Vaccines have helped control and even eradicate many deadly diseases, including polio and smallpox, which is why Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases (NIAID) at the National Institutes of Health (NIH), calls vaccines “one of the greatest tools in medicine.” Through the Vaccine Research Center, established in 2000, the NIH collaborates with universities, pharmaceutical companies and governments worldwide to pioneer and test new vaccines to combat a wide variety of communicable diseases.
Camels are the culprits
The Middle East respiratory syndrome coronavirus (MERS-CoV) is an emerging zoonotic — a disease that can be transmitted from animals to humans. It was first reported in humans in the Arabian Peninsula in 2012 and had spread to the United States by 2014. Once infected, humans can transmit the infection to others through close contact. Because the infection originated in animals, NIAID scientists first studied how the virus behaves in animals. The dromedary camel was identified as the chief disease reservoir. Scientists also found that the camels had antibodies to the MERS virus, which could be a key to developing treatments and a vaccine.
As with MERS, chikungunya is a serious disease that is on the move and for which there is no proven vaccine — yet. In recent years, chikungunya has spread from Africa and Asia to the Caribbean and other parts of the Western Hemisphere. Fortunately, a chikungunya vaccine is in the works, which Fauci says “looks safe” after a Phase I study — a small-scale clinical trial to determine if a vaccine is safe for humans. A larger, Phase II trial will be conducted later in 2015. “It really looks quite promising,” Fauci says, “but you never really know until you test it in the field to see that it actually does protect.”
Malaria and TB
NIAID collaborated with pharmaceutical company GlaxoSmithKline on a malaria vaccine, but the protection was not as broad as needed. Nevertheless, “it’s an important first step toward a malaria vaccine. So we are much better off in 2015 with the malaria vaccine now that we have one candidate that has shown some modest effect,” Fauci says.
Some vaccines don’t work for everyone — or against every strain of virus. For example, the BCG vaccine protects children, but not adults, against some — but not all — strains of TB. “TB is a very interesting disease because the pathogenesis and the role of the immune system in TB are still somewhat of a mystery,” Fauci says, one reason he thinks developing a broad TB vaccine “is going to be quite challenging.” TB causes about 1.5 million deaths per year, and one-third of the world’s population has latent TB.
The goal is to replicate the success of vaccines that, through immunization programs around the world, have saved countless lives.