Following the emergence of bovine influenza attributed to H5N1 infection and with three documented cases of conjunctivitis among dairy herd workers, health authorities are reevaluating risk of H5N1 infection in human populations.  There is a move towards vaccinating at-risk individuals including poultry and dairy workers, veterinarians, lab technicians and those coming into contact with dairy herds and poultry flocks.

In the U.S., vaccine stored at CSL Seqirus Inc. of North Carolina can be filled to provide close to 5 million doses of vaccine.  In Canada health officials are collaborating with GSK a multinational manufacturer of biologics in bulk to prepare an avian influenza vaccine in addition to seasonal influenza doses.

Dr. Matthew Miller co-director of the Canadian Pandemic Preparedness Hub at McMaster University stated, “All of our efforts need to be focused on preventing these events from happening.”  He added, “Once we have widespread infection of humans we will be in big trouble.”  Dr. Dawn O’Connell of the U.S. Administration for Strategic Preparedness and Response stated that the Federal government is examining the possibility of vaccinating farm workers and others in close contact with the virus.

In the U.K., pre-pandemic vaccine administration is under consideration according to Dr. Wendy Barclay, Chair in Influenza Virology at the University College London.

The European Commission Health Emergency Preparedness and Response Authority is working on procurement of CSL Seqirus vaccine to “potentially prevent a pandemic” as a result of infection of workers exposed to infected flocks and herds.

Pfizer and Moderna with extensive experience with mRNA vaccine technology as used against COVID have been approached to develop vaccines effective against H5N1.

Dr. Nirav Shah, Deputy Director of the U.S. Centers for Disease Control and Prevention noted, “The decision on how and when to use the vaccine will hinge on evidence of increased transmission, severity of the disease, cases in people with no link to a dairy or poultry farm and mutations in the virus”.

Reference laboratories worldwide including the Erasmus Medical Center in Rotterdam are closely evaluating the genetic sequences of isolates to determine if any mutations have emerged that could predict infection among humans.  Local surveillance and routine control measures are followed in many countries. The World Health Organization cooperating with member states to monitor the prevalence and distribution of H5N1 in other than avian species.

Downplaying incident cases of bovine influenza-H5N1 and obstruction of surveillance among workers is institutional denialism. Although the emergence of a contagious human strain is extremely remote at present, an adverse outcome would have profound health and cost implications.  For the benefit of the Commissioner of Agriculture of a Southwestern state with multiple affected herds it is not what we know that will cause harm it is what we don’t know!