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Companies Developing Safer Smallpox Vaccine
Two companies have made advances in their work to develop a smallpox vaccine safer than the one now stockpiled by the United States, the Washington Post reported today (see GSN, Oct. 27). A third company, without official U.S. funding, has also been developing a smallpox vaccine that could be used if terrorists released the pathogen simultaneously in numerous cities, according to the Post. The vaccine work raises questions for U.S. lawmakers over what vaccine they should choose to produce, how many doses are needed, whether an abandoned plan to vaccinate health workers before an attack should be revived and how to deliver the vaccine to the public after an incident, the Post reported. “Right at the present moment, we're setting up a committee to really look at this with a very hard eye,” said smallpox expert D.A. Henderson. “There are major changes that have occurred that force us to re-examine what we're going to do.” Experts said that these new, safer vaccines give the Bush administration a chance to remake its smallpox vaccination plans. However, the U.S. Health and Human Services Department has conceded that it is impossible to know how the vaccines would work in an epidemic because there are no existing smallpox cases. Plans would have to be based on animal tests and other sources of information. “You cannot answer all the questions — it's not possible,” said department official Noreen Hynes, who coordinates development of bioterror countermeasures. The vaccine primarily being considered is a weaker version known as modified vaccinia Ankara, or MVA. Developed in Germany in the 1970s, it does not reproduce once in the body and has shown to be less likely to cause illnesses in people with weakened immune systems or who have suffered from skin conditions such as eczema. This vaccine has received most of the public research funds, according to the Post. Acambis PLC and Bavarian Nordic A/S have received federal funds to work on the vaccine and are competing to win the U.S. contract to supply the treatment (see GSN, Oct. 20). While the firms’ vaccines have been tested extensively, full side effects remain unknown. The weaker vaccine could also require higher or multiple doses. Health and Human Services has issued a request for at least 20 million doses of the vaccine and could buy another 60 million. Acambis and Bavarian Nordic are expected to ask for 10 to 20 times the $3 per-dose price of the existing vaccine, according to the Post. Bavarian Nordic is urging the United States to replace its entire smallpox vaccine stockpile, which could cost billions. “What would the public say if smallpox is released, 20 million people get the safe vaccine, and everyone else gets the unsafe vaccine?” said Paul Chaplin, Bavarian Nordic’s executive vice president for research. “Which line would you and your family like to be in?” VaxGen Inc. of California is preparing another vaccine. It prompts strong immunity while lowering the risk of brain infections in children, a side effect of the standard vaccine. VaxGen’s vaccine is expected to be less expensive that the other new vaccines and by requiring only one dose might be more effective in an emergency. However, the purchase of VaxGen’s vaccine would further complicate plans for how to distribute various vaccines in an emergency. Significant quantities of new vaccines are not expected for one or two years. This gives the government time to develop a vaccine plan through consultation with state health departments and medical personnel. “I think the medical community has to take a serious look at this,” said Michael Osterholm, who leads the University of Minnesota’s Center for Infectious Disease Research and Policy. “Anybody who thinks smallpox is off the table also doesn't think a single jet can bring down a skyscraper” (Justin Gillis, Washington Post, Nov. 14).
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