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  • So the story begins with the WHO, the World Health

  • Organization.

  • And the WHO actually works with a few of the regional labs.

  • So there are actually five labs sprinkled around the world.

  • And these labs collect specimens from hundreds of countries.

  • So hundreds and hundreds of countries

  • do surveillance to figure out what type of flu

  • is affecting their particular population.

  • And they will send this information over

  • to these five regional labs.

  • And I'm just going to quickly draw out

  • for you where the regional labs are.

  • There's one over here in the US.

  • There's also one down here in China.

  • And then there's another one over here in Japan.

  • And a fourth one in the southern hemisphere in Australia.

  • And finally, there's one in the United Kingdom.

  • So this is the last one.

  • There are five in total.

  • The WHO will take a look at all the different strains that

  • have come into these five labs again from all over the world.

  • And they'll try to make a decision

  • as to what makes the most sense.

  • Because flu usually moves around the world

  • in a very predictable way.

  • So they can make an educated guess

  • as to what strains they should include in the vaccine

  • to protect people most effectively.

  • Sometimes they'll use a strain that they

  • used in previous years.

  • And sometimes they'll pick something brand new.

  • So let's go through the three strains

  • that they actually picked for the most

  • recent vaccine, the 2012-2013 vaccine.

  • I'll start with the type of virus they put in there.

  • And generally it's two type A's and one type B.

  • That's the usual formula that they use.

  • The WHO recommends that for the trivalent, or three strain

  • vaccine.

  • And the exact one that they choose

  • can be actually followed.

  • They usually name it in part based on location.

  • So they'll say, OK, the type is A.

  • And they'll say the location is-- in this case,

  • the first one actually came from California.

  • The second one came from Victoria, Australia.

  • And the final one came from Wisconsin in the United States.

  • So this is the location of the three strains.

  • In fact, if you ever see it named,

  • you'll see a slash between these two.

  • So I'll put a slash here as well.

  • Next, they actually have strain numbers.

  • So they'll give you a number and what that number refers to.

  • It doesn't mean a whole heck of a lot to us.

  • But we're going to put it in there just because that's

  • how they name things.

  • The strain number is, for the first one, 7.

  • This is 361.

  • And this is strain 1.

  • And then finally, they'll put the year that they actually

  • identified this thing.

  • So the year of identification.

  • And this first one, this type A, was actually

  • identified back in 2009.

  • Whereas the other ones are a little bit newer,

  • identified in 2011 and 2010.

  • So, that's what comes after the strain number.

  • And finally, the last thing, which

  • only applies to the first two, is that if it's a type A,

  • they'll actually tell you the H and N type.

  • So, for example, the first one, the California strain,

  • this one is actually a type H1N1.

  • And the second one is an H3N2.

  • And the third one, because it's a type B,

  • we don't really use that H and N classification.

  • So I'll just put a hash there, meaning nothing.

  • So if you ever come across these things

  • in some sort of formal document, at least now

  • you know what the heck all these numbers and words refer to.

  • So this is literally how they name the strains.

  • And just for you and I to know, this first one here,

  • this one is actually an old strain.

  • So, this is actually part of the last few vaccines.

  • This is not a new one that was included.

  • Whereas these other ones down here, these ones,

  • are actually new strains.

  • They were not part of the vaccine in previous years.

  • These are new additions or changes to the vaccine.

  • So just to remember, we always include

  • two type A's and one type B. And the type A's, one is a H1N1

  • and the other is a H3N2.

  • That's how we've been doing it in recent years.

  • Now let me bring up a little bit more canvas

  • because I want to talk you through exactly what happens

  • once the WHO decides that these are

  • the strains they're going to use.

  • And this decision was actually made back in February of 2012.

  • So months and months in advance they're figuring out what

  • strain we're going to use.

  • And that information then goes to the next group

  • of folks, which is the manufacturers.

  • The manufacturers are going to take this information

  • and they're literally going to start putting things together.

  • They're going to start the manufacturing process.

  • And one of the key parts of this process, which a lot of people

  • don't realize, and it's pretty mind boggling,

  • is that you need millions, actually

  • hundreds of millions of eggs.

  • The same kind of eggs you might eat for breakfast.

  • But these eggs are actually laboratory grade

  • and they're needed for making this process work.

  • And once it's made, one of the key things,

  • and this reassures a lot of folks, is safety.

  • We want to make sure that these things are safe.

  • And so a lot of testing goes into making sure

  • that all of these vaccines that they make are safe.

  • So once that's done and people feel comfortable that it's

  • a safe vaccine, we start distributing it.

  • So distribution is next.

  • And we're going to go through each of these stages

  • and think just a little bit about which people

  • are involved in all these steps.

  • But I just want to lay out all the steps first

  • so you get an appreciation for how many players there are

  • and how many steps are in getting a vaccine to you.

  • So it goes, of course, from distribution,

  • it goes to these clinics.

  • And then finally, at the end of the day there is a person.

  • There might be you.

  • This is you getting your flu shot

  • and you're very happy because you're now

  • protected from the vaccine.

  • And I'll draw a little shield around you,

  • a little protection for you, to make sure

  • that it's clear that you're protected-- not completely--

  • I'll draw a little hole in the protection--

  • not completely because a vaccine isn't perfect.

  • But it's pretty good.

  • And in fact, this year, in terms of how well the vaccine is

  • working-- not in studies, but in the real world-- in terms

  • of how it's doing as people are getting it--

  • about 62% effectiveness.

  • So it's actually really quite good.

  • In studies we always see around 60% to 70%.

  • And now, in real life, we're seeing a 62% effectiveness

  • in terms of vaccine effectiveness.

  • The word effectiveness just means real world data,

  • versus efficacy-- is what we see in studies.

  • That's the difference in the two words.

  • So let me list out some of the different folks involved

  • at each step of the way.

  • So in terms of selecting the strain,

  • we said that the WHO is responsible in working

  • with all the different countries and the public health

  • groups and laboratories and scientists that

  • are looking at all the strain data.

  • And then in terms of manufacturing, there

  • you got to think about the vaccine industry.

  • There are many, many big players here.

  • Big business is involved in terms

  • of churning out millions of doses of vaccine.

  • So here the vaccine industry is a major player.

  • And then, you think of all the other groups that are involved.

  • So I said that you have to get hundreds of millions of eggs

  • to make this process work.

  • And so of course, then you have to really work with farmers.

  • And if you have a year where the flu is really

  • hurting the birds and the chicken population

  • then that's going to make it really hard because there

  • are fewer eggs to contribute to the vaccine manufacturing.

  • So it's actually an interesting thought process.

  • Flu obviously affects chickens as well as humans.

  • And so if those populations start dying out,

  • then even humans suffer because we don't have the vaccine.

  • Now, then safety is huge.

  • So you have to think of all the different countries that

  • have organizations that care about safety.

  • And in the US the one that comes to mind

  • is the FDA, or the Food and Drug Administration.

  • So each country has its own process

  • of thinking about safety.

  • And those groups are obviously very involved

  • in making the vaccine as well.

  • Then you've got all these logistic things to think about.

  • I mean, if you're making hundreds of millions

  • of vaccines, you've got to distribute them

  • around the world.

  • You've got to think about airplanes that can actually

  • take your flu vaccine and move it around.

  • You've got to think about refrigeration.

  • Maybe ships if you're moving across large bodies of water.

  • Maybe trucks to get vaccine inland

  • if it's cheaper that way.

  • So lots of logistical issues to think about how to get vaccine

  • distributed.

  • And then finally, you've got nurses and doctors

  • in the clinics that have to be informed.

  • They need to know when to start making appointments

  • for their patients and how to set up

  • clinics to actually administer the vaccine to all the folks.

  • And finally we've got you.

  • You're at the end of this chain.

  • And not just you, but there are about 250 million folks just

  • like you getting vaccines.

  • So 250 million doses are actually put together.

  • And this is quite an effort.

  • You can see the countries involved.

  • And getting all that information to all these different groups

  • that have to get involved in terms

  • of making this even possible.

  • So, to me, this is actually one of the most impressive feats

  • out there.

  • And it really is a testament to what

  • science can do for mankind.

So the story begins with the WHO, the World Health

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B1 中級

每年製作流感疫苗 (Making Flu vaccine each year)

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    Precious Annie Liao 發佈於 2021 年 01 月 14 日
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