"Anthrax vaccine and public health policy" in AJPH

The latest issue of the American Journal of Public Health includes a very interesting paper by Martin Weiss and colleagues examining the spectrum of issues related to anthrax vaccine development and military vaccination efforts in recent years. The extensively-cited paper, "Anthrax vaccine and public health policy,"(subscription required for full text) also details the U.S. government's relationships with BioPort (now Emergent BioSolutions, the manufacturer of the currently licensed vaccine) and VaxGen, whose failures in anthrax vaccine development have been detailed at length here and elsewhere.

The paper raises far more questions than it answers, but it is worthwhile reading for those interested in the role of vaccines in biodefense efforts and, more generally, the role of government in vaccine development.

Bioterror: VaxGen stops work on anthrax vaccine; smallpox contract awarded

A few recent items about efforts to develop vaccines against possible agents of bioterrorism:

-- We've been following the saga of the VaxGen anthrax vaccine contract since beginning this site in March 2006 (complete coverage here). When we last checked in -- in January -- the news was that HHS had finally canceled the $877.5 million contract awarded to VaxGen as part of Project Bioshield. Just before Memorial Day weekend (likely deliberately timed to reduce media coverage), VaxGen announced that is was ceasing further development of the vaccine, an all-but-inevitable development without new funding.

Here's the VaxGen press release and a story from CIDRAP News. The press release notes that VaxGen will be laying off 20 employees as a result of this decision, which, amazingly, accounts for 25% of its workforce. There's little doubt that this point will be noted by those who had long criticized the decision to award such a significant contract to a very small, unproven player in vaccine development.

Even more bad news is highlighted in this CQ.com story, which notes the new hurdles VaxGen faces is selling its anthrax vaccine technology developed thus far.

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-- Speaking of CQ.com and bioterror vaccines, following up on this previous post, the anticipated agreement between HHS and Bavarian Nordic for a second-generation smallpox vaccine was completed last week. Here's the HHS press release and an AP story, courtesy of CBSNews.com.

Smallpox: Vaccinia exposures linked to vaccinees; new vaccine updates

Somewhat unexpectedly, May has been a very busy month for news about smallpox and the vaccinia vaccine used against it. Here are the headlines:

• MMWR reported a vaccinia infection in the genital region of a woman reporting sexual contact with a U.S. military member who had received been vaccinated against smallpox. Here's the MMWR report, a related story from CIDRAP News, and the Reuters item. The woman's case was minor and resolved with minimal treatment.

• A similar story, albeit a much more severe event, was reported last week, also via MMWR and picked up by CIDRAP News and Reuters. A two-year old child developed a severe case of eczema vaccinatum from his father, a soldier vaccinated against smallpox prior to service in Iraq. After a 48-day hospitalization, the child is expected to suffer no long-term effects from his illness. It is the first case of the rare, potentially fatal condition in the U.S. since 1998.

• A new smallpox vaccine developed by Acambis received a positive vote from a key FDA advisory committee, all but assuring licensure in the near future. Here's the story from Forbes and the Chicago Tribune. The Tribune story acknowledges the very serious side-effects associated with this new vaccine, likely limiting its use to emergency scenarios only.

• The website of Congressional Quarterly reports that HHS is nearing a contract a Danish company called Bavarian Nordic for 20 million doses of a new smallpox vaccine. The vaccine is hoped to have a more favorable side-effect profile than the current vaccine or the Acambis product noted above.
  

• Finally, this MSNBC story notes that the WHO delayed a decision on the fate of the (known) stockpiles of smallpox -- the actual virus, not the vaccine -- held by the U.S. and Russia. The story reports that both countries are reluctant to destroy their stockpiles, citing their potential value if the virus is found elsewhere. Unclear from the story is the WHO or U.N. authority to enforce their decisions, whenever they may be made.