The Chicago Tribune - April 1, 1999
Sue Ellen Christian, Tribune Staff Writer

It could be a nasal spray or an adhesive patch, or even a bite from a genetically engineered potato.

In the future, said Dr. Robert Breiman, director of the national vaccine program office at the U.S. Centers for Disease Control and Prevention, "We'll have vaccines for all sorts of diseases we don't even think of as believable now."

Getting kids immunized is already cumbersome, or impossible in the Third World, because of the required series of injections, say researchers from around the world who gathered in Bethesda this week to discuss a whole new world of vaccines that is expected to be available in the coming millennium.

The buzz among the 400 or so attendees of the Second Annual Conference on Vaccine Research is of experimental immunization, which also could include pushing a powdered vaccine into the skin by a blast of compressed air.

Finding a way of administering drugs other than by needle is under study throughout the pharmaceutical industry. In the case of vaccines, the innovations open up the possibility of immunizations for those in developing countries without the threat of contaminated reused needles.

With the number of vaccines on the rise, "the immunization schedule is becoming crowded with multiple doses and shots that have become a bottleneck for accepting new vaccines," said Dr. Bruce Weniger, assistant chief for vaccine development at the CDC's National Immunization Program.

Up to four injections may be required in a single visit for a 2-year-old, and the complex immunization schedule can lead to missed follow-up visits and decreased vaccination coverage, he said.

Lab results have shown that effective immunization can be achieved by the application of a simple gauze patch on the surface of the skin for several hours, according to the Washington, D.C.-based Iomai Corp.

Another new technology, from PowderJect, which has operations in Madison, Wis., shoots a vaccine powder into the skin cells using a small cartridge of compressed helium. Clinical trials in humans showed a protective immune response using a vaccine against Hepatitis B, according to the company.

Researchers in Cornell University's Boyce Thompson Institute for Plant Research added a piece of chromosome to a potato plant to make the plant produce a vaccine; when someone eats the potato, they also eat the vaccine.

A nasal spray against a common childhood virus that is the leading cause of croup, bronchiolitis and pneumonia showed evidence that it immunized 45 of the 57 children receiving the vaccine, according to its California-based manufacturer, Aviron.

In addition, Aviron's vaccine nasal spray for influenza not only showed protection against the flu but also against otitis media, the middle-ear infection so common in children.

With the rise in drug-resistant bugs, the need for vaccines that will prevent illness becomes even more urgent, scientists at the conference said.

Vaccines are partial, presumably harmless, forms of a germ that are designed to trigger the immune system to create antibodies. These antibodies will then fight disease if the body encounters the germ again.

The questions that researchers are seeking to understand, says Margaret Johnston, the assistant director for AIDS vaccines at the National Institute of Allergy and Infectious Diseases, are what pieces of a disease's genes to include in vaccines and how to present those genes to the body's immune system to get the best response.

Major diseases such as AIDS, malaria and tuberculosis together kill an estimated 6 million people annually, said Dr. Paul-Henri Lambert, chief of vaccine research and development at the World Health Organization. Licensed vaccines for the diseases aren't expected until 2005 to 2010, Lambert said.

There are 16,000 new infections of HIV, the virus that causes AIDS, each day in the world, said Peter Nara, president of the International Society for Vaccines. "We are slowly losing a war."

Nara said a modern global economy has done away with the idea that diseases are relegated to certain areas of the world.

"We have a cosmopolitan international lifestyle today," Nara said. "You just can't ignore what could be at your door tomorrow."

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