Gleacher Center

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Sponsored by The MacLean Center for Clinical
Medical Ethics School of Law Harris Graduate
School for Public Policy Studies University of
Chicago
Gleacher Center Chicago, Illinois May 13, 2005
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Maurice R. Hilleman PhD 1920-2005

• One of the great microbiologist of our times
• Developed 40 vaccines-including 8 of the 14
  vaccines in routine use
• (mumps, measles, chickenpox, pneumonia,
  hepatitis A and B, H Flu meningitis)
• Tony Fauci MD (NIH)- Just one of his
  accomplishments would have been enough
• to have made a great career

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Maurice R. Hilleman PhD 1920-2005

• PhD in Microbiology from the University of
  Chicago-1944
• Director, Merck Institute for Therapeutic
  Research
• Probably has saved more lives than any other
  scientist in the 20th century
• Measles vaccine alone saves millions of lives
  each year

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Maurice R. Hilleman PhD 1920-2005

• Despite these extraordinary achievements, the NY
  Times published only one article
• about this great man- his obituary (Saul
  Bellow had 19 articles 1 week after his death)

Microbiologists, especially Vaccinologists, are
not as sexy as novelists
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Influenza Vaccine Development

• Dr Hilleman developed numerous strains of flu
  vaccine.
• Influenza is the 6th leading cause of death in
  the US (30-50,000 deaths /year) with 1-2
  million deaths/year in developing countries
• Micheal Osterholm NEJM May 5 2005
• Annual influenza epidemics are like Minnesota
  winters-- all are challenging, but some are worse
  than others.

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The Scientific Background Of
Vaccine Development

• Despite the prevalence and potential risk of
  influenza, the US currently only uses two
  manufacturers of flu vaccines
• Chiron-a US company
• Sonofi Pasteur (Aventis Pasteur)-France

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The Scientific Background Of
Vaccine Development

• In October 2004, British suspended the
  manufacturing license of Chirons Liverpool
  factory when it was found to be contaminated
• US officials might have seen this coming as
  contamination was found in 2003, but FDA
  inspectors did not reexamine the British plant
  until 2004.
• There were reports of contamination as early as
  August 2004
• Shutdown meant that 50 million US doses were not
  available

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The Scientific Background Of
Vaccine Development

• CDC rationing- vulnerable groups
• 65 yr, babies 6-23 months, chronic
  lung/cardiac, immune disease
• December 2004- CDC detected a surplus of doses,
  target 50 yr. Mild flu
  season, long lines, led to 3.5 million doses
  which went unused and 1.2 million emergency
  doses were discarded (cost manufacturers
  millions) reduces pharma interest in vaccine
  production
• At Merck, Hilleman pushed for vaccine generation
  even when profit margin was low.

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The Scientific Background Of
Vaccine Development

• Given that here have been 10 flu pandemics in the
  last 300 years, our country was lucky that the
  2004-5 flu season was mild. Spanish Flu of
  1918-1919 was responsible for 50-100 million
  deaths worldwide.
• Influenza experts know another pandemic is
  certain to occur, the only real question is when.
• Public health officials are predicting another
  pandemic of an avian flu virus, one about which
  we know very little. Countries like Singapore are
  taking measures to protect their citizens, most
  countries are not

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Maurice R. Hilleman PhD 1920-2005

• While viruses are unpredictable, preparedness is
  crucial
• In 1957, Hilleman recognized the early stages of
  a pandemic
• Sent off for the specimens from children in NYC
  and isolated a new strain of influenza.
• He demanded that breeders not slaughter roosters
  so they could
• fertilize enough eggs to prepare 40 million
  doses of influenza vaccine to
• protect Americans against the 1957 strain

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Maurice R. Hilleman PhD 1920-2005
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The Scientific Background Of
Vaccine Development

• Kathy Edwards, Professor of Pediatrics
  Vice Chair
  of Pediatrics Research
• Vanderbilt University
  
• Evaluating Vaccines
• Stan Shulman, Professor of Pediatrics
  Head,
  Infectious Diseases
  Northwestern University School of Medicine
  Impediments to Meeting Public Health Vaccine
  Needs