vulnerable. Everyone's susceptible.
MEGAN THOMPSON: The worst flu pandemic, in 1918, killed an estimated 50 million people worldwide. Compared to other diseases, the flu is easily transmitted, by just a cough or sneeze. Osterholm warns, when- not if- a flu pandemic hits again, the toll could be much worse.
MICHAEL OSTERHOLM: Today, we see millions of people going around the world every day on airplanes, and with that, they can spread the virus very quickly, and unbeknownst to them that they might be infected, spread very quickly.
MEGAN THOMPSON: Osterholm is optimistic about a universal flu vaccine. But he estimates the US government is spending only around 35 million dollars a year to find one, compared to around a billion dollars finding a vaccine for HIV, which causes AIDS.
MICHAEL OSTERHOLM: I wouldn't cut that. But it shows the world's lack of understanding of just how critical this flu issue is.
MEGAN THOMPSON: Osterholm also says completing the trials and getting the vaccine to market will cost about a billion dollars… and he's skeptical the pharmaceutical companies will take the financial risk.
MICHAEL OSTERHOLM: When we look at the vaccine area, this is not an area of high profits. The industry has no appetite for that right now, unless there's assurances of support throughout the process and that there's a market at the end of it. There is no market at the end of the rainbow, so why even try to climb on the rainbow to begin with?
MEGAN THOMPSON: A handful of major pharmaceutical companies are supporting universal flu vaccine research now, including GlaxoSmithKline, the third-largest flu shot maker. So is Janssen, a division of Johnson & Johnson. Dozens of biotech firms are exploring universal vaccines, too.
Anthony Fauci believes if the government can help identify a promising vaccine, a pharmaceutical company will take it on. But he admits the government is not funding universal flu vaccine research at the levels it funds research on other diseases.
MEGAN THOMPSON: There's a big disparity there.
DR. ANTHONY FAUCI: Right.
MEGAN THOMPSON: How do we address that?
DR. ANTHONY FAUCI: Well it is always much more difficult to get funding for something that has not yet happened, even though you know sooner or later it will happen, it's a challenge and it's frustrating. Particularly if you know deep down that– that we're probably making a mistake by not addressing something.
MEGAN THOMPSON: So we're making a mistake right now you're saying?
DR. ANTHONY FAUCI: Well, I think that we're not appreciating the opportunity to create a vaccine that could save a lot of money and prevent a lot of sickness and death.
MEGAN THOMPSON: Fauci says he is developing a new strategic plan for the universal flu vaccine that will launch next year. And he vowed to devote more NIH dollars to the cause.
DR. ANTHONY FAUCI: So what I will have to do, and I will do it, I've already made the commitment, is internally reprioritize and say, "This clearly is something whose time has come. And we've gotta really push the envelope on that." And that's what we're gonna do.
MEGAN THOMPSON: And that's welcome news to Gwen and Terry Zwanziger. Today, Gwen calls herself a "disease warrior," talking and writing about her daughter Shannon's death to increase awareness about the flu. She and terry remind everyone they know to wash their hands, cover their coughs, and get the annual vaccine.
GWEN ZWANZIGER: We can't help them make a vaccine, but we can help make people aware.
TERRY ZWANZIGER: Everything was fine, and then, four days later, we lost a daughter.
GWEN ZWANZIGER: Just your average person doing your average day. And then, you die.
TERRY ZWANZIGER: Over flu, yeah.