Research updates: meningococcus, dengue, and cocaine(!?!)

While we were away, there's been news on several fronts related to research on new vaccine candidates, some much farther along than others:

• Meningococcus -- The Jan. 9-16 issue of JAMA reported positive Phase II clinical trial data for a new meningococcal vaccine for infants manufactured by Novartis. The vaccine, called Menveo, would be the first available for infants, a population not covered by two meningococcal vaccines currently licensed in the U.S. Phase III trials are underway. An editorial on the results accompanied the paper in JAMA. Here's the Novartis Press Release and coverage from USA Today and HealthDay News.

• Cocaine -- There's been a great deal of attention to stories like this one on preliminary research at Baylor University that aims to develop what its (media-savvy) researchers generously describe as a "cocaine vaccine." Similar to reports of a "nicotine vaccine" that made the rounds a few years back, more interesting than speculation about a therapy that is many, many years away (if ever) is the continued broadening of the meaning of 'vaccine' by researchers working on just about any strategy that involves the immune system. Nevertheless, the media strategy worked, as one newspaper headline (originally in the Houston Chronicle) proclaims, "Researchers develop cocaine vaccine." Time magazine was on top of the story as well, publishing a news story as well as a bioethicist Q&A with the rather sweeping headline, "The Ethics of Vaccination."
  

• Dengue -- This commentary in the Jan. 9-16 issue of JAMA co-authored by NIAID Director Anthony Fauci reviews public health risks related to dengue and hemorrhagic fever in the United States. The essay reviews the progress and unanswered questions related to dengue vaccine development.
  

HIV, Malaria, TB: vaccine research issues and planning

Several items of note over the past few weeks on research for vaccines that would have the greatest potential benefit in the developing world:

-- HIV/AIDS: In the July-August issue of Health Affairs, a paper appears titled, "The Impact of An AIDS Vaccine In Developing Countries: A New Model and Initial Results." (free abstract). Among its findings, the paper notes that a vaccine with 50% effective administered to 30% of the developing world population (both reasonable estimates) could prevent 17 million infections in 15 years.

Speaking of HIV vaccines, the death of Dr. Edward Brandt was announced this weekend. Brandt was assistant secretary of HHS in the early 1980s when AIDS and HIV were first identified. His (and HHS secretary Margaret Heckler's) overly optimistic predictions of an HIV vaccine's arrival are featured prominently in Brandt's New York Times obituary. He opined that an HIV vaccine would be available by 1987, three years after HIV was identified.

-- Malaria: A news story in the current issue of JAMA reports on malaria vaccine development ("'Roadmap' AIDS Malaria Vaccine Efforts" -- free extract.) The story provides a very good summary of progress toward a malaria vaccine and challenges needing to be addressed. The 'roadmap' referred to is the Malaria Vaccine Technology Roadmap, the product of an international series of consultations.

-- Tuberculosis: We don't talk all that often about the development of new vaccines against tuberculosis, but a paper in PLoS Medicine ("Development of New Tuberculosis Vaccines: A Global Perspective on Regulatory Issues") summarizes the content of an international meeting on the topic. The paper summarizes many of the challenges facing vaccine development and offers recommend strategies to address them.