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Sabin Vaccine vaccine jab

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                                                                                                                                   Volume VI, Number 1
                                                                               Sabin Vaccine                                               Spring 2003

The newsletter of the Albert B. Sabin Vaccine Institute — dedicated to disease prevention                                www.sabin.org

            Accelerating Cancer Vaccine Development is Rallying Cry at 2003 Colloquium
                            Sabin Vaccine Institute Convenes Fifth Annual Meeting at Walker’s Cay
   Cancer vaccines present an elusive                   lant that has found a place in the treat-         cancer, is it possible to use vaccines to
goal, yet one that is increasingly within               ment of bladder cancer. Colloquium par-           prevent disease? The underlying tenets
reach for biomedical researchers. Their                 ticipants were challenged by Dr.                  of immunoprevention maintain that can-
hope is to offer physicians and cancer                  Shepherd’s refrain, “Why are there so             cer formation occurs slowly, thus pro-
patients more and better therapy options                few vaccines, and why does it take so             viding a window of opportunity during
than radiation and chemotherapy. The                    long to develop them?”                            which a meaningful response could be
advancement of cancer vaccine re-                          Forty of the world’s leading scientists,       induced. The capacity to induce a re-
search, from the bench to clinical trials,              medical researchers, and thought lead-            sponse lessens as cancer progresses,
was the focus of the Sabin Vaccine                      ers convened for the think-tank sessions          due to increased suppression of immune
Institute’s 5th Annual Colloquium on                    on the island where former President              cells that correlates with tumor stage.
Cancer Vaccines and Immunotherapy                       Richard Nixon first declared the War              Data Dr. Forni presented showed that
held this past March 5-8 at Walker’s                    on Cancer in 1973. Their discussion               survival was “barely improved” in vac-
Cay in the Bahamas.                                     topics ranged from underlying mecha-              cinated mice bearing tumors only 24-72
   According to H.R. Shepherd, chair-                   nisms of immunity, to clinical results, in-       weeks old, as compared with pretreat-
man of the Sabin Vaccine Institute, this                cluding such concepts as immunocom-               ment of normal mice.
year’s colloquium generated immense                     petence and immunosuppression. “Fun-                In rounds of presentations, encourag-
energy toward progress on cancer vac-                   damental to the presentations was the             ing signs pointed to tangible progress to-
cine research and immunotherapy ad-                     idea that academia, industry, and the gov-        wards a prescribable treatment therapy.
vances. Dr. Shepherd is a proponent of                  ernment can work better when working              Participants provided evidence that in
vaccines as therapeutic agents against                  together to circulate information and pro-        vitro and animal models can be used to
many forms of cancer, having been                       duce more potent and effective cancer             design treatment regimens and remove
treated successfully with BCG vaccine                   treatments,” said Dr. Shepherd.                   less promising vaccines from further de-
(traditionally a tuberculosis vaccine),                    The plenary lecture provided by                velopment. The timing of administra-
which is a non-specific immuno-stimu-                   Dr. Guido Forni from the University               tion and immune status of a patient are
                                                                                     of Turin ad-         as important to achieving therapeutic
                                                                                     dressed pro-                              Continued on page 3
                                                                                     phylactic can-
                                                                                     cer vaccines.
                                                                                     His proposal         I nside
                                                                                     was both simple        ViewPoint .................................................... 2
                                                                                     and fascinating:       Looking Back, Moving Forward ........... 3, 8-9
                                                                                     Since the stimu-       Ciro de Quadros Joins SVI ........................... 4
                                                                                     lation of anti-tu-     Rotavirus, Search for a Next Generation
                                                                                     mor immune re-            Vaccine ................................................... 5
                                                                                     sponses follow-        Samuel Katz to Receive Sabin Gold Medal ... 6
                                                                                                            Immunization on Capitol Hill ..................... 7
                                                                                     ing vaccination
                                                                                                            BioShield ................................................. 10
                                                                                     seems most
                                                                                                            PAHO and WHO Select Leaders .................. 11
Gathered are the 40 participants at the Fifth Sabin Vaccine Institute Colloquium on successful in the
                                                                                                            Double Helix Turns 50 .............................. 12
Cancer Vaccines and Immunotherapy at Walker’s Cay, Bahamas.                         initial stages of
                                                                                                            Lance Gordon Elected to Sabin Board ....... 14
2           SPRING 2003                                                                                               SABIN VACCINE REPORT

         The Sabin Vaccine Report                                                           VIEW
              is published by the                                                           POINT
       Albert B. Sabin Vaccine Institute
              Subscriptions are free               Weight of Science Shows No Link Between Vaccines & Autism
            Please direct inquiries to:                                —by Peter J. Hotez, MD, PHD, FAAP
                 58 Pine Street                           ON APRIL 6, 2003 IN THE ROANOKE TIMES AND TULSA SUNDAY WORLD.
          New Canaan, CT 06840-5408
             phone: 203.972.7907                     As a pediatrician, vaccine researcher and        The second vaccine/autism theory is based
               fax: 203.966.4763                   the father of an autistic child, I have great   on the idea that autism is the result of mer-
                www.sabin.org                      concerns regarding an ongoing debate about      cury poisoning from the thimerosal in vac-
    email: raymond.macdougall@sabin.org            the safety of our infant and childhood vac-     cines. In 1999, public health officials de-
                        EDITOR                     cines. The unfounded association that has       cided that thimerosal should be removed from
               Raymond MacDougall
                                                   been proposed by some between vaccines          vaccines as a precautionary measure.
       Veronica Korn           David Bedell        and autism is at best misleading and at worst      A study on thimerosal conducted by the
          O FFICERS OF THE SVI BOARD OF TRUSTEES   a serious undermining of children’s health.     University of Rochester was published last fall
     H. R. Shepherd, Chairman                        The vaccine/autism question stems             in The Lancet. The study showed that ethyl
     William R. Berkley, Co-Chairman
                                                   from two separate theories that are both        mercury—which is what thimerosal becomes
     Michael E. Whitham, Esq., Secretary/
       Treasurer                                   equally unscientific and have been de-          as it is metabolized—is excreted from the
                      SVI STAFF                    termined as invalid by the qualified ex-        body within seven days and does not appear
     Fran G. Sonkin, Executive Vice President      perts in vaccine science.                       to build up from one vaccination to the next.
     Paul J. Vilk, RPh, RAC, Vice President,         The first claims autism is the result of         Even when it is still in the body following
       Program Management and Regulatory
                                                   the combination measles, mumps, rubella         immunization, the levels of this mercury do
       Affairs, Hookworm Vaccine Initiative
     Ciro de Quadros, MD, MPH, Director,           (MMR) vaccine. The second claims thime-         not exceed the government standard,
       International Programs                      rosal is the autism culprit. Thimerosal is      which is based on a more potentially harm-
     Raymond MacDougall, Director of
                                                   a mercury-based compound that was used          ful form of mercury known as methyl mer-
     David Bedell, Executive Assistant to          in many vaccines since the 1930s, but           cury (the type found in some types of fish).
       the Chairman                                MMR vaccine does not, and has never,            When the report was released, research-
     Michelle Diggs, Assistant to the Director,    contained thimerosal.                           ers wrote that children would likely be ex-
       International Programs
                                                     Let’s begin with the MMR question. Nu-        posed to more mercury by eating a tuna
     Martha Fleischer, Information/Database
       Coordinator                                 merous large-scale studies have shown no        fish sandwich than by vaccines.
     Veronica Korn, Research Associate             increase in autism for children who received       More research into thimerosal is under-
     Christel Lane, Receptionist/Staff Assistant   the MMR vaccine. The most recent study,         way, though if thimerosal were the cause of
     Gboku Lumbila, Executive Assistant,
                                                   published in the New England Journal of         what some believe is a dramatic increase in
       Hookworm Vaccine Initiative
     Vanessa Santiago, Assistant to the            Medicine and funded by the National Alliance    the incidence of autism, one would expect
       Executive Vice President                    for Autism Research, examined more than         the incidence to drop dramatically since the
     Jean-Serge Valcourt, Accounting               500,000 Danish children. The study found        removal of thimerosal from vaccines in 1999.
                   SVI ADVISORS                    there was no greater incidence of autism        But it hasn’t.
     Philip K. Russell, MD, Senior Advisor to      among children who received the MMR vac-           As the father of a child with autism, I know
       the Chairman
     Peter J. Hotez, MD, PhD, Senior Fellow
                                                   cine than those who did not.                    the need for parents to understand the root
       & Chair, Scientific Advisory Council          Scientific organizations including the        of this heartbreaking disorder and find some-
     William Muraskin, PhD, Sabin Fellow           Centers for Disease Control, the Institute of   thing to blame. However, as a medical doctor,
     Patricia Thomas, Sabin Fellow                 Medicine and the American Academy of            I believe a more constructive focus is on ad-
     Nancy Gardner Hargrave, Development
                                                   Pediatrics have all said that the scientific    vancing treatment options, extending reim-
                                                   evidence does not support a causal link         bursement policies, and finding a cure.
                                                   between MMR and autism. Ironically, the            By focusing on unproven theories, we not
                                                   only known cause of autism is rubella,          only risk wasting our precious resources and
                                                   which the MMR vaccine prevents.                                      Continued on page 16
dedicated to disease prevention                                                                             www.sabin.org           3

                                             Looking Back, Moving Forward
            Sabin Vaccine Institute 10th Anniversary Evokes Reflection and Commitment to the Future
                                                                                           them, the human immunodeficiency vi-
 Ten years ago, the Sabin Vaccine Institute was founded to pursue Dr.                      rus presents an urgent and compelling
 Albert B. Sabin’s vision of a world protected from disease by vaccines. The               challenge for the world. Malaria, emerg-
 Institute’s anniversary theme—“Looking Back, Moving Forward”—takes                        ing forms of tuberculosis, rotavirus, and
 stock of these seasons of progress and captures the spirit of ongoing en-                 parasitic diseases like hookworm and
 deavors. The Institute’s projects have international scope. Their range in-               dengue fever also have no effective
 cludes vaccine policy, immunization advocacy, basic vaccine re-                           vaccine. New delivery mechanisms for
 search, and recognition of achievements in vaccinology. Fol-                                vaccines require champions as
 lowing is a brief retrospective and pictorial timeline.                                      well—aerosolized measles vaccine
                                                                                               in fact provoked the initial discus-
   The Sabin Vaccine Institute is the ful-   passion for public health,                        sion between Dr. Sabin and H.R.
fillment of an idea that germinated in a     and is the inspiration for                        Shepherd. The need for more at-
series of conversations between busi-        the Institute that carries                       tention on vaccines has been a clear
nessman H.R. Shepherd and renowned           on his legacy. Scientific                       mandate for the Institute and its on-
scientist Dr. Albert B. Sabin. The two       excellence, ingenuity, re-                    going efforts.
met to discuss aerosol technology, in        sourcefulness, and determina-                   During the first five years of the Sab-
which H.R. Shepherd had become a             tion are Dr. Sabin’s hallmark as both         in Vaccine Institute’s existence, many
successful innovator, having devised a       vaccine developer and statesman.              people lent their time, expertise, support,
full range of products from pharmaceu-         Vaccines have become the greatest           and reputation to building a strong col-
ticals to cosmetics to industrial lubri-     defense against preventable infectious        lection of programs. Mrs. Heloisa Sabin
cants. Dr. Sabin’s quest was to devel-       diseases, but there still is a long list of   was a co-founder, along with Robert
op an aerosolized measles vaccine.           diseases yet to be defeated. Among                                 Continued on page 8
   The series of conversations pro-
gressed through 1992 but were cut short              Cancer Vaccines and Immunotherapy Colloquium
by Dr. Sabin’s grave illness and death             Progress on Vaccine Studies Reported at Walker’s Cay Meeting
in March 1993. Recognizing the impor-                                               from page 1
tance of Dr. Sabin’s work, H.R. Shep-        benefit as are the components of a vac- ernment research laboratories, and in-
herd and a group of colleagues conferred     cine, according to some evidence.            dependent researchers.
with Mrs. Heloisa Sabin about establish-       The colloquium targeted five themes           This year’s colloquium was co-
ing an organization to continue her hus-     of investigation, focusing on why so chaired by W. Martin Kast, PhD, pro-
band’s legacy. With the help of a num-       many patients do not respond to treat- fessor of microbiology and immunology
ber of seasoned scientists, resourceful      ment as well as on data supporting why and pharmacology at Loyola University
entrepreneurs, and trusted advisors, an      some respond more successfully. The Chicago; and Malcolm S. Mitchell, MD,
organization where the ideals of the sci-    themes were:                                 program leader, Biological Therapy,
entist would be emulated and pursued         • Models for Cancer Vaccines                 Karmanos Cancer Institute, Wayne
came into being. The Institute emerged            and Strategies to Enhance the           State University, Detroit.
in 1993 as a tribute to this noted scien-         CD8+ T Cell Tumor Response                 More of this year’s speakers had clini-
tist and public health hero.                 • Immune Response to Tumors                  cal trials underway or under concerted
   In his life, Albert Sabin (1906-1993)     • Developing New Targets and                 development. A continuous pipeline of
courageously pushed the boundaries of             Constructs for Cancer Vaccines          vaccines into clinical trials is essential,
science with his development of the oral     • Clinical Trials and Immune                 since proof-of-principle in cancer pa-
polio vaccine (OPV), which became the             Monitoring                              tients is essential if these biologics are
primary tool in the fight against the        • Escape from Immunological                  to be approved by regulatory agencies
dreaded poliomyelitis pathogen and the            Destruction                             and made available as alternatives to che-
one used to rid the greater part of the        The 40 colloquium participants in- motherapy and radiation. If the cancer
globe from the paralyzing disease. “A        cluded approximately 20 from biomedi- vaccine development described at
scientist who is also a human being can-     cal research departments at several of Walker’s Cay is even partially success-
not rest while knowledge which might         the nation’s leading universities as well ful, the day will come sooner when a
be used to reduce suffering rests on the     as from Italy and Canada; 10 pharma- doctor no longer need tell a cancer pa-
shelf,” said Dr. Sabin. This philosophy      ceutical industry researchers; members tient, “There is nothing more we can do.”
conveys the pioneering vaccinologist’s       of biological research institutes and gov-                  —by Michael Salgaller, PhD
4       SPRING 2003                                                                                         SABIN VACCINE REPORT

              SVI Taps Ciro A. de Quadros, MD, MPH for International Programs Post
Internationally Recognized Vaccines Advocate to Pursue Immunization Goals for Latin America and Elsewhere Around Globe
   The Sabin Vaccine Institute has vaccines to prevent human suffering due                National School of Public Health, Rio
named disease eradication champion to preventable diseases.”                              de Janeiro. He subsequently participated
Ciro A. de Quadros, MD, MPH to lead           At the outset of his activities as direc-   in the organization of the first National
its international programs. Dr. de tor of international programs, Dr. de                  Epidemiology Center in his native Bra-
Quadros is a distinguished international Quadros will head up an advocacy ini-            zil. There he was involved in the devel-
public health diplomat, having this year tiative to call attention to the burden of       opment of the surveillance and contain-
completed an eight-year term as direc- two diseases with devastating health               ment strategies for smallpox eradication
tor of the Division of Vaccines and Im- impact—rotavirus and rubella.                     in Parana State, Brazil. In 1970, Dr. de
munization for the Pan American Health        Rotavirus is the most common cause          Quadros was appointed chief epidemi-
Organization (PAHO). Dr. de Quadros of diarrheal deaths among children in                 ologist for the Smallpox Eradication Pro-
will pursue international immunization developing countries. Each year, it                gram in Ethiopia by the World Health
advocacy for the Sabin Vaccine Insti- claims the lives of 600,000 children, with          Organization. Following the global
tute, with a special emphasis on the at least 18,000 deaths occurring in Latin            eradication of smallpox, Dr. de Quadros
Latin American region.                      America and the Caribbean region. The         joined the Pan American Health Orga-
   “Dr. de Quadros has devoted his en- Sabin Vaccine Institute anticipates the            nization to initiate the Expanded Pro-
tire career to disease prevention and day when a second-generation rotavirus              gram on Immunization for the region
public health and has achieved tremen- vaccine is available. Such a vaccine will          of the Americas. He led the PAHO
dous results in immunization coverage have a tremendous impact not only in                team in the successful eradication of
for the Americas,” said H.R. Shepherd, improving health, but also in furthering           poliomyelitis from the Western Hemi-
chairman of the                                             the social development        sphere, declared in 1991.
Sabin Vaccine Insti-                                        of the countries in which        In addition to disease eradication lead-
tute. “The Institute                                        the disease has the           ership, Dr. de Quadros has overseen
will be energized by                                        greatest hold.                general immunization programs for
Ciro’s role in current                                        “Encouraging the            PAHO. Regional vaccine campaigns
programs and new                                            search for a rotavirus        save the lives of more than 200,000 chil-
international initia-                                       vaccine is a high priority    dren in Latin America and the Caribbean
tives because of his                                        of both the World Health      each year, according to Dr. de Quadros,
expertise and the                                           Organization and the          and over 80 percent of children in the
high esteem in                                              Pan American Health           Americas under one year old are vacci-
which he is regarded                                        Organization,” Dr. de         nated against diphtheria, pertussis
in the international                                        Quadros said. “The            (whooping cough), tetanus, poliomyeli-
public health commu- Ciro de Quadros, MD, MPH              availability of such a vac-    tis, measles and tuberculosis. In his in-
nity.” A staunch sup-                                      cine will be a major con-      ternational public health work Dr. de
porter of the Institute’s efforts tributor to the survival of children around             Quadros has highlighted the important
through the years, Dr. de Quadros the world.”                                             role played by immunization programs.
was recognized in 2000 with the               Rubella and congenital rubella syn-         “I know from my experience with small-
Albert B. Sabin Gold Medal for his drome (CRS) account for several thou-                  pox eradication in Brazil and the Horn
achievements in vaccinology.                sand cases of congenital disabilities each    of Africa, with polio eradication and now
   “We have an opportunity to take the year such as blindness, deafness, and              the measles eradication initiative in the
international programs of the Sabin Vac- heart disease. Several countries in the          Americas, that well-run immunization
cine Institute to a new level, since vac- Americas, following their successful            programs do help strengthen health in-
cines for the developing world are a criti- efforts to eradicate measles, have now        frastructures in the countries where they
cal aspect of both public health and so- launched campaigns to eliminate rubella          are properly implemented.”
cial development,” said Dr. de Quadros. and CRS. “The interruption of transmis-              Dr. de Quadros is associate adjunct
“The Institute is in a unique position to sion of rubella will have an immediate          professor, Department of International
encourage countries to make their vac- impact in eliminating the burden of                Health, School of Hygiene and Public
cine programs a key priority, for all chil- CRS,” Dr. de Quadros said.                    Health at the Johns Hopkins University;
dren and the entire society.” He added,       Dr. de Quadros received his medical         adjunct professor, Department of Epi-
“The Institute has truly embraced the degree from the Catholic School of                  demiology and Biostatistics, School of
legacy of Dr. Albert B. Sabin, whom I Medicine, Pôrto Alegre, Brazil and his              Medicine, Case Western Reserve Uni-
knew as a great believer in the ability of master in public health degree from the                             Continued on page 11
dedicated to disease prevention                                                                                  www.sabin.org          5

                            Rotavirus—The Search for a Next Generation Vaccine
                                                Interview with Ciro de Quadros, MD, MPH
                                                                                                and another by Merck. The
 The following is the first of a series of interviews with Ciro de Quadros, MD, MPH, the
                                                                                                GlaxoSmithKline vaccine is based on a
 Sabin Vaccine Institute’s new director, International Programs. This interview fo-
                                                                                                single strain of rotavirus isolated from a
 cuses on rotavirus vaccine advocacy, one of several international activities in which
                                                                                                human with diarrhea and attenuated by
 he will be engaged. The availability of a new rotavirus vaccine is much needed,
                                                                                                repeated passaging in cell culture. It
 especially for the developing world’s children.
                                                                                                would be given as a live, oral vaccine in
                                                                                                two or three doses to children at the time
SVR Dr. de Quadros, what are the                development of severe disease that              of their routine immunizations. The
factors that make rotavirus such a              could lead to hospitalization or a fatal        Merck vaccine will be based on a bo-
dangerous disease?                              outcome.                                        vine strain of rotavirus that has been
CdQ Rotavirus is the most severe of all                                                         reassorted and combined to provide pro-
                                                SVR Who needs the rotavirus vac-
the diarrheal diseases of children. Un-                                                         tection against the four main serotypes
like many diseases that affect children                                                         of rotavirus in circulation, plus another
                                                CdQ Every child in the world will be
only in developing countries, rotavirus is                                                      outer capsid protein that is the most com-
                                                infected with rotavirus in the first few
a democratic virus and affects children                                                         mon target for virus neutralization. This
                                                years of life and every child could ben-
worldwide—rich and poor, black and                                                              vaccine, a live, oral vaccine as well,
                                                efit from a vaccine. In developed coun-
white—without distinction. Conse-                                                               would be given in three doses.
                                                tries, rotavirus leads to doctor visits, hos-
quently, every child is affected in the first
                                                pitalization, lost parent workdays, and         SVR How would the vaccine be
few years of life. Why this first infec-
                                                economic expense. In developing coun-           administered?
tion is so severe is unknown, but while
                                                tries, the consequences of rotavirus can        CdQ Both vaccines are live oral vac-
most rotavirus diarrhea is mild, about ten
                                                be fatal. A vaccine will serve to prevent       cines that would be administered orally
percent of cases lead to dehydration
                                                severe disease in any setting—fatalities        at the time of the other routine childhood
requiring a doctor visit, and in develop-
                                                in developing countries, or hospitaliza-        immunizations—to children 6, 10, and 14
ing countries one in 250 children will die
                                                tions and economic problems in devel-           weeks of age.
from this dehydration.
                                                oped countries.
                                                                                                SVR We’ve heard about the small
SVR What factors make it so
                                                SVR Your career in public health                number of cases of bowel obstruc-
                                                and disease eradication is impressive.          tions, or intussusception, that
CdQ The fact that rotavirus affects
                                                What has been your experience with              prompted the withdrawal of the pre-
children worldwide, in the United States
                                                implementing efforts to address the             vious vaccine. Is this the main hurdle
and Bangladesh, for example, indicates
                                                rotavirus disease burden?                       to be overcome in developing the sec-
that improvements in water and sanita-
                                                CdQ We have been working to assess              ond-generation vaccine?
tion will not change the incidence of dis-
                                                the burden of rotavirus diarrhea in Latin       CdQ Early studies with the rhesus vac-
ease, but it is likely spread by other
                                                America. Many studies of the importance         cine that was given to nearly one million
routes, such as airborne droplets or con-
                                                of rotavirus have been conducted                children demonstrated that the vaccine
tact. It is highly infectious in low dose
                                                throughout Latin America over the past          was highly effective and relatively safe.
and spreads rapidly among children with-
                                                20 years that indicate rotavirus is a ma-       It was withdrawn because of the rare
out prior exposure.
                                                jor problem. Efforts are being initiated        adverse event of intussusception. In
SVR Besides a vaccine, what pre-                to set up sentinel hospital surveillance        studying new vaccines, we would like
cautions, if any, can be taken to pre-          for rotavirus in many countries of Latin        to know that their risk of intussuscep-
vent rotavirus?                                 America, so the full extent of the dis-         tion is less than the risk posed by the
CdQ We know of no way to prevent                ease burden can be further ascertained.         rhesus vaccine. This safety profile is the
rotavirus infection but we do know that                                                         biggest hurdle to overcome in testing the
                                                SVR Can you describe the general
the disease can be made less severe if                                                          next generation of vaccines. It requires
                                                formulation of the vaccines that could
children are begun on treatment with oral                                                       that tests be conducted in more than
                                                potentially effectively prevent
rehydration when the first signs of vom-                                                        60,000 children to ensure that the rate
                                                rotavirus? How will it be a better vac-
iting and diarrhea begin. This strategy                                                         of intussusception is less than one in
                                                cine than the one that was used from
of early oral rehydration therapy will                                                          11,000. It also requires that investiga-
                                                1998 to 1999?
work for all acute diarrheal illness re-                                                        tors conducting trials have in place a
                                                CdQ Two vaccines to prevent rotavirus
gardless of etiology, so while we can’t
                                                diarrhea are currently under develop-
prevent rotavirus, we can prevent the                                                                              Continued on page 13
                                                ment: one by GlaxoSmithKline (GSK)
6       SPRING 2003                                                                                      SABIN VACCINE REPORT

                          Samuel L. Katz, MD, to Receive 2003 Sabin Gold Medal
                               Co-developer of Measles Vaccine to Be Honored at May Ceremony
   Samuel L. Katz, MD, the Wilburt        teem in which I hold all the former Medal Vaccine Action Program and the Na-
Cornell Davison Professor and chair-      recipients.”                                 tional Network for Immunization Infor-
man emeritus of pediatrics at Duke           According to Peter Hotez, MD, chair- mation, in addition to his consultancies
University, will be this year’s recipi-   man of the Institute’s Scientific Advi- with the National Institutes of Health,
ent of the Sabin Gold Medal. The          sory Council, “Since the measles vac- Centers for Disease Control, Food and
award recognizes exemplary leader-        cine was implemented widely through Drug Administration and World Health
ship in the field of vaccinology. Dr.     the Expanded Program                                                Organization.
Katz is contributor to numerous vac-      on Immunization in                                                    Dr. Katz provided
cine discoveries, including collabora-    1974, the number of                                                 professional lead-
tion to develop the measles vaccine       childhood deaths from                                               ership as president
in use today.                             measles decreased                                                   of the American
   “Samuel Katz exemplifies a rare        from roughly 7 million                                              Pediatric Society
sort of commitment and perseverance       deaths per year to now                                              and of the Associa-
that culminates in life-saving medical    less than 800,000                                                   tion of Medical
discoveries,” said H.R. Shepherd,         deaths per year.” Dr.                                               School Pediatric
chairman of the Sabin Vaccine Insti-      Hotez noted that the six                                            Department Chair-
tute. “The global benefit of the          million young lives con-                                            men. His published
measles vaccine alone is tremendous       ceivably saved by the                                               studies include nu-
and can be realized even further with     vaccine every year                                                  merous original sci-
amplified immunization rates.” In ad-     since 1974—150 mil-         Samuel L. Katz, MD                      entific articles,
dition to development of the measles      lion total—is in number                                             chapters in text-
vaccine, Dr. Katz worked extensively      greater than the estimated toll from all books, abstracts, commentaries, edito-
on a range of other vaccines, in-         wars during the 20th century.                rials, and reviews. He is co-editor of
cluding vaccinia (used as                         Dr. Katz’s early career included Infectious Diseases of Children, a text-
smallpox vaccine), polio,                         an internship at Beth Israel Hos- book now in its 11th edition.
rubella, influenza, per-                            pital, a residency in pediatrics
tussis (whooping                                     at the Massachusetts General                 Previous Recipients
cough), Haemophilus                                   Hospital and the Boston                  Albert B. Sabin Gold Medal
influenzae b conju-                                   Children’s Hospital, followed
gates, and HIV.                                      by a research fellowship in vi-                       1994
   His selection by the                             rology and infectious diseases.        Donald A. Henderson, MD, MPH
Sabin Gold Medal Advi-                           He became a staff member at                               1995
sory Committee of the Albert                Children’s Hospital, working with Nobel             Robert M. Chanock, MD
B. Sabin Vaccine Institute places Dr.     Laureate John F. Enders to develop the                           1996
Katz among a prestigious fraternity       attenuated measles virus vaccine.                Joseph L. Melnick, PhD (d. 2001)
of 10 previous recipients. The award         For 22 years, Dr. Katz was chairman                           1997
will be presented at 7:30 pm on May       of Duke University’s Department of Pe-            Maurice R. Hilleman, PhD, DSc
6 at the Crystal City Marriott Hotel      diatrics. In addition to mentoring two                           1998
in Arlington, Virginia. The medal cer-    decades of students and residents, he               Myron M. Levine, MD, DTPH
emony is planned during the 6th An-       established an exchange program with                             1998
nual Conference on Vaccine Re-            Oxford University and provided train-                   Allen C. Steere, MD
search, a meeting of several hundred      ing for an annual succession of residents                        1999
of Dr. Katz’s fellow scientists that is   from the American University of Beirut.        Major General Philip K. Russell, MD
co-organized by the Sabin Vaccine In-     Having relinquished the chairmanship in                      (USA Ret.)
stitute and sponsored by the National     1990, his activities continue with vac-                          2000
Foundation for Infectious Diseases.       cines and pediatric AIDS. He partici-             Ciro A. de Quadros, MD, MPH
   “This award is especially meaning-     pates in the clinical research trials of the                     2001
ful,” Dr. Katz said. “I am thrilled to    NIH, serves on their Committee for                     John B. Robbins, MD
be selected as the 2003 recipient of      AIDS Vaccines and devotes time to the                            2002
the Sabin Gold Medal and there are        care of children with HIV infection. Dr.              Stanley A. Plotkin, MD
so many reasons, including the es-        Katz currently co-chairs the India-U.S.
dedicated to disease prevention                                                                           www.sabin.org               7

                      Message on Importance of Immunization Brought to the Hill
                    Peter Hotez, Paul Offit, and Walter Orenstein Present Congressional Education Session
   The National Partnership for Immu-        through cases of varicella (chickenpox)     entry; vaccines in the pipeline; and the
nization and 27 other sponsoring organi-     disease; the most recent information        parameters and cost-benefit of develop-
zations, including the Sabin Vaccine In-     regarding thimerosal; parents’ noncom-      ing new vaccines.
stitute, hosted a briefing on vaccine        pliance because of their misperception        The initiative was intended to inform
safety at the U.S. Capitol in Washing-       that there is no disease risk; how cul-     the policy making process. By encour-
ton, DC on Thursday, January 23, 2003.       tural barriers are being addressed when     aging questions and dialogue, the brief-
“Vaccines: Our Children Are Worth a          dealing with minority populations to re-    ing delivered the public health messages
Shot” gave attendees the opportunity to      duce disparities in immunization; delay     familiar to the immunization community
view the new video, Vaccines and Your        of vaccination until mandated for school    regarding vaccine safety.
Baby, produced by the Vaccine Educa-
tion Center at the Children’s Hospital of
Philadelphia.                                    The following congressional members were represented at the briefing,
   The video screening was followed by           Vaccines: Our Children Are Worth A Shot:
a question and answer period with Paul
Offit, MD, director of the Vaccine Edu-                                             Senator Jeff Bingaman, D-NM
                                                                                    Senator Christopher Bond, R-MO
cation Center, and Peter Hotez, MD,                                                 Senator Barbara Boxer, D-CA
PhD, FAAP, chairman of The George                                                   Senator John B. Breaux, D-LA
Washington University Department of                                                 Senator Hillary Rodham Clinton, D-NY
Microbiology and Tropical Medicine and                                              Senator Christopher J. Dodd, D-CT
                                                                                    Senator Richard J. Durbin, D-IL
Sabin senior fellow. Walter Orenstein,
                                                                                    Senator John Edwards, D-NC
MD, director of the CDC’s National Im-                                              Senator James M. Inhofe, R-OK
munization Program, was also available                                              Senator Jack Reed, D-RI
to field the questions posed by Hill staff                                          Senator John D. “Jay” Rockefeller, D-WV
members and others attending.                                                       Congressman Dan Burton, R-IN
                                                                                    Congressman Jim Cooper, D-TN
   The issues raised during the meeting                                             Congressman James C. Greenwood, R-PA
included the efficacy of the Vaccine Ad-                                            Congressman Ralph Regula, R-OH
verse Events Reporting System                                                       Congressman Henry A. Waxman, D-CA
(VAERS) for new vaccines; the appar-
ent increase in the number of break-

                    Sixth Annual Conference on Vaccines Research, May 5-7, 2003
    The National Foundation for Infec-       Biodefense; Vaccine Supply: Global Cri-     cluding epidemiologists, microbiolo-
 tious Diseases (NFID), in collabora-        sis; Regulatory/Suppressor T Cells: Im-     gists, immunologists, molecular biolo-
 tion with the Sabin Vaccine Institute       plications for Vaccinology; Vaccines        gists, vaccine researchers, and public
 and a number of other organizations,        Against Nosocomial Infections; Vaccines     health officials. Attending physicians can
 will host the Sixth Annual Conference       for Zoonotic Diseases; Malaria Vaccines;    register for continuing medical education
 on Vaccine Research on May 5-7, at          and Hot Topics in Immunology.               credits.
 the Crystal Gateway Marriott in Ar-            The 2003 conference will include a
 lington, Virginia. Expert faculty from      keynote address on Effector and                For registration information,
 various disciplines will present the lat-   Memory T Cells featuring Antonio               contact the National Foundation
 est vaccine-related scientific data, re-    Lanzavecchia, MD, director of the In-          for Infectious Diseases at (301)
 sults, and issues via symposia and          stitute for Research in Biomedicine in         656-0003 x19, or by e-mail at
 panel discussions. The program in-          Bellinzona, Switzerland.                       vaccine@nfid.org, or you may
 cludes symposia on the Long-term Im-           The 2002 conference was attended by         visit the conference website at
 pact of Vaccination Strategies on Dis-      more than 500 scientists, physicians, and      www.nfid.org/conferences.
 ease Epidemiology; Vaccines and             veterinarians from around the world, in-
8          SPRING 2003                                                                                                                     SABIN VACCINE REPORT

                            Looking Back, Moving Forward                                                               Today, with national and global rec-
                                                                                                                    ognition, an $18 million Bill and Melinda
                           The Sabin Vaccine Institute at 10 Years                                                  Gates Foundation grant to develop a
                from page 3                                to get the Institute off the ground and into             hookworm vaccine, and global and do-
Chanock, MD, a close friend and con-                       a position of influence amidst the vac-                  mestic projects, the Sabin Vaccine In-
temporary of Dr. Sabin. Maj. Gen. Phil-                    cine research, public health, and global                 stitute has established a strong record
ip K. Russell, MD (USA Ret.), an ex-                       community. The entire cast of founding                   of successful initiatives.
pert on infectious diseases and biological                 organizers kept the Institute on track de-                  The pictorial on these two pages
warfare, stepped forward to serve as the                   spite its broad focus on the many aspects                shows various highlights of a vital re-
Institute’s founding president. Many oth-                  of vaccine advocacy that urgently pre-                   search and advocacy activities organized
ers whose backgrounds exemplified the                      sented themselves from the start.                        by the Sabin Vaccine Institute in the crit-
enormous potential of vaccines worked                                                                               ically important vaccine field.

1993-1998                                                  1999
                                  H.R. Shepherd, Sabin                                                                  The Cold Spring Har-
                                  Vaccine Institute
                                  Chairman, addresses
                                                            Education                                                   bor Laboratory has be-
                                                                                                                        come a favorite venue
                                  attendees at 1998 re-                                                                 for Sabin Vaccine In-
                                  ception at George-                                                                    stitute colloquia. The
                                  town University in                                                                    Laboratory is research
                                  Washington, D.C.                                                                      home to James
                                                                                                                        Watson, PhD, co-dis-
                                                                                                                        coverer of the structure of DNA, shown here with
                                                                                                                        H.R. Shepherd, SVI chairman, in 1999.

                                                              From 1999 to 2001, the Institute sponsored prizes
                                                              in infectious disease research to high school stu-
                                                              dents convened at the Intel International Science
                                                              and Engineering Fair.

                                                            Recognizing Achievement
                                                            and Humanitarianism                                         Participants discuss a presentation at the 1999 Vac-
Sabin Vaccine Institute Trustees Carol Ruth Shepherd,                                                                   cine Policy Colloquium at Cold Spring Harbor Labo-
                                                                                            Since 1996, Steuben
left, and Heloisa Sabin confer during a 1998 celebration                                                                ratory.
                                                                                            glass eagles have
in Washington, D.C.
                                                                                            been presented an-
                                                                                            nually by the Sabin
                                                                                            Vaccine Institute to
                                                                                            Lifetime Achieve-
                                                                                            ment Award and
                                                                                            Award recipients.

                                                                                                              Dr. Philip K. Russell (center) recipient of the 1999 Albert B.
                                                                                                              Sabin Gold Medal, is flanked by Sabin Vaccine Institute Chair-
Scientific forums on vaccine topics quickly be-                                                               man H.R. Shepherd and Dr. Sue Bailey, Assistant Secretary of
came the trademark of the Sabin Vaccine Insti-                                                                Defense for Health Affairs. Dr. Bailey praised Dr. Russell’s
tute. At a 1997 forum, above, Robert Gallo, MD,                                                               contributions to disease research and vaccine development as
co-discoverer of the HIV virus that causes AIDS,                                                              a major general and Commander of the U.S. Army Medical
confers with H.R. Shepherd.                                                                                   Research and Development Command.
dedicated to disease prevention                                                                                                       www.sabin.org                    9

                                                                                                                 Science writer Pat Thomas, who received support from
                                                                                                                 the Institute in 1996 for her investigation into AIDS
                                                                                                                 vaccine research, had the book Big Shot:
  Research                                                                                                       Passion, Politics and the Struggle for an
                                                                                                                 AIDS Vaccine published in 2001. Below,
  Peter J. Hotez, MD, MPH, de-                                                                                   SVI Board Member Allan Goldstein,
  picted here with a Honduran                                                                                    PhD, introduces her at a SVI celebra-
  child, is principal investiga-                                                                                 tion of her accomplishment.
  tor for the Sabin Institute’s
  Hookworm Vaccine Initiative.
  The work is funded by an $18
  million research grant
  awarded in 2000 from the Bill                                         Allan L. Goldstein, PhD, SVI Trustee,
  and Melinda Gates Foundation                                          and H.R. Shepherd, SVI chairman, pre-
  and is being conducted at The                                         pare for scientific colloquium on can-
  George Washington University, where Dr. Hotez is chairman of the      cer vaccines and immunotherapy at
  Department of Microbiology and Tropical Medicine. He also is          Walker’s Cay, Bahamas, 2000. The meet-
  chairman of the Institute’s Scientific Advisory Council.              ing has been held annually since 1999.


                                                        SVI Board Members Lance Gordon, PhD, Edward S.
Cold Spring Harbor was the site for the 2000 Collo-     Neiss, MD, and Lewis A. Miller meet at the 2000 Sabin
quium of the Sabin Vaccine Institute, attended by,      Gold Medal ceremony.
from left, Carol Nacy, PhD, Sequella; Karin Holm,
IPPH Global Health Research; and Philip Russell,                                                                 Guests revel at the 2002 Awards Dinner at The Pierre
MD, SVI Founding President.                                                                                      Hotel in New York City.

       LABORATORY, 1994-2003
  October 2002      Global Vaccine
    Shortage: The Threat to Children and
    What to Do About It
  October 2001     Making Vaccines for
    the Developing World: Access to and
    Deployment of New Technologies                      The 2000 colloquium team featured Gina Rabinovich,
  October 2000      Social Venture Capital              MD, PATH/Malaria Vaccine Initiative (currently with      Presenters at the 2002 scientific meeting Facing the
    for Neglected Vaccines: Creating                    the Bill and Melinda Gates Foundation) Phil Russell,     Challenge: Disease Prevention in a Time of Crisis,
    Successful Alliances                                MD, Lance Gordon, PhD, VaxGen, and Melinda Moree,        held at the New York Academy of Sciences. Front row,
  December 1999 Vaccines for                            PhD, PATH/Malaria Vaccine Initiative.                    from left, Margaret Hamburg, MD; Peter Hotez, MD,
    Developing Economies: Who Will Pay?                                                                          PhD; Tee Guidotti, MD, MPH; Tom Zink, MD; Sam
  October 1998      From the Bench to                                                                            Katz, MD; and Tom Frieden, MD. Back row, Philip
    Bedside: Colloquium on Translational
    Research                                            2001                                                     Russell, MD; John Robbins, MD; John Woodall, PhD;
                                                                                                                 Allan Goldstein, PhD; and Paul Offit, MD.
  November 1996 Case Studies in
    Vaccine Development
  March 1996      AIDS Vaccine Initiative:
                                                                                                                 2003 . . .
   The Sabin Foundation’s Role in                                                   H.R. Shepherd was rec-                            Ciro de Quadros, MD, heads up
   Developing an AIDS Vaccine                                                       ognized in 2001 with an                           International Programs for the
  October 1995       Vaccine Development                                            honorary DSc degree from                          Institute, including projects ad-
    and Delivery in the Era of Managed                                              The George Washington                             dressing rotavirus and rubella. Dr.
    Care                                                                            University.                                       de Quadros was a leader in both
  October 1994     Planning for the Next                                                                                              the smallpox and polio eradica-
    Generation of Vaccines                                                                                                            tion programs.
10       SPRING 2003                                                                                                  SABIN VACCINE REPORT

                                             President Details Project BioShield
                      SVI’s Philip Russell, MD Provides Expertise on Defense Against Bioterrorism
   In his State of the Union Address in             According to the White House, the           tory process is underway and they go
late January, President Bush announced           national stockpile of medical counter-         through testing for effectiveness and
Project BioShield, which the White               measures is extensive and it can be ac-        safety on their way to licensure.”
House calls “a comprehensive effort to           cessed more rapidly than ever before.             New FDA “emergency use authori-
develop and make available modern,               Additional diagnostic tests, drugs, and        zation” would also be implemented for
effective drugs and vaccines to protect          vaccines are under development. How-           promising medical countermeasures un-
against attack by biological and chemi-          ever, the medical treatments for some          der development. Some of the most
cal weapons or other dangerous patho-            types of bioterrorist attacks have seen        promising treatments for a terrorist agent
gens.” He included BioShield in the Fed-         little recent improvement. BioShield will      may still be under formal FDA review
eral FY04 Budget request now being               bring researchers, medical experts, and        when an attack occurs. BioShield
considered by Congress.                          the biomedical industry together in a new      would permit the effective use of such
   Project BioShield was conceived to            and focused way to develop treatment           treatments in an emergency, if alterna-
ensure that resources are available to           breakthroughs for bioterrorism.                tive treatments are not available. This
pay for “next-generation” medical coun-             “As we worked through the budget            will improve access to a potentially ben-
termeasures. The novel program will              process we garnered the very strong sup-       eficial treatment in an emergency situa-
allow the government to buy improved             port of the Office of the Vice President,”     tion, when it is most likely to save lives,
vaccines and drugs to treat such                 Dr. Russell said. “The vice president also     even if it has not yet been proven to be
bioterror agents as smallpox, anthrax,           asked what other initiatives can help this     suitable for routine general use or has
and botulinum toxin. Use of this author-         process along. So we included in the fi-       not completed the formal process for full
ity is currently estimated to be $6 billion      nal legislation an initiative for streamlin-   FDA licensure.
over ten years. Funds would also be              ing the current processes at NIH and a            The extraordinary authorization is
available to develop countermeasures to          legislative initiative for FDA work.”          carefully written not to undermine ex-
protect against other dangerous patho-              NIH’s usual methods for supporting          isting FDA licensing processes.
gens, such as Ebola and plague.                  research and development on conven-            BioShield would supplement the tradi-
   “The president’s BioShield Initiative is      tional diseases, while extremely effective     tional FDA licensing process, ensuring
basically a legislative initiative on the part   in those areas, may not always be suited       that the government could respond ef-
of the administration freeing obstacles to       to meet the urgent demands posed by the        fectively in a crisis with a medical coun-
very rapid development of biological             risk of terrorism. Under the BioShield         termeasure. These countermeasures
products,” said Maj. Gen. Philip K.              authority, technical experts could be rap-     would be deemed by experts to be safe
Russell, MD (USA Ret.), special advisor          idly hired and NIH could more quickly          and effective, even though they have not
on vaccine development and production,           execute research grants and contracts.         completed the formal FDA review pro-
Office of the Assistant Secretary for Pub-          How would the special authority to          cess. This authority is very narrowly
lic Health Emergency Preparedness, U.S.          engage BioShield be invoked? The Sec-          focused and targeted only at drugs and
Department of Health and Human Ser-              retary of Homeland Security and the            vaccines under the direct control of the
vices. “In order to manufacture this large       Secretary of Health and Human Ser-             U.S. government. It would only be in-
list of products in very large volume we         vices will collaborate to identify critical    voked after certain certifications had
need special procurement authority.”             medical countermeasures by evaluating          been made, and civilian use of the treat-
   The new initiative would strengthen           potential threats. New biomedical re-          ments would be voluntary.
development capabilities at the National         search initiatives will be developed in            The BioShield program provides a
Institutes of Health (NIH) to acceler-           view of public health requirements and         stable funding source for the pharma-
ate research and development on medi-            appropriate NIH programs would be cre-         ceutical industry to produce drugs and
cal countermeasures based on the most            ated to speed research and development         vaccines for the national stockpile. “The
promising recent scientific discoveries.         for medical countermeasures.                   really exciting thing about this to me is
It would also give the Food and Drug                “The strategy we put in place is to         that it produces a mechanism for the
Administration (FDA) the authority to            overlap several of the activities we usu-      government to assure a financial incen-
rapidly approve promising investigational        ally do end to end,” Dr. Russell said. “For    tive,” Dr. Russell said. “We need a solid
treatments for emergency situations.             instance, with the smallpox vaccine the        manufacturing base to build the vaccines.
FDA can judiciously use its new au-              manufacturing will be completed prior          For a long time there was a problem
thority to make the newest treatments            to completion of a Phase II trial. For all     showing long-term support.”
widely available to patients who need            of these products, we expect to have           (This article draws upon White House press state-
them in a crisis.                                them in the stockpile while the regula-        ments and Dr. Russell’s presentation at the National
                                                                                                Vaccine Advisory Council meeting on February 5, 2003.)
dedicated to disease prevention                                                                             www.sabin.org          11

                                New Leaders Take the Helm at PAHO and WHO
   In the past few months, two international organizations that coordinate and conduct public health activity
 around the globe have chosen new leaders to govern their international programs. The Pan American Health
 Organization (PAHO) and the World Health Organization (WHO) both conduct vaccine purchase and immuniza-
 tion programs that reach millions around the world.
           Dr. Mirta Roses Sets Commitments as New Director of the                          Jong-Wook Lee, MD Begins New
                      Pan American Health Organization                                       Role as Director-General of the
  Renewing her commitment to work for continue serving health in the Americas,”                World Health Organization
public health in the Americas, Dr. Mirta she said. “The focus of my attention will            The Execu-
Roses Periago was sworn in January 31 be working in and with the countries.                tive Board of
as the new director of the Pan Ameri- Faithful to my profession as an epide-               the       World
can Health Organization (PAHO), be- miologist, I will seek contact with the                Health Organi-
coming the first Argentine and first communities and observe the projects                  zation nomi-
woman to lead the Organization. “We in the field.”                                         nated Dr Jong-
are committed to health                                 “This Director and her team        Wook Lee to
for all, to the strategy                             will be defending your health,”       become the
of primary health care                               Dr. Roses declared in her first       organization’s
                                                                                                               Jong-Wook Lee, MD
strategy, to health pro-                             address as director. She said she     director-gen-
motion, and to the re-                               will give special importance to       eral this coming
duction of inequities                                the fight against the AIDS epi-       July. The post is WHO’s chief technical
and social exclusion,”                               demic, focusing on the countries      and administrative office and Dr. Lee
Dr. Roses said. PAHO                                 of the Caribbean, and to im-          will be charged with setting the policy
works with all the                                   provements in health conditions       for the Organization’s international
countries of the Mirta Roses Periago, MD             in priority countries, particularly   health work.
Americas to improve                                  Haiti, she said.                         Dr. Lee received his medical degree
the health and living standards of all their    After thanking outgoing Director Dr.       from Seoul National University and a
peoples. It also serves as the Regional George Alleyne and a host of well-wish-            master of public health degree from the
Office for the Americas of the World ing dignitaries, Dr. Roses said, “I reaf-             University of Hawaii. During the past
Health Organization.                         firm my commitment with emotion and           19 years with WHO, he held technical,
  In her inaugural speech, Dr. Roses pride as the first woman to assume the                managerial and policy positions, notably
recalled her first paid public health job direction of this centenary and presti-          leading the fight against two of the
as a door-to-door vaccinator in the gious Organization and to guide it at the              greatest challenges to health and devel-
smallpox eradication campaign of 1965. beginning of this new Millennium.”                  opment: tuberculosis and vaccine pre-
“I feel very moved after 38 years to                                                       ventable diseases of children. After
                                                                                           heading the WHO Global Programme
                                                                                           for Vaccines and Immunization and
                                                                                           serving as a senior policy advisor, in 2000
  Ciro de Quadros to Direct International Programs for SVI                                 he became director of the Stop TB
              from page 4                    Needle, for his contribution to smallpox      program, a coalition of more than 250
versity; and adjunct professor in the        eradication; the International Child Sur-     international partners including
Department of Microbiology and Tropi-        vival Award from UNICEF and the               WHO member states, donors, non-
cal Medicine at The George Washing-          Carter Center, for personal contribu-         governmental organizations, industry
ton University.                              tion to polio eradication; the Prince         and foundations.
  Dr. de Quadros is a member of the          Mahidol Award of Thailand, for his               Dr. Lee, a South Korean national, will
American Public Health Association,          contribution to polio eradication in the      succeed Dr. Gro Harlem Brundtland, a
American Association for the Advance-        Americas; the Order of Rio Branco             former Norwegian prime minister, who
ment of Science, National Council for In-    of Brazil, for contributing to improv-        is stepping down following a single term.
ternational Health, American Society of      ing the health of the peoples of the          Dr. Lee will begin a five-year term on
Tropical Medicine and Hygiene, and the       world; and this past February he re-          21 July 2003. His nomination is expected
New York Academy of Sciences. Among          ceived the Order of Public Health from        to be approved at the 56th World Health
his awards are the World Health              the Government of Bolivia. He is the          Assembly scheduled to meet in Geneva
Organization’s Order of the Bifurcated       recipient of numerous other honors.           from May 19-28, 2003.
12        SPRING 2003                                                                                     SABIN VACCINE REPORT

                      Marking 50 Year Anniversary of Discovery of the Double Helix
              Cold Spring Harbor Laboratory Commemorates Landmark Event with Scientific Meeting
  Genetics and genomics are cutting-            This year, the Cold Spring Harbor        sequences can be calculated per day and
edge research fields today, offering         Laboratory on Long Island, New York,        fed into “public” databases to be
enormous medical potential and               celebrates this landmark discovery along    analyzed by all scientists. This
opportunity for therapeutic innovations.     with the role the Laboratory has played     information has spawned a new field of
Just 50 years ago, the structure of DNA      as a research base for investigations in    informatics, which scans large libraries
was hardly understood and a new              genetics. A featured scientific meeting     of data to derive new discoveries.
discovery offered a breakthrough of          of the anniversary commemoration was          Take for example, the comparison of
immense proportions. Dr. James Watson        the conference on Biology of DNA, held           genome homology of gorillas,
and Dr. Francis Crick determined how         from February 26 to March 2, 2003.                         c h i m p a n z e e s ,
deoxyribose nucleic acid (DNA) is               The conference featured noted                             Neanderthals        and
structured and governed and launched         speakers, including Nobel laureates,                         humans—this analysis
a sort of scientific revolution.             who recounted their discoveries,                               can yield not only the
  At the time of their landmark              including developments on the                                  sequence of evolution
discovery in 1953, the chemical structure    enzymatic and structural processes                             but also determine the
of DNA was known, as were its                involved in DNA replication,                                 millions of years
bases—GCAT, their pairing—G=C and            translocation and expression (see                        between each evolutional
A=T, and that they were strung along         list). The impact on subsequent                           deviation that occurred.
polyphosphate chains. Still to be            research illustrated the progression                      Similarly by comparing
discovered was how they were arranged        in science that has led up to modern                     genomic homology amongst
into strands to make chromosomes, the        sophisticated technologies and                           Africans, Europeans, and
basic building blocks of life. Using x-ray   techniques in the field. Those                         Asians, the tree of human life
crystallography and chemical bonding         scientists who came more                               can be established and the
information, Dr. Watson and Dr. Crick        recently to the field also                            spread of the human race
were able to describe the double helical     participated. Computer                             timed. Non-genetic DNA in the
structure. Their discovery won for them      graphics, fluorescence                            chromosome (80 percent of the
the Nobel Prize and publication in such      techniques, and molecular                          total) and in mitochondria also
leading journals as Nature. This             modeling created a                                 may be very important in dictating
discovery opened the window into the         staggering depiction of the                       human variation.
three-dimensional double helix structure,    cellular and molecular events                   The events surrounding the 50th year
therefore making it possible to              associated with DNA and                     celebration showcased senior
understand the function of genes and         chromosomal synthesis and replication,      researchers who were part of the early
their mutations.                             and ultimately expression.                  discoveries in the genetics field as well
                                                The degree of sophistication among       as the promise of new discoveries in the
                                             techniques in the field was on display at   field assured by a new generation of
  Select Speakers and Talks Featured         the meeting. Researchers can boast an       investigators.
     at the Biology of DNA Meeting
                                             understanding of how three billion base       For those anticipating an impact of
 Replication and Recombination of the        pairs are linked to make life as we know    genetics discoveries on the vaccine field,
       Double Helix, Frank Stahl
                                             it. With the accumulation of the base       significant understanding has already
       The Enzymology of DNA and             compositions of the 30,000 human genes      been gleaned from the concepts
      Polyphosphates, Arthur Kornberg
             (Nobelist, 1959)                elucidated by the Human Genome              elucidated by Dr. Watson and Dr. Crick.
                                             Project, it has become possible to          DNA defines “self.” It is this
         Chromosome Replication,
              Bruce Stillman                 envision an “encyclopedia” containing       characteristic that enables the nervous
     Recombination with DNA Strands,
                                             the determination of how we are             system and the immune system to
             Robin Holliday                  uniquely different from plants and other    recognize what is “self” and what is the
      Deciphering the Genetic Code,          forms of life.                              “other,” and to react appropriately.
     Marshal Nirenberg (Nobelist, 1968)         The impact of the Human Genome           Immunologic response is rooted in this
     Comparative Genetics, Eric Lander       Project on molecular biology is             concept, and the immune system, in
                                             outstanding. The technical achievement      defense of self, conveys vaccine-
     Closing Remarks, James Watson           to assess the base sequences of a           induced protection from pathogen
             (Nobelist, 1962)                number of species is itself                 challenge.
                                             remarkable…such that millions of base                    —by John W. Hadden, MD
dedicated to disease prevention                                                                                                                             www.sabin.org           13

                       On Rotavirus: An Interview with Ciro de Quadros, MD, MPH
                                                            continued from page 5

mechanism to identify children with           ery, with many economic, political and                                                      SVR How would this differentia-
symptoms that might represent intussus-       cultural overtones. However, with the                                                       tion be addressed in a new vaccine?
ception, which can be assessed and            trials ongoing and new vaccines prepar-                                                     CdQ The only way to know if a new
treated by a quality-care facility.           ing for future tests, we can develop a                                                      vaccine will work against the main se-
   Since the new generation vaccines be-      vaccine that is as effective as the first                                                   rotypes of rotavirus is to conduct large-
ing tested are both live, oral vaccines,      vaccine, but with a safer profile and                                                       scale field trials in a variety of settings.
one might question whether it will be any     fewer adverse events.                                                                       These studies are planned and will be
better than the rhesus vaccine that was                                                                                                   ongoing shortly, and should give us an
                                              SVR I’ve heard that there can be
licensed in 1998. In fact, we won’t know                                                                                                  answer to these important questions in
                                              different strains or serotypes of
the safety profile of these two vaccines                                                                                                  a couple of years.
                                              rotavirus. Are these different serotypes
until 60,000 children have been immu-
                                              distributed geographically so that                                                          SVR What about the clinical tri-
nized and we can assess whether these
                                              different kinds of cases would appear                                                       als for a new vaccine? What will
children develop intussusception. None-
                                              in say Latin America, than Africa or                                                        they entail?
theless, for the GSK vaccine, we have
                                              North America?                                                                              CdQ Trials need to be large, with ac-
no evidence that natural human rotavirus
                                              CdQ There are four or five main sero-                                                       tive follow-up for intussusception, and
is implicated as a cause of intussuscep-
                                              types of rotavirus found worldwide. The                                                     are relatively costly. It is unfortunate with
tion, so we hope that this holds for the
                                              vaccine—to be effective—must cover                                                          rotavirus that we have no good proxy
vaccine as well. For the Merck vaccine,
                                              these principal serotypes. At the same                                                      for protection from vaccine. Conse-
the bovine strains replicate less than the
                                              time, the common serotypes in the                                                           quently, the only way to assess the effi-
rhesus strains and cause less fever than
                                              United States are also common in Latin                                                      cacy of a new vaccine is through a
the rhesus strains, meaning they are
                                              America and worldwide; however, in                                                          large-scale clinical trial. Large-scale
more attenuated. We hope that these
                                              some countries like Brazil, unusual se-                                                     clinical trials of both the GSK and Merck
milder infections will also be associated
                                              rotypes have emerged, perhaps from                                                          vaccines are ongoing, so it conceivable
with fewer adverse events.
                                              contact with cows or pigs, which also                                                       that these vaccines could be licensed in
SVR There has been some contro-               have rotavirus. Some evidence exists                                                        two to four years.
versy over the withdrawal of the 1998         that genes of rotavirus of animal origin
                                                                                                                                          SVR What is the global outlook for
vaccine because intussusception               can reassort and infect humans. These
                                                                                                                                          a vaccine once it is licensed?
cases were few and the cases of chil-         situations appear to be rare, but will re-
                                                                                                                                          CdQ Our hope for the global agenda is
dren who die as a consequence of              quire some monitoring of strains over
                                                                                                                                          that in 10 years, we would be able to
rotavirus are tremendously greater in         time. Trials of the new vaccines are
                                                                                                                                          immunize 80 percent of the world’s chil-
number—between 600,000 and                    about to be conducted in many countries
                                                                                                                                          dren against rotavirus and decrease
800,000 per year. How does this di-           of Latin America, Asia, and the United
                                                                                                                                          rotavirus mortality by 60 percent.
lemma impact the urgency of making            States and Europe. At the same time, a
a rotavirus vaccine available? Is the         vaccine has already been licensed in                                                        SVR Do you imagine rotavirus ul-
rotavirus vaccine a good case study           China and several other new vaccines                                                        timately will be on the recommended
on rethinking the benefit versus risk         could be licensed in India and Indonesia                                                    childhood immunization schedule?
of vaccines, in general?                      in five to seven years.                                                                     CdQ Absolutely, yes!
CdQ The risk-benefit analysis of
rotavirus is quite different in developed
and developing countries. In the United                                                                                            The Sabin Vaccine Institute published

States, few children die of rotavirus and                                                                                          a white paper following its October

the disease is generally mild. Conse-
                                                                                                                                   2002 vaccine policy colloquium titled
                                                                                                                          E 2003

quently, a vaccine with any adverse                                  ortage:
event poses an unacceptable risk. In              Global Va
                                                  The Threa
                                                           ccine Sh
                                                            t To Child
                                                                      ren and W
                                                                               hat To Do
                                                                                         About It
                                                                                                                                   Global Vaccine Shortage: The Threat
developing countries where one in 250              A White
                                                              Lessons from
                                                                          e’s 9th Ann
                                                                                     ual Vaccine
                                                                                                                                   to Children and What to Do About It.
                                                             cine Institut

children die of rotavirus, even a vaccine           Sabin Vac

                                                                                                                                   Readers can locate an electronic PDF
with a small risk of an adverse event

could still be effective in preventing this                                                                                        file of the document on the Sabin
most common cause of death in children.                                                                                            Vaccine Institute website,
This is a true dilemma in vaccine deliv-                                                                                            www.sabin.org.
14      SPRING 2003                                                                                          SABIN VACCINE REPORT

                Vaccine Developer Lance Gordon, PhD, Elected to Sabin Institute Board
                            VaxGen CEO Named to the Board of Trustees at February Meeting

  The Sabin Vaccine Institute Board of        Therapeutics Group. He was the found- tor of the Connaught Haemophilus
Trustees elected Lance Gordon, PhD,           ing president and chief executive officer influenzae type b conjugate vaccine,
to its membership during its meeting this     of OraVax from 1990 though 1999.           ProHibit®. Dr. Gordon serves on the
past February. Dr. Gordon is chief ex-           In the late 1980s, Dr. Gordon led advisory board of BioSciences Contract
ecutive officer of VaxGen, Inc., the Cali-    Selcore Laboratories, Inc., as CEO, as Production, a private biopharmaceutical
fornia-based biopharmaceutical com-           well as its successors, American Vac- services company. He is a member of
pany whose AIDS vaccine trials were           cine Corporation and North American the Scientific Advisory Council of the
so closely followed the world over this       Vaccine, Inc. He was associate direc- Sabin Institute and is a Fellow of the
past year.                                    tor, Infectious & Inflammatory Diseases, U.S. Medicine Institute. He is a con-
  “Lance Gordon’s name is virtually           Clinical Pharmacology—                                    sultant on vaccine re-
synonymous with cutting-edge vaccine          Drug Medical Affairs, of                                  lated issues to the Part-
development and we’re entirely pleased        E.R. Squibb & Sons, Inc.,                                 nership for Appropriate
that he is now a member of the Institute’s    pharmaceutical com-                                       Technologies in Health,
board of trustees,” said H.R. Shepherd,       pany. He was research                                     the United Nations
chairman. “He’s been in the vaccine           director with Connaught                                   Children’s Fund, and
business, making progress in an indus-        Laboratories for six                                      the World Bank .
try that has struggled to stay alive. He      years in the early and mid                                  Dr. Gordon is a
understands the critical importance of        1980s, before its merger                                  graduate of the Univer-
vaccines in modern health care and his        with Pasteur Mérieux,                                     sity of California at
name is the first to come to mind re-         which later emerged as                                    Humboldt and from the
garding the current state of the art in       Aventis Pasteur.                                          University of Connecti-
vaccines.”                                       During his seven years Lance Gordon, PhD               cut, where he received
  Dr. Gordon is an expert vaccine sci-        with Connaught, Dr. Gor-                                  his PhD in biomedical
entist and entrepreneur who has held a        don was responsible for both bacterial science. Dr. Gordon completed his
number of senior executive management         and viral vaccine research and devel- postdoctoral fellowship with the
roles in biopharmaceuticals. Prior to join-   opment programs as well as for scien- Howard Hughes Medical Institute at
ing VaxGen in 2001, he served two years       tific support of licensed products. He Washington University Medical School
as North American director for Peptide        was also the inventor and project direc-
                                                                                            in St. Louis, Missouri.

                                          The Iditarod—The Last Great Race
                Famous Sled Dog Race Reenacts Heroic Effort in 1925 to Arrest Diphtheria Outbreak

   An epidemic of the disease diph-           The name “Iditarod” refers to an              can cause a complete loss of visibil-
 theria loomed over the small town of         Athabascan term for their inland hunt-        ity, long hours of darkness, and treach-
 Nome, Alaska in 1925. A serum was            ing ground—“the distant place.” A trail       erous climbs.
 needed to inoculate the townspeople          from Nome through Iditarod and on to             The original Iditarod was a race
 but it was in short supply. Bad weather      Seward, the major seaport in southern         against time and the ravages of a
 in the area kept airplanes from              Alaska, originally called the Seward Trail,   deadly disease. One can only imagine
 Fairbanks on the ground. The serum           later became known as the Iditarod Trail.     the relief and satisfaction of the
 was instead rushed from Nenana to              The Iditarod is also called the “Last       mushers in 1925, whose efforts
 Nome—about 675 miles—by dog                  Great Race on Earth.” Today competi-          averted the progress of the diphtheria
 teams. The medicine was relayed the          tors navigate across 1049 miles of the        epidemic by transporting the vital se-
 distance in just 127.5 hours.                Alaska’s roughest terrain, including          rum. This year’s winner, Robert Sorlie
   The Iditarod Trail Sled Dog Race is        jagged mountain ranges, frozen rivers,        of Norway, was the first European
 run to commemorate the historic se-          dense forests, desolate tundra, and miles     musher to continue the tradition and
 rum run. The race begins in Anchor-          of windswept coast. Each team of 12           cross the Iditarod finish line. He fin-
 age during the first weekend in March        to 18 dogs and their musher endures           ished the race in 9 days, 15 hours, 47
 and ends about 10 days later in Nome.        temperatures far below zero, winds that       minutes and 36 seconds.
dedicated to disease prevention                                                                                www.sabin.org              15

                             Sabin Vaccine Institute Salutes Deborah Wexler, MD
             Immunization Action Coalition Founder Turns Community Outreach into National Forum
   Deborah Wexler, MD believes in be-        resident in the University of Wisconsin      hepatitis B vaccination for all children
ing well informed. Her work, her pas-        Madison’s Department of Family Medi-         up to 18 years of age, screening for all
sion, and her life is seeing to it that      cine and Practice, she trained at the        pregnant women, testing and vaccina-
healthcare providers—along with an           community-based program in Eau Claire,       tion for high-risk groups, and education
often misinformed public—are well in-        Wisconsin. There she became interested       and treatment for people who are chroni-
formed about immunizations and the ca-       in hepatitis B preven-                                     cally infected with hepati-
tastrophes that can result when compla-      tion as she treated                                        tis B. In 1994, the Hepati-
cency sets in on this health topic.          refugees from South-                                       tis B Coalition became an
   Dr. Wexler is the founder and execu-      east Asia, where there                                     official program of IAC
tive director of the Immunization Action     is a high rate of hepati-                                  when IAC was granted tax
Coalition (IAC), a nonprofit organization    tis B infection. She de-                                   exempt status.
she started from grassroot efforts to        veloped a clinic-wide                                         IAC has grown from hav-
boost immunization rates and thus pre-       tracking system to en-                                     ing just one staff member
vent disease. Today it is an information     sure that these refu-                                      to an operation of eight full-
clearinghouse helping healthcare provid-     gees received vaccina-                                     time and two part-time em-
ers to stay abreast of immunization re-      tions against hepatitis B                                  ployees, with several con-
quirements, benefits, and breakthroughs.     or were followed for                                       sultants who assist in pro-
The information published by IAC is          liver disease.                                             gram development, grant
available on the organization’s website         In 1988, while work- Deborah Wexler,     MD             writing, and web site devel-
www.immunize.org and includes pedi-          ing at a community                                         opment. Today the IAC has
atric and adult immunization schedules       health center in St. Paul, Minnesota, she    a $1 million budget.
and practical vaccine information and        again treated refugees regularly and            A major focus of the IAC is its publi-
guidelines not only for physicians but for   discovered that most of the refugees         cation of three newsletters twice a year
the public as well. In fact, some of the     and their children citywide were not         which provide helpful, practical immu-
information has been translated into 29      getting screened for or vaccinated           nization information for health profes-
languages!                                   against hepatitis B.                         sionals and the public. NEEDLE TIPS
   Dr. Wexler graduated from the Uni-           Because of this, Dr. Wexler and other     (illustrated by Dr. Wexler’s children) is
versity of Minnesota with an under-          public health and healthcare profession-     a 28-page newsletter mailed to 200,000
graduate degree in biology in 1975 and       als formed the Hepatitis B Coalition.        health professionals; VACCINATE
a medical degree in 1982. As a medical       The Hepatitis B Coalition promotes           ADULTS! is mailed to 180,000 adult
                                                                                          medicine specialists; and VACCINATE
                                                                                          WOMEN is mailed to 35,000 obstetri-
                                                                                          cian/gynecologists and others who are
        SAVE THE DATE                                                                     concerned with women’s health issues.
                                                                                          All IAC’s information is available on the
                                                                                          main web site, www.immunize.org,
                                                                                          which provides links to the other
                                                                                          websites maintained by the IAC,
                                                                                          w w w. v a c c i n e i n f o r m a t i o n . o r g ,
                                                                                          www.izcoalitions.org, as well as
                        Wednesday, May 14, 2003                                           www.hepprograms.org.

                   Sabin Vaccine Institute                                                                Would you like to read
                   Annual Awards Dinner                                                                                Vaccine
                                                                                                           the Sabin Vaccine
                                                                                                           Report online? Our
                                                                                                          newsletter is available
                               The Pierre Hotel                                                             in a PDF format at
                                New York City                                                                www.sabin.org.
16       SPRING 2003                                                                                              SABIN VACCINE REPORT

             VIEWPOINT:                                                                  SABIN
          Science Confirms                                                             CALENDAR
           Vaccine Safety                           APRIL 2003                                   14                 New York, New York
                 from page 2                        23-25            Boston, Massachusetts         Sabin 2003 Awards Celebration
                                                      2nd Annual Conference on Advances            The Pierre Hotel
not finding the real cause of autism, but             in Designing Cancer Vaccines                 sabin@sabin.org
we also risk parents losing confidence in             Hilton Boston Back Bay
                                                                                                 19-22           Amsterdam, Netherlands
vaccines, resulting in fewer children be-                                                          Phacilitate Vaccine Forum Spring
ing immunized. This would leave our                                                                2003
                                                    30 - May 2         Bethesda, Maryland          The Grand Hotel Krasnapolsky
youngest vulnerable to diseases that we
                                                      Ninth National Symposium: Basic              www.phacilitate.co.uk/pages/
have only read about in history books, re-            Aspects of Vaccines                          spring_vaccine/home.html
versing one the world’s most successful               Walter Reed Army Institute of
                                                                                                 28-30       Phoenix-Scottsdale, Arizona
public health programs.                               Research
                                                                                                   The Fifth National Conference on
   A proposed link between autism and vac-                                                         Immunization Coalitions
cines is a distraction that focuses attention                                                      Westin Kierland Resort and Spa
away from the real needs of parents of autis-
tic children, namely finding respite care,          MAY 2003
                                                    5-7                Arlington, Virginia
searching for a child psychiatrist who accepts                                                   JUNE 2003
                                                     Sixth Annual Conference on
health insurance, and getting quality special                                                    2-4                     Washington, DC
                                                     Vaccine Research
                                                                                                   Biodefense Vaccines, Therapeutics
education through public school systems.             Crystal Gateway Marriott
                                                                                                   and Diagnostics: Policy, Funding,
   Ireland and parts of the U.K. are a case          www.nfid.org/conferences
                                                                                                   Development, Testing, Production,
study of what happens when the fear spreads         6                      Arlington, Virginia     and Distribution
through the media; fears of the “MMR jab”               Albert B. Sabin Gold Medal Award           www.infocastinc.com/Biodefhome.htm
                                                        to Samuel L. Katz, MD
have led to a significant drop in the immuni-                                                    3-5               Alexandria, Virginia
                                                        Crystal Gateway Marriott
zation rate, resulting in a dramatic increase                                                      Chlamydia Vaccine Development
                                                                                                   Hilton Alexandria Mark Center
in the number of measles and mumps cases.
                                                    7-11                 New York, New York        veronica.korn@sabin.org
We often forget that measles is still the single      8th Conference of the International
                                                                                                 4-6                   Dublin, Ireland
leading killer of children in the world.              Society of Travel Medicine (CISTM8)
                                                                                                   Modern Vaccine Adjuvants
   With today’s ease of travel, these diseases        Marriott Marquis Hotel
                                                                                                   & Delivery Systems
can quickly be imported into the United                                                            The Alexander Hotel
States, putting children who are unprotected                                                       www.meetingsmanagement.com/
at great risk of contracting the disease.
   Every parent has to decide: is it worth pro-
tecting my child from a real, deadly threat
or protecting him from a hypothetical, sci-
entifically unproven leap of logic? I chose
                                                                                                                         NON-PROFIT ORG.
the former and I am confident I made the                                                                                   U.S. POSTAGE
right decision.                                                                                                               PAID
                                                                                                                           MONTROSE, PA

Peter J. Hotez, MD, PhD is professor and                                                                                   PERMIT NO. 2

chair of the Department of Microbiology and        58 Pine Street                                               RETURN SERVICE REQUESTED
                                                   New Canaan, CT 06840
Tropical Medicine, The George Washington           U.S.A.
University, and senior fellow of the Albert
Sabin Vaccine Institute. He is also visiting
professor of the Institute of Parasitic Dis-
eases of the Chinese Academy of Preventive
Medicine in Shanghai.

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