3n.1 What vaccines are currently under development?
Description
This article is from the Childhood Vaccinations FAQ, by Lynn Gazis-Sax lynng@alsirat.com with numerous contributions by others.
3n.1 What vaccines are currently under development?
New vaccines under development include vaccines for HIV (vaccines are
being tested both to improve the immune response in those already
infected and to resist infection), respiratory syncytial virus
(Rathone), malaria, leprosy, gum disease, herpes, shigella, dengue,
cervical cancer, type I diabetes, and other illnesses, as well as an
intranasal flu vaccine, new versions of the pneumococcal,
meningococcal, and TB vaccines. Harrison's Internal Medicine has a
list of vaccines in human trial, and a list of those toward which
priority efforts are being targetted.
As of May, 1998, the National Institutes of Health had evaluated 23
vaccine candidates and 10 adjuvants (substances that might enhance the
effect of a vaccine) in 49 Phase I and Phase II clinical trials to
determine the safety of the vaccine candidates and their effect on the
human immune system. These studies have been conducted with 2,900
volunteers. Despite all these vaccine candidates, the variation of
retroviruses and the virus transmission directly from cell to cell by
fusion pose significant obstacles. It's anyone's guess when (and if)
an AIDS vaccine will be ready. Two articles which discuss AIDS vaccine
development are "Vaccine Against AIDS?" in the British medical journal
Lancet ((02/26/94) Vol. 343, No. 8896, P. 493) and "AIDS Vaccine:
Shooting Blanks or Loaded for Bear?" in Men's Fitness ((03/94)
Vol. 10, No. 3, P. 118). Information about efforts to produce an AIDS
vaccine is sometimes posted in sci.med.aids, and references, updates,
and current information is available by gophering to
odie.niaid.nih.gov. If you have gopher, gopher odie.niaid.nih.gov will
get you there. The AIDS FAQ (available from the
pub/usenet/sci.med.aids directory of rtfm.mit.edu) describes some
other Internet resources with information about AIDS.
When I wrote this section in 1994, I had, "The malaria vaccine has
shown positive results in Phase I/II trials, which were reported on
February 18, 1994 issue in the British medical journal _Vaccine_
(volume 12 no. 4, pp 328-336; 1994). (A report on an earlier trial can
be found in the medical journal Lancet, volume 341, pp 705-710;
l993). More details can also be found in a WHO press release kept on
gopher.who.ch. The first results of Phase III trials are expected to
be available in October 1994." Unfortunately, the years since then
have not seen as much progress toward a malaria vaccine as was
hoped. It is known to be possible to induce immunity to malaria, as
letting volunteers be bit by irradiated mosquitos has done so. But
translating that into an effective vaccine has proved tricky. An
editorial in The New England Journal of Medicine -- January 9, 1997 --
Vol. 336, No. 2 reported that, though one vaccine has shown efficacy,
recent trials in malaria endemic areas couldn't confirm that
efficacy. An improved subunit vaccine reported in the same issue of
NEJM, but needs to be tested in malaria endemic areas. WHO has malaria
vaccine as a high priority, and aims to have an effective and
affordable vaccine within the next decade.
Respiratory syncytial virus (RSV) is a major respiratory pathogen
among infants and young children which results in an "estimated 90,000
hospitalizations among infants in the US every winter" (Williams,
1997). Trials have indicated that the vaccine is safe and immunogenic
(produces antibodies), but there are mixed results so far on efficacy.
Shigella is one of the leading causes of diarrhoeal illnesses. A
shigella vaccine is moving toward clinical trials soon.
The vaccine for periodontitis (gum disease) has shown some positive
results in macaque monkeys (less bacterially induced bone loss in the
vaccinated monkeys), indicating that a human periodontitis vaccine is
feasiable. Full-fledged clinical trials, however, may be a decade
away.
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