a vaccine is an almost guaranteed lifeline.

But influenza is different.

We have a very good measles vaccine.

We have a very good rubella vaccine,

very good mumps vaccine.

All of these viruses in the population haven't changed

over the last 50, 60, 70 years.

In contrast, influenza changes every year.

The World Health Organization

estimates that influenza infects 1 billion of us every year;

causing up to 650,000 deaths worldwide.

Vaccines are critical,

but they're only around 50% effective

because they don't fight every strain of flu.

So scientists around the world are searching for a shot

that fights different strains of the virus

including some that might not even exist yet.

It's really very exciting,

because you know that you're working for something good

that may change the whole world

and the health of many people.

This breakthrough will give us lasting protection

against influenza, but it might also help us understand

how we get there with other viruses too.

Difficulty breathing, highly contagious,

returning year after year.

Hippocrates first described influenza in 412 BC.

Since then, the virus has caused annual epidemics.

Most notably the Spanish flu in 1918

that killed an estimated 50 to 100 million people worldwide

and changed the world in ways

that seem all too familiar today.

1918, when the influenza H1N1 showed up,

was during a period of a lot of problems

in the United States at the time.

World War I was ongoing at that time,

there was a lot of movement from rural areas into cities.

So at the time we didn't even know it was a virus.

Viruses were kinda still being figured out at the time.

So it really was not until the 1930s,

that we knew the cause of the 1918 pandemic

and then subsequently the seasonal epidemics

that we would have every winter

that they realized that was actually due to a virus.

And so from the '30s,

it wasn't really until the late 1940s and 1950s

that actual vaccines were being used more regularly.

Even though there are just three basic types of flu,

A, B and C; type A which is the most dangerous for humans,

has a surface covered in two main proteins, H and N.

There are 18 different types of H protein

and 11 types of N protein.

And they combine to create up to 198 influenza subtypes

including ones like H3N2 and H1N1.

The influenza virus is constantly changing.

And so if you look at a virus,

on the inside of the virus are the genes,

and genes are just the recipe,

the instructions for making more copies of itself.

So if somebody sneezes or coughs,

and you happen to breathe that in,

those viruses that are in those respiratory droplets

go to the back of your throat

they grab on to the respiratory cells that are there.

They push themselves into the cells

and then release those genes that are in there.

Those genes, it's not one long string of instructions,

it's eight separate strings of instruction.

And so there's so much opportunity for that virus to mess up

in terms of making copies of itself.

It's not a very good editor.

It really doesn't have good quality control.

In one way, that's bad for the virus

beause it makes copies of itself that may not even live on,

they don't even reproduce.

But it also means that it can find ways

to get around your own immunity,

and ways to get around vaccines that are being used.

to get around antiviral drugs as well.

This genetic shape-shifting,

is known as antigenic drift.

And means that our body can't always recognize the virus,

even if we've caught it or been vaccinated before.

But scientists at pharmaceutical company BiondVax,

have worked for almost three decades creating a vaccine

which targets parts of the virus that don't change.

All influenza virus are different in their appearance

but they are still considered as influenza

because they have a lot in common.

And what the immune system wants to do it,

they want to recognize the virus and to attack it

when it enters the body.

So we have to teach the immune system

how the virus looks like.

So what we thought will be more effective

and to have a universal vaccine,

is to show the immune system and teach it

to recognize the conserved and common denominator

of all influenza viruses.

So we constructed a vaccine, it is called M-001.

It contains nine such conserved regions

from the influenza virus.

Variations between influenza viruses,

usually happen on the surface.

But dig a little deeper,

and there are similarities in its peptides;

short strings of amino acids

that are responsible for how the virus functions.

M-001 is made up of nine different peptides

that our immune system can learn to recognize

and fight off in the future.

One of the peptides that we selected in our vaccine

is very close to the point where the virus

is entering the cells.

So it's like a key and the lock.

Where the key is on the side of the virus,

and the lock is the entrance to our cells.

And if the virus wants to enter the cell

and cause the disease, it enter its key into the lock,

opens it, and the disease starts to develop.

So by our vaccine, we block this key

and the virus cannot anymore enter into the cell

and we prevent the disease.

So M-001 is in phase three clinical trials.

Are you feeling nervous about the results?

Of course, I'm worried all the time.

I hardly breathe

until we get the outcomes

of our pivotal phase three trial

which is a trial was over 12,000 participants

that was conducted in Europe.

In this trial, we injected half of the participants

with our vaccine,

and the other half received placebo, which was a saline.

And at the end of the trial,

which means at the end of this month,

we'll know how many participants

were ill in the experimental group

that was immunized with our vaccine, and how many were ill

in the control group that actually was not immunized.

And if the difference would be high enough,

then our vaccine works and then we're happy.

We will know if it is safe,

if it is protective against influenza.

A universal vaccine, like M-001,

would radically change the way we make our flu shots.

Currently, for Northern Hemisphere vaccines,

every February WHO picks four strains of influenza

which scientists predict

will most likely be circulating in October,

the start of the flu season.

This vaccine recipe is sent out to manufacturers

and the majority of vaccines

are made just like back in the 40s,

by injecting the vaccine virus into fertilized eggs.

It takes at least six months

to produce the high quantities we need.

So we have to really base

on what happened two months before February,

but we are not really good at that, unfortunately.

Dr. Peter Palese is a microbiologist,

who built the first genetic map of the influenza virus

back in the '70s.

The yearly influenza vaccine,

I think is underappreciated, underutilized.

So I think there is a benefit in taking the vaccine,

because even if you get the flu, it was a failure

but your disease morbidity is much lower.

Clearly, I think I want to encourage your listeners

to take the current vaccine,

the current influenza virus vaccine,

as an insurance against whatever might happen, yeah.

So it is a very safe vaccine.

I think it is a very good vaccine.

Having said that, if we want to make a better vaccine,

we have to show that it is at least

as good as the current vaccine.

But also that it really preempts

or knows what the other strains in year three,

four or five from now, will be.

And also the potential new pandemic strains.

Dr. Palese's team is also part of the race

to create a universal vaccine.

Like BiondVax, they're using an area of influenza

that that doesn't mutate.

The stem of the H protein on the surface of the virus.

We are redirecting the immune system

towards these conserved regions.

And I have to say, I can protect any animal,

whether it's a mouse, whether it's a ferret,

whether it's a guinea pig against any strain.

So using these constructs

which present the conserved domain of the virus,

it works beautifully in animals.

But remember, mice are not man, ferrets are not humans.

I think we make progress, but it is still not there.

And I can't promise you that it will be two years

or three years; we cannot really predict

how long it will take

that we will have such a universal influenza virus vaccine.

With disappointing results

in the M-001 phase three trials,

the wait will be longer than some had hoped.

But the research and time that's been invested

isn't wasted, far from it.

Could the work we're doing

to find a universal flu vaccine help in the way

that we tackle viruses like Covid-19?

Absolutely the other way around too.

And so the work that now with significant resources

and speed being put into Covid right now,

could have a significant impact on flu vaccine choices.

If you have a system in place

where you can make those kinds of vaccines fast,

as soon as you see an emerging, a pandemic influenza,

you can start making vaccine immediately,

so faster vaccines.

And so I think we'll learn a lot about that

with the Covid vaccines as well.

So all of that together, we would love to see

what we're learning with Covid, be applied to flu.

Because what we're doing right now with COVID

is highly informed by what we were doing

with flu previously.

What would be the next steps

if we got a universal vaccine?

What would be wonderful, is to get to that place

where flu vaccines aren't something

that are just for middle and higher income countries.

That low and middle income countries globally

have a significant impact of flu every year.

But a program to vaccinate children and adults every year

in a country with billions of people,

is really complicated and can be pretty expensive.

Coming up with a simple solution

that can be rolled out in a programmatic way

where it's cost effective for that country to do it,

would have a significant impact

for a better functioning country.