Influenza H5N1 (also known as the “bird flu”) has been hovering in the wings since 1997 when the media reported human-to-human virus transmission in a Hong Kong wet market. 

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In the years that passed, several alarms were raised, like in 2005-06, when the world appeared to be on the verge of a catastrophe. Nothing happened. Investigation of the few deaths in faraway places showed that H5N1 had an inefficient transmission and favoured situations of high promiscuity between humans and animals. 

However, in those years, the seeds were planted for much of what we have witnessed since. The modellers ran riot with catastrophic predictions/scenarios/forecasts and what’s just around the corner based on evidence from their previous models. 

In 2006, Neil Ferguson set the scene for what’s next. In his Nature paper that reported, ‘Vaccine stockpiled in advance of a pandemic could significantly reduce attack rates even if of low efficacy.’

Now, we learn that, against this background, the UKHSA has purchased 5 million doses of influenza H5N1 vaccine “to boost the country’s resilience in the event of a possible H5 influenza pandemic.” 

We warned readers way back in March 2023 that something was boiling.

So, models are back in Vogue, and it didn't take that long. 

For the stockpiled vaccine to align with Ferguson's assumptions, it must be a single-dose vaccine that provides protection within two weeks. It has to reduce susceptibility by 70% and decrease infectiousness and the probability of developing a clinical case in those who still get infected by 30% and 50%, respectively. Additionally, vaccination must occur at a rate of 1% (roughly 680,000 people in the UK) of the population per day.

However, we are unclear on several  issues:

1. What is the composition of the vaccine?

2. What its effectiveness (UKHSA will undoubtedly claim that it triggers an antibody response, which we know is an imperfect correlate of protection)

3. What is the harm profile (previous pandemic influenza vaccines did not have a sterling safety record)?

4. Are the vaccines ready now, or will they be produced at a level to keep the production lines open?

5. Given that “to limit waste and prolong the inventory,” why has the UKHSA deviated from the guidance that providers should have no more than two to four weeks’ supply of vaccines at any one time? 

6. Why 5 million and not 60 million doses? Ferguson estimated that a minimum 20% stockpile of pre-prepared vaccine against the source avian virus was required to impact attack rates—that’s 13.6 million doses.  

7. Finally, what is the cost (currently unknown), and has a cost-effectiveness analysis based on actual data been carried out? And if so, how can that be in the absence of a willingness-to-pay estimate?

Public health functions have been devolved to the UKHSA, which decides what vaccines to stockpile. The strategy is predicated on a generation of the public, media, academics, and busybodies who believe influenza is the only pathogen in town.  

While financial resources are limited, the contractual pre-purchase or option lodging of "pandemic" vaccines is increasingly the norm. The quality of scientific discourse has declined to a point where the content you consume—whether it be articles or videos—is often indistinguishable from a well-crafted episode of "Yes Minister." However, the key difference is that "Yes Minister" was much closer to reality. Alongside the social upheaval caused by COVID-19 restrictions came a rise in censorship. You either adhere to the mainstream narrative or risk losing your job, friends, and social contacts. 

None of this UKHSA’s strategy makes sense. We used Ferguson’s 2006 assumptions; even if you believe these, the strategy still doesn’t add up. If the UKHSA doesn’t use Ferguson’s strategy as the guide, where is its model to drive the purchasing and its associated action plan? 

However, as the ongoing strategy proves increasingly costly, taxpayers will ultimately bear the burden, creating pressure to utilise the vaccine stockpile to justify the costs.  

This post was written by two geezers who are beginning to shift uncomfortably in their seats.