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Fears of coronavirus second wave prompt flu push at U.S. pharmacies, drugmakers – Reuters

NEW YORK (Reuters) – U.S. pharmacy chains are preparing a big push for flu vaccinations when the season kicks off in October, hoping to curb tens of thousands of serious cases that could coincide with a second wave of coronavirus infections.

FILE PHOTO: A nurse displays a flu vaccine at a free medical and dental health clinic in Los Angeles, California, U.S., April 27, 2016. REUTERS/Lucy Nicholson

CVS Health Corp (CVS.N), one of the largest U.S. pharmacies, said it is working to ensure it has vaccine doses available for an anticipated surge in customers seeking shots to protect against seasonal influenza.

Rival chain Rite Aid Corp (RAD.N) has ordered 40 percent more vaccine doses to meet the expected demand. Walmart Inc (WMT.N) and Walgreens Boots Alliance (WBA.O) said they also are expecting more Americans to seek these shots.

Drugmakers are ramping up to meet the demand. Australian vaccine maker CSL Ltd’s (CSL.AX) Seqirus said demand from customers has increased by 10 percent. British-based GlaxoSmithKline (GLAX.NS) said it is ready to increase manufacturing as needed.

Pharmacy shares rose in Tuesday trading, with CVS up 2.5% and Rite Aid and Walgreens up 4.5%.

A Reuters/Ipsos poll of 4,428 adults conducted May 13-19 found that about 60 percent of U.S. adults plan to get the flu vaccine in the fall. Typically fewer than half of Americans get vaccinated. The U.S. Centers for Disease Control and Prevention (CDC) recommends the vaccine for everyone over age 6 months.

Getting a flu shot does not protect against COVID-19, the respiratory disease caused by the novel coronavirus for which there are no approved vaccines. Public health officials have said vaccination against the flu will be critical to help prevent hospitals from becoming overwhelmed with flu and COVID-19 patients.

“We’re in for a double-barreled assault this fall and winter with flu and COVID. Flu is the one you can do something about,” Vanderbilt University Medical Center infectious disease expert Dr. William Schaffner said.

Drugmakers last year produced nearly 170 million doses of influenza vaccine, according to the CDC. There were up to 740,000 hospitalizations and 62,000 deaths in the 2019-2020 flu season that ended last month, the CDC said.

While health insurance typically covers the flu shot at a doctor’s office and other groups offer free flu vaccine clinics, the adult vaccine retails for about $40.

Global revenue for influenza vaccines is about $5 billion, according to Wall Street firm Bernstein, and in the United States each additional 1 percentage point of Americans getting the vaccine is worth $75 million in revenues to drugmakers.

HEAVIER TOLL

CDC Director Robert Redfield has said that flu and COVID-19 combined could exact a heavier toll on Americans than the initial coronavirus outbreak that began this winter.

Some experts said creative ways must be developed to ensure that people are vaccinated against flu because patients may be less likely to see their doctors in person out of fear of getting infected with the coronavirus in medical offices.

Pharmacies, public health clinics and other flu shot providers may need to develop drive-up clinics – popular with COVID-19 diagnostic tests – for flu vaccines, said Dr. Nancy Messonnier, director of the CDC’s National Center for Immunization and Respiratory Disease.

“My goal is that every single vaccine dose that gets made gets into somebody’s arm to protect them. I don’t want any vaccines left on the shelves or in doctors’ offices,” Messonnier said in an interview.

One reason for reluctance among Americans to get the flu shot is that it does not always prevent disease, in part because the flu strains selected as targets of the vaccine months ahead of time are not always a perfect match for the dominant flu strains that actually circulate in any given season. But the shots reliably reduce hospitalizations every year, according to experts.

“Even if it protects 35 to 40 percent of the population, it’s a lot better than zero,” University of Minnesota influenza expert Dr. Michael Osterholm said.

In a survey commissioned by CVS Health between January and May, consumers who said they will definitely or are likely to get a flu shot rose from 34 percent to 65 percent. They also said they would increasingly go to pharmacies and less often to a doctor’s office or healthcare centers.

Rite Aid Chief Pharmacy Officer Jocelyn Konrad said the pharmacy chain, which provided about 2.6 million flu shots last year, upped its order by 40 percent this year.

Rite Aid said social distancing policies may cut into workplace flu clinics but that it may offer voucher programs to employers and is considering setting up drive-through clinics. In Australia, where the winter flu season is underway, such sites are already in use.

Some U.S. doctors are also considering clinics in parks and community centers and even home visits for vulnerable patients, said David Ross, vice president of commercial operations for North America at Seqirus.

“As we look at immunization this coming fall, it will play an enormous role in this battle against COVID-19,” Ross said.

Reporting by Caroline Humer in New York and Julie Steenhuysen in Chicago; Additional reporting by Grant Smith in New York; Editing by Michele Gershberg and Will Dunham

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Fears Trump

Fears rise that Trump will incite a global vaccine brawl – msnNOW

“You would think that, based on the past, that the U.S. would be a galvanizing, lead element in pushing for transparency and early planning” on the vaccine front, said Stephen Morrison, who runs a global health program at the Center for Strategic and International Studies. “I don’t think that’s true in this administration.”

A European ambassador said he and his colleagues remain “hopeful” that the United States will take the lead on ensuring fair global vaccine access. “But we are a bit skeptical at the moment,” he said, “because we don’t see the forthcoming attitude that we’ve seen in the past.”

One disputed report in particular is driving much of the angst: that the Trump administration tried to acquire exclusive rights to the coronavirus vaccine business of CureVac, a German-based company. Trump aides and CureVac officials adamantly denied the mid-March report, but German officials confirmed and condemned it.

The U.S. is planning an intense push to create a vaccine and have enough doses available to cover most Americans by the end of this year, the president confirmed this week. The project is called “Operation Warp Speed,” according to Bloomberg News and other media reports, which described it as an effort to compress the usual process for developing a vaccine into a shorter timeline.

Asked about the project Thursday, Trump said he was in charge of it and that he was not overpromising. “Whatever the maximum is, whatever you can humanly do, we’re going to have,” the president said.

Health officials and analysts caution that it’s too early to go into full-fledged panic about a looming global vaccine fistfight.

An acceptable vaccine could be at least a year to 18 months away; companies across the world, especially in the United States, Europe and China, are in the hunt to find a vaccine, and some trials are already underway. Some diplomats carefully pointed out that by the time vaccines are ready for sale and distribution, Trump may no longer be president, and his “America First” ideas may be shunted aside.

“You have the election in six months’ time — you never know,” an Asian diplomat told POLITICO.

But further blurring the picture is the fact that the global health infrastructure isn’t entirely under the thumb of any one government. It’s a complex amalgam of government bodies, private companies, NGOs, foundations and multilateral partnerships that at times do overlapping work.

There’s no binding treaty or other mechanism that governs how a vaccine will be produced and distributed worldwide. And while the World Health Organization has for decades offered a forum for coordination, discussion and standard-setting, its authority is still limited, including when it comes to private companies with profit motives.

Trump has also dealt a blow to the WHO by recently pausing America’s substantial funding for it. He alleges that the U.N. body effectively helped China cover up the extent of the crisis when the virus first emerged in the Chinese city of Wuhan last year. The WHO’s supporters say Trump is trying to deflect attention from his own downplaying of the crisis early on.

But the growing U.S. hostility to the WHO is hardly the only obstacle to international coordination on a vaccine rollout: China likewise did not express support last month for a new global partnership to coordinate research and development for vaccines, tests and coronavirus cures. The absence of the two pharma powerhouses from the April 24 gathering, led in part by the WHO, disappointed European leaders, who are pushing for a cooperative approach. French President Emmanuel Macron said he hoped they could “reconcile this initiative with China and the U.S.”

Officials involved in the April 24 gathering as well as Monday’s planned EU-led conference stress that there is an American presence in such events even if the U.S. government itself doesn’t formally take part. A number of foundations, companies and others playing a role are U.S.-based.

“There is a strong American footprint in the whole construction,” European Commission President Ursula von der Leyen said about Monday’s gathering in an interview with France 24. “We have a lot of American scientists and philanthropists that are working with us in this global framework we’ve created. The government of the United States is informed. And I hope they consider to participate.”

Asked about the Trump administration’s participation and plans for future international coordination on vaccines, a spokesperson for the U.S. State Department offered a vague comment that attacked the WHO.

“America’s world-leading scientists are working hard on a Covid-19 vaccine,” the spokesperson said. “We welcome serious efforts to assist in that endeavor and look forward to learning more about the World Health Organization’s proposal. We remain deeply concerned about the WHO’s effectiveness, given that its gross failures helped fuel the current pandemic.”

Spokespersons for the White House and the Department of Health and Human Services did not offer comment.

The United States has historically been a leader in global vaccine initiatives, often footing much of the bill. Its interest dates back decades and covers successful efforts to eradicate or dramatically constrain diseases such as smallpox, polio and measles. The focus has often been on vaccinating children so that they never fall ill and over time contribute to what’s known as “herd immunity” in their broader communities.

But infectious disease crises that have arisen in more recent years have exposed weaknesses in a system that relies so much on goodwill and benevolence, rather than any particular set of international rules.

For example, the rise in 2009 of an H1N1 novel influenza led wealthier nations to put in large advanced orders for a vaccine and buy most of what was eventually manufactured, angering developing countries who lacked similar funds. The WHO and others managed to secure pledges of donations for the poorer countries, but even those were limited, according to research posted by the National Center for Biotechnology Information.

The Covid-19 crisis is in many ways more severe, with infections in more than 180 countries. Aside from the vaccine issue, it has exposed the frailty of global cooperation in other ways. Efforts to work together at the G-7, G-20 and United Nations level have had limited impact amid finger-pointing between Washington and Beijing.

It’s not just the U.S. that has put the needs of its own citizens first. Dozens of countries, including the U.S. and some in Europe, have imposed travel restrictions as well as limits on the exports of masks and other critical medical equipment.

Global health leaders are trying to avoid a repeat of such nationalist tactics when it comes to vaccines and other types of medicines that could combat Covid-19. They warn in particular that leaving the virus to fester in one country could, simply due to migration patterns, mean it will re-emerge elsewhere. And they say that a globally coordinated approach to distributing a vaccine — prioritizing at-risk populations, for instance — would yield better results.

Melinda Gates told POLITICO in an interview that medical workers should be at the head of the line for vaccinations because of their regular exposure to the virus. She also praised European leaders for being out in front in coordinating on vaccines and therapeutics.

“It’s the European leaders, quite honestly, who understand that we need global cooperation,” she said.

National security officials and public health experts also are increasingly concerned about the prospect of China developing a vaccine first, and how America’s unwillingness to take charge of global vaccine coordination might help both China’s economy and its propaganda efforts.

“China does have a head start” in the global effort to come up with a vaccine, said one national security official who spoke on condition of anonymity to discuss U.S. government concerns. “But they also have a pattern of theft and trying to steal everyone else’s research. So you would think they’d be very benevolent [with the vaccine] so as not to be seen as a pariah.”

A spike in hacking attempts on U.S. hospitals and labs, which intelligence and national security officials have attributed primarily to China, is a sign of how high the stakes are for the Chinese government — especially as it attempts to repair its reputation amid accusations that it covered up the origins and severity of the novel coronavirus late last year.

“They know that whoever finds a workable vaccine right now basically rules the world,” said another national security official.

The propaganda coup alone is a strong incentive, experts said. But the economic and diplomatic implications of being the first to develop a vaccine, especially if the U.S. continues to retreat, would be enormous for the Chinese Communist Party.

Being able to vaccinate its own population first, for example, would serve as a strong “economic rudder” for China and allow it to fully open its economy to global companies, said Dr. Ross McKinney, Jr., the chief scientific officer at the Association of American Medical Colleges.

It would also yield diplomatic leverage, said Matt Kroenig, a former Pentagon and CIA official who now serves as deputy director at the Atlantic Council’s Scowcroft Center.

“Often, Chinese offers of aid come with strings attached,” said Kroenig, whose new book examines American power competition with China. “So they could use it as a way to try to increase their influence and further push out the U.S.”

But the question remains of whether the world would even trust a vaccine produced by China, Kroenig noted, given the recent episodes of China delivering faulty medical equipment to Europe.

“One of the great advantages the U.S. has in this competition is that we have these 30 formal treaty allies with leading scientific research communities,” Kroenig said. “So we could and should be doing a much better job of galvanizing allies and bringing them together” on the vaccine issue.

Having perceived a void in U.S. leadership in this area, the Atlantic Council convened an “allied town hall” on Tuesday to discuss how the U.S. and its allies could better cooperate on vaccine development — but the fact that a think tank, rather than the Trump administration, organized the event only drove the point home for some attendees that the U.S. is not positioning itself as a leader in this space.

Meanwhile, as their governments have been sparring, American and Chinese scientists have actually been cooperating on Covid-19 research. Researchers in the U.S. and China have co-authored about 407 papers on coronavirus this year, according to data compiled by Axios, and Pennsylvania-based Inovio Pharmaceuticals announced in January that it was collaborating with Beijing Advaccine Biotechnology Co. on a Covid-19 vaccine.

Such collaboration can be positive “as long as the information flows both ways,” said McKinney, of the AAMC. “But we’ve been finding that the information does not always flow both ways. So there is some asymmetry going on with regard to the research efforts that I think is the worry.”

Other joint U.S.-China research efforts have spawned mistrust: The Trump administration recently cut off grant funding to an American NGO that had been working with Chinese scientists at a lab in Wuhan, China, that some in the Trump administration suspect was responsible for unleashing the virus on the world.

Some officials and diplomats argue that instead of waiting for Washington and Beijing to cooperate on a vaccine, it’s better to work with those who are willing to cooperate now, while leaving the door open for the U.S. and China to join later.

“We can be in the camp of those who say without the U.S. and without China it’s useless, and we give up and we wait for the vaccine to maybe come one day, or we take action and find our third way,” a French official said.

Jillian Deutsch, Rym Momtaz and Sarah Wheaton contributed to this report.

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