The emergence of H5N1 virus in dairy cow herds has raised concerns about a potential influenza pandemic. Global flu vaccine production capacity is inadequate to vaccinate a large portion of the world’s population in the first year of a pandemic. The use of adjuvants could lower vaccine dosage requirements, but adjuvant supply remains a bottleneck. Stockpiled H5N1 vaccines in the US may offer some protection, but their efficacy and availability are uncertain. mRNA vaccines may play a role, but more data is needed to assess their effectiveness and scalability. Equitable distribution of vaccines during a pandemic remains a challenge, with low- and middle-income countries potentially facing limited access.