Most people see the flu as seasonal annoyance-but influenza is more than just ‘the flu’- it’s one of the biggest threats to worldwide public health. That’s why we’re bringing together innovators from all backgrounds to outsmart the flu. I’m Stacey Knobler, Director of Influenza Vaccine Innovation at the Sabin Vaccine Institute, a non-profit in Washington, DC. AMA!

With our fast-paced and interconnected lifestyles, a flu pandemic could put millions at risk worldwide. I’m here to answer your questions about this very real risk, and how the Influenzer Initiative is bringing together bright minds from different backgrounds—from tech to AI to biology—to end the threat once and for all.

To make a universal influenza vaccine a reality, the Sabin Vaccine Institute has launched the Influenzer Initiative. This groundswell campaign is designed to bring disruptive and innovative thinking to current research and development practices. That’s why we’re fostering creativity and collaboration of experts and thought leaders from across disciplines to jump-start the development of the first universal influenza vaccine. And we need your help to make influenza history.

Proof: https://twitter.com/sabinvaccine/status/1123226772286394368

Thank you for all the interesting questions and discussion. I will close this AMA at 4:15 EST.

Comments: 748 • Responses: 38  • Date: 

smallchunkofstardust834 karma

From what I understand, the frequent mutations that the influenza virus undergoes makes it difficult to develop a vaccine against it. How are you overcoming that?

GottaLetMeFly1841 karma

This whole AMA is a scam. This person uses a lot of high tech buzzwords and talking about disrupting the industry and bringing together people from a bunch of different fields, but this is just Theranos2.0. This person doesn’t know the first thing about science or virology, and don’t you think people with a lot more education and experience haven’t already considered attempting to make a universal vaccine?!? The lack of real answers to questions in here should make this scam obvious.

FBI-Shill193 karma

It looks like they're starting up a new organization to take donations and other funding to support itself, before funneling money to other organizations that are doing the actual work. So if you donate or pay taxes used for grants, your dollar can go to support these people who are "raising awareness" about influenza, and then maybe 10 cents will go to an independent research lab that produces a bunch of academic papers on the subject, but never any real results.

StaceyKnobler-140 karma

You are correct, it is a new initiative. However, we are not seeking donations to support our organization. Instead, we are working with existing funders to make the case that they support new R&D initiatives to support influenza vaccine research. We are very much hoping to direct new funding toward independent research labs and we welcome any suggestions on how best to support novel cross-disciplinary approaches.

StaceyKnobler-149 karma

Our team is here not to solve the science but to facilitate the connections between talent across the broad disciplines of science to solve this big problem. Our work is designed to figure out how to build a system to support innovation and drive more research toward a solution. We're not looking for donations.

StaceyKnobler-151 karma

There have been significant challenges to making UIV a reality.

  1. The science isn’t easy, we need to understand more about the human immune response to influenza, but the convergence of lots of emerging science and technology today makes a breakthrough more possible than ever.
  2. We need to better coordinate the work that is happening in the field. Learn more quickly from what doesn’t work so that we can drive research and development more rapidly to a solution. There are people working on this—lots of very talented people .

Squirrelthing11 karma

I'm going to take a guess and say you guys are going public soon

StaceyKnobler-28 karma

We're not a start-up. The Sabin Vaccine Institute is supported through individual donors, foundations, corporations and government funding. Sabin is proud to dedicate nearly 80% of our functional expenses to program services. We maintain high standards of accountability and transparency as we strive to achieve our vision of a world free from vaccine-preventable diseases.

DocCannery84485 karma

I'm confused as to how there's any chance of a universal vacinnes ever existing. How could you even cater for constant antigenic drift, let alone sudden shifts like what happened with the 2009 H1N1?

Alwayssunnyinarizona247 karma

Former vaccine researcher here - it's one of the toughest problems to solve (maybe the only thing tougher is a vaccine for prions and other misfolded proteins - my current field), and will likely take some advancements in fields across cell biology, virology, and immunology to make it happen. My guess is that the vaccine won't be targeting antigens that are subject to drift and shift, but processes that are common to all influenza viruses - cell surface binding, replication, etc. That's where the bright minds from different fields comes into play. This requires some real out-of-the-box thinking.

StaceyKnobler-65 karma

Yes, exactly. You sound like a great candidate for the Influenzer Initiative! https://www.influenzer.org/

StartsWithFuckYou344 karma

Fuck, you've got a lot of start-up buzzwords in this post and on your site, but what are you actually doing? Who are you working with? Any big names in the industry?

More importantly, what are you providing in this scenario? Labs are already researching things like this across the world, how is your involvement making a difference?

StaceyKnobler-27 karma

Sorry for the slow responses. This is my first AMA and all the questions are really interesting. I work for the Sabin Vaccine Institute. It was founded on the legacy and global vision of pre-eminent scientific figures in the history of medicine, Dr. Albert B. Sabin. Best known as the developer of the oral live virus polio vaccine.

TitusDevOps179 karma

Have you considered using AI? That's artifical intelligence. Sometimes called machine learning. We have computers today that we didn't have yesterday and those computers can allow us, when clustered and utilizing the cloud, provide the ability for disparate technologies with the coordination and cooperation of cross-field introspective regression of complex and unified algorithms.

Will your diverse initiative allow for social and economic success applied to all levels of society?

StaceyKnobler-59 karma

Yes, increasing the contributions of artificial intelligence, machine learning and predictive analytics to universal influenza vaccine development is part of our goal. Beyond some of the groundbreaking work already being done, we want to focus more AI talent on this challenge.

Not sure what you mean by the second part of the question. Part of our mission is for vaccines to benefit all people, everywhere, if that's what you're asking.

spiralaalarips140 karma

Great idea, great goal, but what everyone in this thread here has asked multiple times is: WHAT are you doing currently to achieve this? WHO are you currently working with?

You still haven't answered these questions.

StaceyKnobler-127 karma

We are in the early stages of this initiative. To date, we have convened several meetings and been in discussions with scientists from different disciplines and with funders to begin working through how we might best support innovative research. We are also trying to secure funds from sources that haven’t traditionally funded influenza research in order to accelerate vaccine development. We are not raising funds for our organization since we are fully funded, our goal is to drive resources to new scientific approaches. At this early stage, we are very much soliciting feedback from researchers to figure out how we can best support their work and bring in those from other disciplines who might help advance the goal of developing a universal vaccine.

freakinidiotatwork49 karma

So you can't answer any questions?

StaceyKnobler-58 karma

We are certainly here to answer questions about our initiative and the threats related to pandemic flu, but we admittedly will not have specific technical answers to the scientific challenges at hand.

ToastedHedgehog83 karma

I think maybe in that case you should have done this AMA later on when you have answers to the obvious questions people are gonna ask

StaceyKnobler-28 karma

Point well taken. We will revisit after the program progresses.

achegarv75 karma

Can you share your CV to forestall an assumption of "next theranos?" (Or Fyre festival, to keep it ungendered)

It kind of seems like "but what if an intractible problem weren't intractible?"

StaceyKnobler-25 karma

Yes, happy to share my background, my professional bio is here https://www.sabin.org/leadership#stacey

JamesQueen41 karma

What are your Medical and/or Scientific credentials?

Found them posted here

Were any of the people with medical degrees working on the actual UIV unavailable for this AMA? Or is this just a AMA to boost PR?

What can you tell us about the actual science of what you're program is doing?

terekkincaid37 karma

She has stated several times (and I'm paraphrasing a bit here) that so far they have done jack shit and have no solid ideas of how to realistically proceed. They're still in the "early stages" you see. But not too early to want $$$

StaceyKnobler-32 karma

You are correct, we are in the early stages but we are not seeking funding. Rather, we are working with funders to encourage resource allocation to researchers working to develop a universal vaccine.

wobblebase33 karma

There are already many labs working on this exact question. So which experts are you recruiting exactly?

StaceyKnobler-59 karma

To be clear, we’re not recruiting for positions, but we’re looking to establish new integrated networks that both complement and challenge traditional research avenues.

While we don’t want to limit who these new problem solvers may be, we are currently exploring areas such as computational, structural, and synthetic biology, nanotechnology, immuno-oncology, protein science, genetics, engineering and material science. We will be hosting several activities in 2019 and 2020 (like a hackathon for vaccines) to engage collaborative and novel thinking that may contribute to making UIV a reality. Through this AMA, we hoped to provide some initial information on where the work was headed. Through our on-line Influenzer network, we hope to identify those that could be included in these events to propel novel ideas toward funders. Some great examples of the kind of work we hope to amplify and extend are nanotechnology for immunotherapy and genome sequencing for real time data analysis and outbreak surveillance.

slugfive26 karma

Do you have any actual science or “thinkers” on board, and what have you done so far? RemindMe! 1 week, as this looks like some sort of stunt or scam and very dodgy.

StaceyKnobler-12 karma

We have begun working with scientists from a range of disciplines and with funders to begin working through how we might best support innovative research. We are also working to secure funds from sources that haven’t traditionally funded influenza research. We fully acknowledge existing researchers are making progress, but we would like to make the case for new funders to support flu vaccine development. We are not raising funds for our organization, our goal is to drive resources to new scientific approaches and support researchers.

sweetjenso20 karma

So if you aren’t raising funds for your organisation, who specifically are you directing funds towards?

StaceyKnobler-13 karma

Although we are in the early stages, our goal is to direct funds to researchers taking multi-disciplinary approaches to development of a universal flu vaccine. We are still in the process of understanding how best to garner interest from other disciplines and to figure out how non-traditional skills might advance the scientific challenges at hand.

wearer_of_boxers13 karma

How do you guys plan on making this a reality?

What could "the common people" do to contribute to this?

Have you taken into account the (recent) uptake in anti-vaxxer stupidity/ignorance and what this might mean for a vaccine if it turns out to be successful?

StaceyKnobler-24 karma

And in response to the anti-vaxxer part of the question, you're absolutely right. Vaccine hesitancy has been identified by the World Health Organization as one of the top 10 threats to global health. More work is needed on this to understand the root causes.

StaceyKnobler-34 karma

That’s great- we need all hands on deck. We’re looking to many disciplines for expertise and insights for innovation. Disciplines such as tech, AI, predictive analytics, computational modeling, engineering, start-up strategy, venture capital, catalytic funding mechanisms, and more. Join us at influenzer.org

And get your flu shot!

AMAInterrogator12 karma

How are you scoping this project?

What is considered a minimum viable success?

What is the ideal outcome?

StaceyKnobler-15 karma

We are at the early stage of scoping and are speaking with a range of funders and researchers to see how we can best support advancing vaccine development. We have had a few conversations about minimum viable success in terms of duration of immunity and level of efficacy but clearly we need more input on making a final decision on minimal efficacy to advance development. Ideal outcome would be a vaccine with a robust and durable immune response.

saltyd0m11 karma

What process goes into predicting this years strain? How often is it completely wrong?

StaceyKnobler-20 karma

From the CDC: "Flu viruses are constantly changing, so the vaccine composition is reviewed each year and updated as needed based on which influenza viruses are making people sick, the extent to which those viruses are spreading, and how well the previous season’s vaccine protects against those viruses."

Flu vaccines reduce risk of influenza illness on average by 35-60%.

Increasingly, innovative computational biology is being applied to better predict emerging strains. https://nextstrain.org/

HeckDang11 karma

Are vaccines necessarily going to be the way forwards when it comes to tackling Influenza in the long term and at the large scale, considering the difficulties involved?

Are there other potential solutions that could possibly one day lead to the eradication of influenza just as widespread vaccination was integral to eradicating smallpox, or is it likely the case that a universal vaccine will really be the most practical way to achieve that?

StaceyKnobler-9 karma

In almost all cases, prevention of disease is better than treatment. Unlike smallpox, influenza can come from multiple animal reservoirs and there is no expectation that it can be eradicated. Improved antivirals and other drugs to treat influenza infection are important and our ability to more rapidly identify and track infection will also make us better prepared to respond.

Triv028 karma

What is the biggest challenge posed to the medical world by the rise of the anti-vax movement?

StaceyKnobler-5 karma

The biggest challenge is the widespread dissemination of misinformation and disinformation regarding the safety of vaccines which has resulted in declining vaccine coverage. Medically, the greatest risk is to those in our communities who are most vulnerable, such as the very young and people with compromised immune systems who can’t be protected by vaccines.

supergeekmike5 karma

How do you handle getting these vaccines to less developed regions of the globe? Are there any additional issues that arise intercontinentally with the flu’s constant mutation?

StaceyKnobler-12 karma

Access to vaccines more broadly in less developed regions remains a challenge because of the cost of vaccines and limited infrastructure and the fragility of health systems. A universal influenza vaccine that is more broadly cross-protective and offers longer-lasting immunity may be able to better integrate into existing systems.

msannethropik5 karma

What kinds of precautions would need to additionally be taken for patients with higher risk of side effects, such as immunosuppressed patients?

Would the vaccine potentially deliver a higher risk of negative side effects because of its intended potency?

StaceyKnobler-10 karma

There are clear risks for numerous special populations including immuno-compromised people, pregnant women and very young children (which is why it's so important for healthy people to get vaccinated to better limit disease spread). All vaccines go through rigorous clinical trials and efficacy studies, first in animals, then in people, before they are rolled out for public use. For a vaccine candidate to be licensed for public use, government regulators require a certain level of efficacy. Government and research institutions make sure the vaccine is safe and will protect people from getting influenza before the new vaccine is offered to the public. Then once it is available, public health institutions like the CDC will study how well the influenza vaccine protects against illness to make sure the vaccine continues to work as expected.

The vaccine doesn't exist (yet) but safety is always a critical element of vaccine development and testing.

abushk4 karma

Could you talk a bit more about why Influenza is a real threat to public health? Who is at risk if a large scale outbreak occurs?

StaceyKnobler11 karma

Public health officials aren’t trying to scare people, but prepare and protect them from what is a deadly and disabling disease. Influenza is commonly written off as “just the flu” but it actually causes tens of thousands of hospitalizations and deaths every year, not to mention the economic impact and loss of productivity every year. In the US alone, Influenza annually causes employees to miss approximately 17 million workdays - that costs about $7 billion a year in sick days and lost productivity! The 2017-2018 seasonal epidemic resulted in more deaths in the US than those from opioids and road traffic injuries.

The “flu”, or seasonal influenza, is a real and present threat every year with the potential for an even deadlier worldwide pandemic from an emerging novel strain of the disease not covered by the vaccine. Up to 650,000 people die worldwide from seasonal influenza each year, and when the next global pandemic occurs, it is estimated that 33 million lives could be lost within the first 6 months alone.

Halphos4 karma

Oof... What were your expectations from the Reddit AMA community?

StaceyKnobler-5 karma

We wanted to start the conversation with science-minded people beyond just influenza vaccine researchers. We’re looking for people who can look at a problem differently and apply their skills.

StaceyKnobler-7 karma

Because we are interested in advancement of a universal flu vaccine, we were hoping the tech and science folks from the AMA community would ask questions and provide comments that would help us understand resource challenges and scientific gaps related to flu vaccine development that might be supported by bringing together professionals from a range of disciplines.

Raider4404 karma

How do you react to people with antivaccine beliefs? Do you argue, do you ignore them? What would you recommend other people to do

StaceyKnobler-5 karma

I’d like to start with understanding their concerns, understanding their fears, (because this mostly comes from a very human place of fear for their health or children’s health) and then presenting the evidence we have from research. The “antivax” movement is very well mobilized on social media so it’s also important for us in vaccine science to better utilize these platforms and spread awareness on vaccine safety and importance. (Good article here) .

For more on this subject, the CDC website is a great resource for research and answers to common vaccine concerns as is the Sharing Knowledge About Immunisation.
Also check out this review of how vaccines work by the National Institute of Allergy and Infectious Diseases.

squared_up3 karma

Hello. In what ways do you see Artificial Intelligence (AI) helping to reach an influenza solution?

StaceyKnobler-10 karma

We're not limiting our ideas about the possibilities, but we see potential for machine learning to leverage existing data and extract findings to be more quickly applied to the work of discovery and development.

squiddypds2 karma

Do you think eventually vaccines will be something that can be introduced in a single universal vaccine that can prevent all disease? What would be the challenge with such a vaccine?

StaceyKnobler-16 karma

I'm sure there are creative minds that may already be working on this, but our current scientific understanding and technology are no match for this challenge.

SatsumaLowland2 karma

Why aren’t people working on a universal influenza vaccine already if it’s so important?

StaceyKnobler-5 karma

People are working on it, but as is the case in many fields, opportunities to learn quickly from scientific discovery are limited. We need coordination and leadership to accelerate the translation of discovery to vaccine development.

planejane152 karma

What strategies can you recommend for talking to someone opposed to vaccinating their child?

StaceyKnobler-4 karma

We need to recruit more parents, epidemiologists, doctors and vaccine research scientists for the job. I would recommend that you ensure that parents know you understand their concerns and fears, prior to supplying them with evidence-based research on the benefits of immunization. People need to hear directly from parents they trust and from health experts about why vaccines work, why it’s safe and why community immunity is important for those who are too young to get vaccinated (or can’t get them for a medical reason). There are so many great resources available, and we need vaccine advocates to share them when talking to those who oppose vaccination, like CDC & Sharing Knowledge About Immunisation

cthree871 karma

Got the flu here, yes I got vaccinated. The aim is obvious but is the solution? Simple doesn’t translate to easy.

StaceyKnobler-7 karma

There's nothing simple about developing a universal influenza vaccine. Many talented minds have been seeking solutions for decades. They persist because solving this problem will be game-changing. By working to focus more talent and the possibilities from many different areas of science and technology, we are seeking to generate ‘more shots on goal’. The more we try, the faster we learn, the more rapidly we succeed in generating this transformative change!

shakycam30 karma

I had a healthy friend who died from it. He was 41 and went to the gym every day. His family and friends were left absolutely devastated and confused. How could this happen? From him first showing symptoms to being dead was less than a week.

StaceyKnobler0 karma

I'm so sorry for your loss.

LoganPhyve-8 karma

Thanks for posting this, maybe you can shed some light on these questions?

Part 1 - I've gotten the flu shot 3 times, and every single time, I have the full blown flu starting immediately/next day. Everyone claims that the vaccine doesn't cause the disease to manifest but after 3/3 I've sworn it off. Are there any other cases of this happening to others? I am an otherwise healthy adult.

Part 2 - Your post highlights the other reason I've stopped getting this vaccine. What's the point of being vaccinated against maybe 25% of the flu strains? It's a crap shoot every year, and even if you happen to get lucky with the common strain in this year's vaccine, it won't stop you from getting the other strains. What justifies spending so many resources on protecting against only 25% of the diseases's current strains? Both my wife and kids (who all got vaccinated this year) got the flu (I did not, through good hygiene and avoidance). Feels like we wasted a lot of our, and others, time and money.

I'm definitely pro-vax and not an anti-vaxxer in any way, but it seems silly to me that A) this "preventative" measure has made me get the flu in 100% of incidences, and B) we're not vaccinating against other strains... why?

I am not convinced that this vaccine works at all. It's the only one that's pushed and pushed and pushed and seems to consistently fail. What can someone like me do to help? I would LOVE to see a vaccine that actually works and works against all of the common strains of the season.

StaceyKnobler-4 karma

It is true that a flu vaccine may not prevent you from getting sick, but it will reduce your symptoms and reduce the risk of complications from the disease. It takes at least a week or more for protection from the vaccine to develop and it is not uncommon for people to be exposed before they get vaccinated. It’s also important to consider how eliminating or reducing your illness protects individuals in the community. This protection is critically important for individuals at higher risk from serious illness and to those who cannot receive the vaccine for medical reasons.

The annual strains that cause illness are frequently mutating, vaccinating against strains that are not currently circulating will not offer long-lasting immunity.

bagthatweasel-9 karma

Very well done on what is a very commendable task!

I'm curious as to whether there are any anthropologists involved in this project, and what specific challenges you would expect them to overcome?

StaceyKnobler-3 karma

Yes, understanding health behavior is key to overcoming vaccine hesitancy challenges and ensuring use of the vaccine when it would be available. Anthropology and social and behavioral health disciplines are becoming increasingly important in this environment. We do have a team member with great expertise in this area for our Vaccine Acceptance program and we’re working to integrate these skills to fight the influenza threat.