As the U.S. government sinks billions of dollars into developing vaccine technologies, U.S. researchers said Friday that younger, healthier people should receive inoculations before the elderly, should an influenza pandemic hit.

In case an influenza pandemic sweeps across the U.S., the government has a recommended hierarchy of who should receive vaccines.

But the plan should be altered, putting younger, more able-bodied folks before the elderly, wrote Ezekiel Emanuel, chair of the department of clinical bioethics at the National Institutes of Health, in Friday’s issue of Science.

As it stands now, vaccine workers, healthcare providers, and then ill senior citizens are at the top. At the very bottom, even after embalmers, are healthy people between two and 64 years of age.

The current rationale is in part based on the save-the-most lives principle, which aims to support the continued life-saving efforts of healthcare workers. It also works to curb the high rates of hospitalization and dying by vaccinating the elderly, wrote Mr. Emanuel and his co-author Alan Wertheimer.

But the two authors suggest another scenario. They propose putting people between 13 and 40 years of age ahead of the elderly.

“Death seems more tragic when a child or young adult dies than an elderly person—not because the lives of older people are less valuable, but because the younger person has not had the opportunity to live and develop through stages,” wrote the authors.

But that’s not the only reason. Their decision weighs the fragile balance between the amount a person has invested in his or her life, and the amount left to live. It also prioritizes the group that is able to help ensure public safety by working to meet basic survival needs like food.

Tragically, such a plan needs to be heavily debated. Currently vaccine manufacturing is far from capable of producing enough inoculations to protect the masses. As it stands now, the authors suggest more than 90 percent of the U.S. population will not be vaccinated in the first year of a pandemic.

Biotech Steps In

Trying to curb such a scenario, the U.S. government has turned to the biotech industry.

In May, the government awarded five drugmakers contracts totaling more than $1 billion to develop vaccine technologies (see US Awards $1B in Flu Contracts).

The highest amounts were doled out to Solvay Pharmaceuticals ($298.59 million), GlaxoSmithKline ($274.75 million), and Novartis ($220.51 million).

The companies have been asked to use the funds to advance vaccine-manufacturing technologies that will ultimately target both seasonal flu and H5N1 avian influenza should a bird flu strain emerge that can be easily transmitted from person to person.

Currently bird flu virus is not easily transmitted between people. Nearly all the 208 cases of H5N1 human infections that have led to the 115 deaths reported by the World Health Organization have occurred because people picked up the virus from birds.

To help boost manufacturing capabilities, the companies will in part look to develop flu cell culture vaccines.

This type of vaccine relies on modern biotechnology cell cultures, as opposed to the more common vaccine production methods that work with eggs to develop inoculations.

Long Pipeline

Egg-derived vaccine production requires several months of logistics planning for ordering and receiving eggs.

The big advantage of cell-based production is that it allows for a flexible, faster startup time for vaccine manufacturing. This is particularly helpful in the event of a flu pandemic, where high rates of protection are needed due to the lack of natural immunity.

Should a flu pandemic take place, Mr. Emanuel and Mr. Wertheimer estimate the potential number of lives it could claim at 1.9 million in the U.S. alone.

To better prepare the country, the U.S. government has set aside $3.3 billion this year.

Another challenge the country faces is the lack of U.S.-based manufacturers to produce influenza vaccines. There are few facilities worldwide, and only one in the United States, according to the authors.