AAASStimson briefing on public health countermeasures

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AAAS/Stimson briefing on public health
countermeasures

• Gigi Kwik Gronvall, PhD
• April 19, 2006

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SARS
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Outline of Talk

• What is a vaccine? (how does it work? why does it
  take so long to make one? how can we get them
  faster?)
• Escaping the vaccine the case of flu (seasonal
  influenza and H5N1 how can we make sure we have
  enough vaccine?)

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Things to remember about vaccines

• 1 point vaccines TRAIN the immune system
• Goal is to create immunological memory

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Immune system

• Innate immunity and Adaptive immunity
• Innate is general, adaptive is specific
• Adaptive response leads to memory
• Vaccination shortens response time for adaptive
  immunity
• T cells, B cells, and antibodies

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What do you want in your vaccine?

• Safe (vaccine itself should not cause illness and
  death)
• Effective (should protect against illness
  resulting from exposure to live pathogens)
• Effective for a long time
• Induce antibody response (some cells cant be
  replaced!) and T cell response
• Practicality (stability, low , ease of use)

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The lab is just the beginning.
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Flu vaccine the virus escapes

• Vaccines are usually very specific
• Stable (no engineering) smallpox, anthrax
• Evolving quickly flu, HIV
• Flu vaccine killed, split, trivalent, 15
  micrograms each strain, 1 shot
• Capacity is low 300 M doses worldwide. More
  capacity takes time.

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How antibodies work
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The Problem(s) with H5N1

• Poorly immunogenic 2 doses, 90 micrograms, 57
  effective
• Here Edison. Worldwide ?
• Vaccine still best way to save lives
• Even in best case, starting the race well behind
  the virus

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What can be done to expand capacity?

• Technical adjuvants (such as alum) and
  dose-sparing strategies
• Regulatory harmonization
• Small of companies
• Large of regulatory agencies
• Duplicative testing and waste of resources
• Good idea even for seasonal flu vaccine
• Meeting in March, June ?? RESULTS!

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To come

• Accelerate the process Patient ? Lab ? Other
  labs ? product development ? FDA approval ?
  Vaccine
• Remove artificial barriers technical, funding,
  and regulatory

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Thank you!
ggronvall_at_upmc-biosecurity.org Office
443-573-3308