The Trump administration recently canceled $766 million in contracts with Moderna to develop and produce an mRNA vaccine against pandemic influenza viruses, including H5N1 avian flu.
This is a tragic decision for many reasons, and also quite ironic. Perhaps the most important thing President Trump did during his first term was to invest in Operation Warp Speed, which gave us mRNA-based Covid-19 vaccines in time to save millions of lives here and around the world. This biomedical miracle allowed for unprecedented rapidity in vaccine production and deployment, compared with what would have been possible with older production platforms. And mRNA vaccines have clearly been found to be extremely safe, all conspiracy theories aside.
Yet today, even as mRNA vaccines have been a target of political attacks by some, we face a much more frightening virus: H5N1 avian (or animal) influenza. Covid-19, with a mortality rate in the U.S. of just over 1%, is estimated to have killed more than 1.2 million Americans and sickened millions more. If H5N1, or a similar influenza strain, starts to transmit human to human in the absence of vaccines, some estimate that the number of dead Americans could be orders of magnitude higher, given that a mortality rate of 50% is in the realm of possibility. Despite its slogans about making America great or healthy again, this administration may well find itself ushering in another pandemic, accompanied by unprecedented mortalities, suffering, and economic chaos, if it continues to ignore the unique, proven benefits that Trump’s first-term investments in mRNA technology yielded.
As a veterinarian who’s worked with domestic animals and wildlife around the world, I can attest to the seriousness of the threat of H5N1 and other influenza strains. Long known to infect wild birds and poultry, H5N1 has now made unprecedented leaps to approximately 50 species of mammals — as diverse as rats, elephant seals, bears, house cats, and humans — with an unprecedented outbreak in U.S. dairy cattle having affected 17 states and more than 1,000 herds. The more a virus like this is able to mutate and find its way into a wide range of species, especially farmed species that live in close contact with people like poultry and now cattle, the more the odds go up that a viral strain will more easily make that leap to people.
We are already seeing this in relatively small numbers (with 70 known human cases thus far in the U.S., which is undoubtedly an underestimate given the diminishing state of surveillance efforts). The first U.S. H5N1 death was in Louisiana in January, a man who likely caught it from his backyard chickens. But the real fear is the development of a strain that starts to easily transmit between people (a risk which can be exacerbated when a person or perhaps a pig gets infected with a seasonal flu virus and also with H5N1, allowing the viruses to mix or reassort, yielding a more human-adapted strain). What could happen next is viral spread from person to person akin to a wildfire in a dry forest.
We must prepare for this very real risk via a multi-pronged approach now, not when it happens. Given that current immigration raids have understandably induced a state of fear among farm workers most likely to be exposed to H5N1 or other influenza strains in our poultry and dairy farms — combined with a dialing back of overall federal public health surveillance efforts — it is safe to assume we no longer have any real idea of who is getting sick or with what. Influenza outbreaks tend to wax and wane over time, but they will not go away, nor will the risk we face in the absence of a robust, proactive vaccine program.
The decision to cancel the Moderna contracts, undoubtedly driven by anti-vaccine crusader and HHS Secretary Robert F. Kennedy, Jr., puts the entire nation at risk, as does this administration’s cutbacks on disease surveillance (early warning systems)— and Kennedy’s absurd yet predictable firing of all 17 experts on the CDC’s Advisory Committee for Immunization Practices. And then he announced that the Trump administration is abandoning Gavi, the Vaccine Alliance, which provides life-saving vaccines for the world’s poorest children. But that morally reprehensible act needs to be the subject of other editorials, and surely will.
In less polarized times, the public health community would be helping Americans understand the importance of striving for herd immunity when a serious infectious disease threat is looming, based on the fact that the more of us who get vaccinated, the safer everyone is. But at a time when disinformation is peddled by our own health officials (at a time when measles, defeated here years ago, has now spread to more than 30 states), I am willing to acknowledge that an ideal level of herd immunity is unlikely to be achieved if/when we need it. Nonetheless, many Americans, likely including senior government officials, want to have the option to protect themselves and their families from a pandemic virus with potentially catastrophic mortality rates.
If we don’t invest in technologies like mRNA vaccines for pandemic influenza now, once a virus starts going human-to-human, it will simply be too late. Members of Congress, regardless of party, need to get these legally appropriated funds back into the hands of Moderna — recognizing that the next pandemic could become the largest mass casualty event in American history. To let such assaults on science and good governance stand is simply a travesty this country cannot afford.
Steve Osofsky, D.V.M., is a wildlife veterinarian and the Jay Hyman professor of wildlife health and health policy at Cornell University’s College of Veterinary Medicine. He directs the Cornell K. Lisa Yang Center for Wildlife Health and is also a Cornell Atkinson Center for Sustainability senior faculty fellow. He was a science and diplomacy fellow with the American Association for the Advancement of Science in Washington, D.C. from 1996-1998. He has no financial interest in Moderna.
