Researchers at Annual Science Fest Hail Universal Vaccines
In the world of public health, no scenario involving infectious disease is too far-fetched. How often can scientists predict what virus is going to emerge and survive long enough to take hold around the world? How rapidly can governments gear up and prepare to deal with a pandemic? And should we worry about such things at all, or is the era of fast-spreading infectious diseases behind us?
Those were some of the questions raised at the fifth annual World Science Festival held here in New York last week, at an event that gathered leading vaccine researchers, public health scientists, and health journalists to reflect on past mistakes and offer a prognosis for the future.
“Science is informing ways to treat infections better. But new diseases will almost certainly continue to emerge,” said Harold Varmus, a Nobel Prize-winning scientist, setting the stage for a discussion that doubted not the future abundance of new viruses, but the public and scientific community’s preparedness to deal with them.
“What we usually think about when we think about vaccines is our own immunity. But what we need to think about is vaccines as a global immune system,” said Gary Nabel, director of the Vaccine Research Center at the National Institutes of Health, who is recognized for his efforts to develop a global vaccine against HIV.
The challenge with developing such a system is that it depends largely on vaccine acceptance, which varies around the world and over time. For example, more young women in Rwanda are getting Gardasil, the vaccine that protects against cervical cancer, than are women in the U.S.
Low vaccination rates mean health care workers need to do a better job explaining the risks and benefits of vaccines, said Nabel. But he noted that scientific literacy on the part of consumers also plays a role in how they interpret vaccine recommendations.
Vaccine hesitancy, or the dilemma over whether to follow through with recommended immunizations, has taken root largely because of sensationalized reports about vaccines’ side effects. Efforts by anti-vaccination groups to discredit the science that shows immunizations protect against at least 17 debilitating or potentially deadly diseases, and to link them instead to autism and other neurological disorders, have also contributed.
Michael Osterholm, a public health scientist who serves on the Department of Health and Human Services’ advisory board on biosecurity, said that vaccine hesitancy is a major reason for the interrupted success of immunization campaigns. He noted it highlights the need for scientists to develop universal vaccines that protect against several diseases, or against different strains of the same virus, with a single shot.
“We’re having a harder time vaccinating people today than we did even a decade ago,” Osterholm said. “The challenge today is not only with the scientific data regarding vaccine effectiveness, but with much broader forces such as public sentiment that make it difficult to predict the success of vaccines going forward.”
A perennial example is the belief shared by vaccine opponents that by hyping up viral health threats, governments and the media are helping drug makers profit handsomely from sales of mandatory vaccines. But the 2009 H1N1 swine flu epidemic, which was declared a pandemic by the World Health Organization and the U.S. Centers for Disease Control and Prevention two months after it emerged, was contained precisely because of the rapid launch of a vaccine. The vaccine was fast-tracked because it relied on previous flu safety experiments and manufacturing processes. And although it turned out to be underused, it served as a counterexample to a situation where a novel and previously unstudied virus would have thrown vaccine developers in a race against time.
Here’s the ironic thing about H1N1: although the epidemic did not pan out to reach the proportions the WHO had predicted, it did not make the virus any less dangerous.
“Pregnant women were dying in 2009 just because they were pregnant. There were more years of life lost in 2009 than in 1918,” Osterholm said, referring to the flu pandemic that devastated communities in the early 2oth century, and adjusting for life expectancy in both years.
Nevertheless, the fact that the spread of the disease did not live up to the worst-case scenario damaged the health organization’s credibility, likely for years to come.
“In 2009, public health professionals didn’t make a difference. That pandemic happened as if we weren’t even there. Intensive care medicine made a difference,” Osterholm said. He was referring to medical workers who saved lives after people had been infected, rather than federal and state health departments whose warnings should have been sufficient to avert a crisis in the first place.
Laurie Garrett, a science journalist and senior fellow for global health at the Council on Foreign Relations (CFR), said the course of the swine flu epidemic also played right into the hands of vaccine opponents and conspiracy theory sympathizers selling the idea that “phony-baloney pandemics” are exaggerated to profit the pharmaceutical industry.
“If H1N1 had not been the s0-called ‘wimpy’ virus, we would have had carnage worldwide,” said Garrett, who was awarded the Pulitzer Prize in 1996 for her investigative series on the Ebola virus in Zaire. Luckily, she noted, the WHO assumed it was going to be a virulent flu, so geographic tracking started in case further measures would have been needed. [See CFR's interactive map charting past and present vaccine-preventable disease outbreaks around the world.]
Osterholm said he worries that many highly educated people hold unscientific views that translate into blocking progress. “The bottom line is we need better vaccines. But we’re being held up from developing better vaccines from the sense that the current ones are good enough,” he said.
Sounding a note of optimism, Nabel predicted that a universal vaccine that protects against multiple strains of the flu and does away with the need for annual shots could be developed within five years. Varmus added that three new vacccines are currently in development, with one likely to be approved soon by the Food and Drug Administration.
The panel was moderated by ABC News’ health and medical editor Richard Besser and was hosted by the New York Historical Society. It was preceded by a screening of the film “Contagion.”