The debate about how to protect humans from the H5N1 avian influenza continues. During the H1N1 swine flu pandemic in 2009, vaccines became available months after the virus had spread—and even then there was only enough for 20% of the world’s population. Now, talk is centering on immunizing people years in advance against a flu pandemic that has yet to happen—“pre-pandemic vaccination.” Keeping the idea in the concept stage is how to get governments to pay for a health emergency that hasn’t happened yet. Same goes for persuading the public to get a shot that could potentially cause mild fever, pain at the injection site and the occasional allergic reaction. “It’s got loads of common sense about it and it’s got loads of science behind it,” said David Salisbury, Britain’s director of immunization. “But it is a big step.”

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