For most illnesses,
a vaccine is an almost guaranteed lifeline.
But influenza is different.
We have a very good measles vaccine.
We have a very good rubella vaccine,
very good mumps vaccine.
All of these viruses in the population haven't changed
over the last 50, 60, 70 years.
In contrast, influenza changes every year.
The World Health Organization
estimates that influenza infects 1 billion of us every year;
causing up to 650,000 deaths worldwide.
Vaccines are critical,
but they're only around 50% effective
because they don't fight every strain of flu.
So scientists around the world are searching for a shot
that fights different strains of the virus
including some that might not even exist yet.
It's really very exciting,
because you know that you're working for something good
that may change the whole world
and the health of many people.
This breakthrough will give us lasting protection
against influenza, but it might also help us understand
how we get there with other viruses too.
Difficulty breathing, highly contagious,
returning year after year.
Hippocrates first described influenza in 412 BC.
Since then, the virus has caused annual epidemics.
Most notably the Spanish flu in 1918
that killed an estimated 50 to 100 million people worldwide
and changed the world in ways
that seem all too familiar today.
1918, when the influenza H1N1 showed up,
was during a period of a lot of problems
in the United States at the time.
World War I was ongoing at that time,
there was a lot of movement from rural areas into cities.
So at the time we didn't even know it was a virus.
Viruses were kinda still being figured out at the time.
So it really was not until the 1930s,
that we knew the cause of the 1918 pandemic
and then subsequently the seasonal epidemics
that we would have every winter
that they realized that was actually due to a virus.
And so from the '30s,
it wasn't really until the late 1940s and 1950s
that actual vaccines were being used more regularly.
Even though there are just three basic types of flu,
A, B and C; type A which is the most dangerous for humans,
has a surface covered in two main proteins, H and N.
There are 18 different types of H protein
and 11 types of N protein.
And they combine to create up to 198 influenza subtypes
including ones like H3N2 and H1N1.
The influenza virus is constantly changing.
And so if you look at a virus,
on the inside of the virus are the genes,
and genes are just the recipe,
the instructions for making more copies of itself.
So if somebody sneezes or coughs,
and you happen to breathe that in,
those viruses that are in those respiratory droplets
go to the back of your throat
they grab on to the respiratory cells that are there.
They push themselves into the cells
and then release those genes that are in there.
Those genes, it's not one long string of instructions,
it's eight separate strings of instruction.
And so there's so much opportunity for that virus to mess up
in terms of making copies of itself.
It's not a very good editor.
It really doesn't have good quality control.
In one way, that's bad for the virus
beause it makes copies of itself that may not even live on,
they don't even reproduce.
But it also means that it can find ways
to get around your own immunity,
and ways to get around vaccines that are being used.
to get around antiviral drugs as well.
This genetic shape-shifting,
is known as antigenic drift.
And means that our body can't always recognize the virus,
even if we've caught it or been vaccinated before.
But scientists at pharmaceutical company BiondVax,
have worked for almost three decades creating a vaccine
which targets parts of the virus that don't change.
All influenza virus are different in their appearance
but they are still considered as influenza
because they have a lot in common.
And what the immune system wants to do it,
they want to recognize the virus and to attack it
when it enters the body.
So we have to teach the immune system
how the virus looks like.
So what we thought will be more effective
and to have a universal vaccine,
is to show the immune system and teach it
to recognize the conserved and common denominator
of all influenza viruses.
So we constructed a vaccine, it is called M-001.
It contains nine such conserved regions
from the influenza virus.
Variations between influenza viruses,
usually happen on the surface.
But dig a little deeper,
and there are similarities in its peptides;
short strings of amino acids
that are responsible for how the virus functions.
M-001 is made up of nine different peptides
that our immune system can learn to recognize
and fight off in the future.
One of the peptides that we selected in our vaccine
is very close to the point where the virus
is entering the cells.
So it's like a key and the lock.
Where the key is on the side of the virus,
and the lock is the entrance to our cells.
And if the virus wants to enter the cell
and cause the disease, it enter its key into the lock,
opens it, and the disease starts to develop.
So by our vaccine, we block this key
and the virus cannot anymore enter into the cell
and we prevent the disease.
So M-001 is in phase three clinical trials.
Are you feeling nervous about the results?
Of course, I'm worried all the time.
I hardly breathe
until we get the outcomes
of our pivotal phase three trial
which is a trial was over 12,000 participants
that was conducted in Europe.
In this trial, we injected half of the participants
with our vaccine,
and the other half received placebo, which was a saline.
And at the end of the trial,
which means at the end of this month,
we'll know how many participants
were ill in the experimental group
that was immunized with our vaccine, and how many were ill
in the control group that actually was not immunized.
And if the difference would be high enough,
then our vaccine works and then we're happy.
We will know if it is safe,
if it is protective against influenza.
A universal vaccine, like M-001,
would radically change the way we make our flu shots.
Currently, for Northern Hemisphere vaccines,
every February WHO picks four strains of influenza
which scientists predict
will most likely be circulating in October,
the start of the flu season.
This vaccine recipe is sent out to manufacturers
and the majority of vaccines
are made just like back in the 40s,
by injecting the vaccine virus into fertilized eggs.
It takes at least six months
to produce the high quantities we need.
So we have to really base
on what happened two months before February,
but we are not really good at that, unfortunately.
Dr. Peter Palese is a microbiologist,
who built the first genetic map of the influenza virus
back in the '70s.
The yearly influenza vaccine,
I think is underappreciated, underutilized.
So I think there is a benefit in taking the vaccine,
because even if you get the flu, it was a failure
but your disease morbidity is much lower.
Clearly, I think I want to encourage your listeners
to take the current vaccine,
the current influenza virus vaccine,
as an insurance against whatever might happen, yeah.
So it is a very safe vaccine.
I think it is a very good vaccine.
Having said that, if we want to make a better vaccine,
we have to show that it is at least
as good as the current vaccine.
But also that it really preempts
or knows what the other strains in year three,
four or five from now, will be.
And also the potential new pandemic strains.
Dr. Palese's team is also part of the race
to create a universal vaccine.
Like BiondVax, they're using an area of influenza
that that doesn't mutate.
The stem of the H protein on the surface of the virus.
We are redirecting the immune system
towards these conserved regions.
And I have to say, I can protect any animal,
whether it's a mouse, whether it's a ferret,
whether it's a guinea pig against any strain.
So using these constructs
which present the conserved domain of the virus,
it works beautifully in animals.
But remember, mice are not man, ferrets are not humans.
I think we make progress, but it is still not there.
And I can't promise you that it will be two years
or three years; we cannot really predict
how long it will take
that we will have such a universal influenza virus vaccine.
With disappointing results
in the M-001 phase three trials,
the wait will be longer than some had hoped.
But the research and time that's been invested
isn't wasted, far from it.
Could the work we're doing
to find a universal flu vaccine help in the way
that we tackle viruses like Covid-19?
Absolutely the other way around too.
And so the work that now with significant resources
and speed being put into Covid right now,
could have a significant impact on flu vaccine choices.
If you have a system in place
where you can make those kinds of vaccines fast,
as soon as you see an emerging, a pandemic influenza,
you can start making vaccine immediately,
so faster vaccines.
And so I think we'll learn a lot about that
with the Covid vaccines as well.
So all of that together, we would love to see
what we're learning with Covid, be applied to flu.
Because what we're doing right now with COVID
is highly informed by what we were doing
with flu previously.
What would be the next steps
if we got a universal vaccine?
What would be wonderful, is to get to that place
where flu vaccines aren't something
that are just for middle and higher income countries.
That low and middle income countries globally
have a significant impact of flu every year.
But a program to vaccinate children and adults every year
in a country with billions of people,
is really complicated and can be pretty expensive.
Coming up with a simple solution
that can be rolled out in a programmatic way
where it's cost effective for that country to do it,
would have a significant impact
for a better functioning country.