An HIV vaccine is one step closer to reality following a human trial that produced rare and elusive antibodies, a new study reports.
Many hurdles stand in the way of an effective HIV vaccine. The virus is a master of evasion, dodging the immune system by coating itself in sugars that resemble those made by the body, said Dr. Barton Haynes, a leader of the recent trial and director of the Duke Human Vaccine Institute. The virus also mutates rapidly, changing its form so that the immune system struggles to make antibodies that can grab hold of it.
A major goal in HIV vaccine development is triggering the production of broadly neutralizing antibodies, which latch onto parts of the virus's outer coating, or envelope, that are very similar between different HIV strains. This makes the antibodies protective against a wide variety of strains, regardless of how they mutate.
The challenge is that "these antibodies, naturally during infection, are very rare to find," said Thomas Hope, a professor of cell and developmental biology who studies HIV at Northwestern University Feinberg School of Medicine. "It takes a couple years of real infection to make these antibodies," said Hope, who was not involved in the new study but has collaborated with some of its authors in the past.
Related: We could end the AIDS epidemic in less than a decade. Here's how.
Vaccines typically work by eliciting a similar immune reaction to what's seen during a real infection. But in the case of HIV, vaccine developers have to dramatically expedite the process, calling forth antibodies in weeks that would usually take years to show up.
Now, in a study published Friday (May 17) in the journal Cell, scientists have demonstrated that this feat is possible in humans.
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"We're gathering proof of concept that a vaccine could be made can be made," Haynes told Live Science. "We're having to coax the immune system, to guide the immune system in a way we've never had to do."
In the trial, the researchers targeted a protein embedded in HIV's envelope specifically, part of the protein called the membrane proximal external region (MPER). The coveted antibodies that target MPER bind to both the backbone of this protein and to the fatty membrane it's embedded within.
"These are very unusual because they bind two things at once," Haynes said, and this makes the antibodies oddly shaped. To make antibodies of the right shape, immune cells must pick up genetic mutations over time, following exposure to a pathogen. But for reasons not fully understood, the mutations required to make antibodies against MPER and similar targets happen only very rarely.
The idea behind the new vaccine is to make these mutations more probable by exposing the immune system to a series of reaction-triggering substances. These substances, or immunogens, contain short snippets of protein and bubbles of fat. "What we're learning to do is design immunogens that can select for these rare mutations very efficiently," Haynes said.
This strategy has been demonstrated in various animal models and early human studies that aimed for targets other than MPER. These previous studies successfully coaxed immune cells to make precursors to the final, desired antibodies but the new trial represents the first time that the end-goal antibodies have been achieved in people.
"This supports the whole concept," Hope told Live Science. "Many worry if this is possible," so the new study lends credence to this iterative HIV vaccination strategy.
The trial included 20 HIV-negative volunteers. Fifteen received two vaccine doses, spaced two months apart, while the remaining five got a third dose four months after their second. Tests showed that two doses of vaccine triggered a robust response from immune cells and kicked off the production of broadly neutralizing antibodies. The team further confirmed the presence of these antibodies in the three-dose group by closely analyzing their immune cells.
The original goal of the trial was for everyone to get four doses, but it was paused after one participant given three doses had a serious allergic reaction to a vaccine ingredient called polyethylene glycol (PEG). PEG helps to stabilize certain types of vaccines in the body, but rarely, patients can have a reaction to it. The researchers have now reformulated the vaccine without PEG and will soon test the new version.
This is just one step toward making an effective HIV vaccine, Haynes emphasized. The ideal vaccine would induce four different types of broadly neutralizing antibodies that is, anti-MPER antibodies plus three more kinds. This would help prevent HIV from escaping the vaccine's protection. In addition, the antibodies need to be made in high quantities and hang around in the body for a long time.
"It's a decent starting point and it can be built upon and combined with other people's work," Hope said of the recent trial. He added that he hopes this vaccine strategy pans out, given the potential it has shown so far. Hope has been studying HIV since the late 1980s.
"I would really like to see the end of this virus," he said. "It'll lose eventually, but I'd like to see it losing."
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(Precision Vaccinations News)
The World Health Organization (WHO) today announced that UNICEF successfully delivered over 43,000 doses of the R21/Matrix-Mmalaria vaccine to Bangui, Central African Republic.
As of May 24, 2024, 122,000additional R21 doses are scheduled for delivery, funded by Gavi, the Vaccine Alliance.
TheCentral African Republic, with a population of over 5 million, is the first country to receive the R21vaccine for routine childhood immunization. This marks another step forward in preventing the disease and saving children's lives.
The WHO says that along with the earlier WHO recommendation of the RTS,S vaccine, there is now sufficient vaccine supply to scale up malaria vaccination in Africa.
Chad, Cote d'Ivoire, Democratic Republic of Congo, Mozambique, Nigeria, South Sudan, and Uganda are preparing to receive R21 shipments.
Director of UNICEF Supply Division Leila Pakkala commented in a press release,"Previous concerns about supply meeting demand are firmly behind us. Our priority is for the vaccines to reach every child at risk."
The Central African Republic has one of the highest rates of malaria incidence globally. In 2022, an estimated 1,733,000 malariacases were reported in the country, averaging about 4747 cases a day.
The disease also claimedaround 5180 lives over the year, or 14 deaths each day.
Dr. Sania Nishtar, CEO of Gavi, the Vaccine Alliance, stated,"That is what matters most that countries, where our vaccines can be most impactful, can access them, saving thousands of lives each year and offering relief to families, communities, and entire health systems."
On October 2, 2023, the WHOrecommendedR21 vaccination to prevent malaria in children. R21is a protein-basedvaccinedeveloped by the University of Oxford, using Novavax AB'sMatrix-M adjuvant technology.
"The R21/Matrix-M vaccine is a vital new tool to help stop the devastating health and economic impact of malaria on nearly half of the world's population, including the tragic loss of 1,300 children every single day," said John C. Jacobs, President and Chief Executive Officer, Novavax,on May 20, 2024.
(Updated - May 23, 2024 11:20 AM EDT)
Shares of Moderna (NASDAQ:) and other vaccine stocks rose on Wednesday after Australia reported its first human case of avian influenza.
Moderna gained 13.7%, Pfizer (NYSE:) rose 3.6%, BioNTech SE (NASDAQ:) jumped 11% and CureVac N.V. (CVAC) rallied 18%.
In a note to clients following the news, analysts at UBS said, "mRNA vaccines offer unprecedented speed/capabilities."
They added that while few human cases are confirmed, they note that "very little is known about the potential for human transmission and [the] broader public health risk."
UBS also noted that a "top investor inbound has been on [the] size of [the] recent stock move."
Elsewhere, Bloomberg reported that Moderna and Pfizer are in talks with the US on H5N1 bird flu vaccines.
Following the news, analysts at Jefferies put the Moderna stock move down to a flurry of events, including the Q1 beat, the short covering and unwind, the soon-to-come RSV FDA decision, ASCO PCV updates soon, and now public attention to any upside from Avian flu cases and/or any stockpile deals.
"These are all in play in the near-term while fundamentally - we're also focused on RSV approval, ACIP meeting in June and important IMS script data," said the firm.
Focusing on the avian flu cases, analysts at Jefferies said they will be watched and they reiterate that the headlines will "likely continue to impact the stock action and/or any stockpile deals may be a consideration for modest revenue contributions this year to any upside guidance impact."
Analysts at Jefferies added: "That said -- the stock action seems to already price a lot of this in on Avian flu - and more reasonably - has driven short covering - rather than any fundamental financial long-term impact."
Even as health systems continue to recover from the impacts of the pandemic, historic and steady investments in global health over the past few decades are delivering astounding returns. A new United Nations report shows that the global death rate for children under five has been halved since 2000, falling below 5 million for the first time ever.
This historic milestone can and should be celebrated but our work is far from over as 4.9 million children died before their 5th birthday in 2022, most of them from causes that could have been prevented or treated.
No child should die of a preventable disease. Thats why I support the work of Gavi, the Vaccine Alliance, which helps protect kids from deadly diseases by promoting access to routine immunizations for measles, cholera, HPV, Ebola, and most recently malaria. Since 2000, Gavi has helped prevent 17.3 million deaths around the world (Continued U.S. investment in life-saving vaccines is essential, May 17).
I want to thank U.S. Sen. Ben Cardin for sponsoring a resolution in support of Gavi so it can continue its life-saving work and I hope to see other lawmakers follow suit. Investing in Gavi is a strong sign of this countrys commitment to global health security and helps leverage support we need from other donor countries to create a safer, healthier world for everyone.
Deidree Bennett, Rockville
The writer is a volunteer for The ONE Campaign which seeks to end extreme poverty and preventable disease by 2030.
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When I was in elementary school, I remember going to the county health department before every school year. There were many other kids there, and we were all there for the same reason: shots. Like terrified, trembling puppies at the vet, we all knew what was coming and the sound of a screaming kindergartener meant that the nurse had created yet another happy customer. Next!
Now, imagine a world where this didnt have to happen. Instead of injecting your little rugrat with a needle, the nurse simply slaps a patch on their arm and sends them on their way. That world could exist right now and it would benefit not only wailing toddlers in this country but poor kids all over the globe.
Microneedles
Vaccine patches work because of a technology known as microneedles. True to their name, microneedles are tiny: 150-1500 m long, 50-250 m wide, and a tip diameter of 1-25 m. Importantly, unlike hypodermic needles, they do not penetrate far into the skin. As a result, they dont trigger pain receptors located deeper in the dermis, making their application painless.
There is a lot of buzz surrounding this new technology, but scientists still want to make sure that they work well. So far, research indicates that they do, sometimes even better than traditional needles. Still, there is more to learn, and a new study published in The Lancet aimed to be the first to test the safety and efficacy of a measles and rubella vaccine microneedle patch (MRV-MNP) in children.
The researchers enrolled 45 adults, 120 toddlers, and 120 infants from The Gambia in the study, but the infant cohort was the most interesting, as they were immunologically nave to MRV that is, they never had been vaccinated against measles and rubella. (Despite that, a few of the infants had antibodies against them at baseline, likely due to environmental exposure to the viruses.)
The results are shown in the charts below. The red bars represent infants who had received the vaccine patch plus a placebo shot, while the blue bars represent infants who had received a placebo patch plus a legit MRV shot. Both worked extremely well, as measured by the percentage of infants who were seroprotected (that is, had developed a sufficient antibody response) against the viruses at day 42 and day 180. Just over 90% of infants in each treatment group were seroprotected against measles, while 100% in each treatment group were seroprotected against rubella.
Source: Adigweme I, et al. The Lancet. 2024.
Side effects were minor, mainly limited to redness and induration (that is, hardening and thickening of the skin due to inflammation). Those side effects were largely absent from the infants who received a placebo patch. But, of course, most parents would trade a bloodcurdling scream for a minor rash. Indeed, vaccine patches should come with the slogan, No more tears. Too bad Johnson & Johnson trademarked it for its baby shampoo.
Vaccines of the future
Nobody likes getting jabbed, even adults. One study suggested that if we could get rid of needles, we would eliminate 10% of vaccine hesitancy cases. For many people, therefore, fear of vaccines is based not on the contents of the syringe but the fact that theres a syringe.
Given all their benefits, microneedle patches almost certainly will be the vaccines of the future. The biggest obstacle is finding the best way to manufacture them at scale, which will require a lot of research and trial and error. Some potentially good news is that microneedle patches can be 3D-printed. They also may not require a cold chain (a series of refrigerators), which would make it much easier to deliver them to people in isolated areas of poor countries. They also dont require a medical professional to administer them, as theres nothing particularly complicated about slapping a patch on someones arm.
Source: Adigweme I, et al. A measles and rubella vaccine microneedle patch in The Gambia: a phase 1/2, double-blind, double-dummy, randomized, active-controlled, age de-escalation trial. The Lancet. 2024;403(10439):1879-1892. doi:10.1016/s0140-6736(24)00532-4
By now, its as familiar as sunscreen hitting the shelves: Americans are headed into another summer with new coronavirus variants and a likely uptick in cases.
This is shaping up to be the first covid wave with barely any federal pressure to limit transmission and little data to even declare a surge. People are no longer advised to isolate for five days after testing positive. Free tests are hard to come by. Soon, uninsured people will no longer be able to get coronavirus vaccines free.
View of vials on a production line at the factory of British multinational pharmaceutical company GlaxoSmithKline (GSK) in Saint-Amand-les-Eaux, northern France, on December 3, 2020, where the adjuvant for Covid-19 vaccines will be manufactured. Francois Lo Presti/AFP via Getty Images hide caption
The two-year effort to produce a global pandemic treaty did not meet its deadline.
On Friday, Tedros Adhanom Ghebreyesus, director general of the World Health Organization, announced that the negotiators from the groups 194 member nations couldnt find consensus in time for the World Health Assembly that starts next week.
The goal had been to draw up a document that could be adopted at the meeting and then sent to countries for ratification. But the sticking points including the willingness of richer countries to share vaccines and treatments with less well-off countries in the Global South could not be resolved in time.
Nonetheless, Tedros holds out hope.
The world still needs a pandemic treaty. Many of the challenges that caused the serious impact during COVID-19 still exist, said Tedros. So let's continue to try everything.
Experts in global health expect that WHO will grant another six to 12 months for negotiators to complete their work and resolve the sticking points.
It was a huge disappointment, says Lawrence Gostin, a professor of global health law at Georgetown University, after learning about the delay. But there is a strong appetite to carry on.
In the U.S., lawmakers on both sides of the aisle have sought to ensure that any agreement would not infringe on a pharmaceutical companys proprietary information or stifle investment in drug development. A number of Republican governors have also raised concerns about whether the pandemic treaty could grant the WHO too much authority in a public health emergency.
Roland Driece, a top official in the negotiations, says that such concerns reflect disinformation about the treaty that has been circulating. He says that false claims include that WHO would have the ability to require lockdowns and mandate vaccinations.
The idea of a treaty was born at the height of the COVID pandemic when glaring gaps in the worlds collaboration and coordination became apparent and many lives were lost as a result. By one count, more than a million people died because dozens of poor countries had next to no vaccines while some wealthier nations were giving out boosters.
It was a very desperate situation, says Hadley Sultani Matendechero, deputy director general for health in Kenya. [Vaccines] in our minds were the only antidote to this catastrophe, but we were not able to access them.
SINGAPORE The number of people hospitalised for Covid-19 has increased to about 280 over the past week, said Minister for Health Ong Ye Kung, as he reiterated his call for the vulnerable to get an additional shot of the vaccine.
To make it more convenient for vulnerable seniors to get their vaccinations, mobile Covid-19 vaccination teams will be deployed at selected heartland locations across the island from now until June 28.
The number of Covid-19 hospitalisations has been increasing in recent weeks, with around 250 such cases for the week of May 5 to May 11, up from 181 the week before that.
Speaking at the Kaki Bukit Health Fiesta on May 25, Mr Ong urged residents, especially seniors, to protect themselves by wearing masks or getting an additional dose of the Covid-19 vaccine.
Get your vaccination about once a year, especially if youre older, he said at the event held at Kaki Bukit Community Centre.
This comes amid a wave of Covid-19 infections driven by the KP.1 and KP.2 sub-variants, which account for more than two-thirds of Covid-19 cases here.
As of May 3, the World Health Organisation has classified KP.2 as a variant under monitoring.
The Ministry of Health(MOH), however, has noted there is currently no indication, either globally or locally, that KP.1 and KP.2 are more transmissible or cause more severe disease than other circulating variants.
The ministry said on May 18 that the estimated number of Covid-19 cases for the week of May 5 to May 11 was 25,900, almost double the 13,700 cases for the previous week.
Mr Ong said then that the current wave was expected to peak by the end of June.
Responding to queries from The Straits Times, MOH said about 5,700 people received a dose of the updated Covid-19 vaccine between May 20 and May 23, about half of whom were aged 60 and above.
While this is over 3.5 times the number of people who received a dose of the updated Covid-19 vaccine in the period from May 13 to 16, 2024, most vulnerable Singaporeans are no longer up to date for their Covid-19 vaccinations, said an MOH spokesman.
With each new wave, there is a higher risk of them falling severely ill if infected, he added.
More Resources:Respiratory Virus Information|CDC's COVID Data Tracker
RespiratoryVirus Dashboard
Welcome to the CDPH Respiratory Virus Dashboard.
Here, you'll find weekly updates on deaths and test positivity for both influenza and COVID-19 in California. This dashboard focuses on state-level data to give a clear overview of respiratory virus trends.
Due to changes in reporting requirements for hospitals, CDPH is no longer including hospitalization data on the CDPH dashboard. CDPH remains committed to monitoring the severe outcomes of COVID-19 and influenza, including the impact on hospitals. CDC's National Healthcare Safety Network (NHSN) will remain open to accept data, and CDC and CDPH strongly encourage all facilities to continue reporting.
Tracking Respiratory Viruses in California
The latest edition of the World Health Statistics released today by the World Health Organization (WHO) reveals that the COVID-19 pandemic reversed the trend of steady gain in life expectancy at birth and healthy life expectancy at birth (HALE).
The pandemic wiped out nearly a decade of progress in improving life expectancy within just two years. Between 2019 and 2021, global life expectancy dropped by 1.8 years to 71.4 years (back to the level of 2012). Similarly, global healthy life expectancy dropped by 1.5 years to 61.9 years in 2021 (back to the level of 2012).
The 2024 report also highlights how the effects have been felt unequally across the world. The WHO regions for the Americas and South-East Asia were hit hardest, with life expectancy dropping by approximately 3 years and healthy life expectancy by 2.5 years between 2019 and 2021. In contrast, the Western Pacific Region was minimally affected during the first two years of the pandemic, with losses of less than 0.1 years in life expectancy and 0.2 years in healthy life expectancy.
There continues to be major progress in global health, with billions of people who are enjoying better health, better access to services, and better protection from health emergencies, said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. But we must remember how fragile progress can be. In just two years, the COVID-19 pandemic erased a decade of gains in life expectancy. That's why the new Pandemic Agreement is so important: not only to strengthen global health security, but to protect long-term investments in health and promote equity within and between countries.
COVID-19 rapidly emerged as a leading cause of death, ranking as the third highest cause of mortality globally in 2020 and the second in 2021. Nearly 13 million lives were lost during this period. The latest estimates reveal that except in the African and Western Pacific regions, COVID-19 was among the top five causes of deaths, notably becoming the leading cause of death in the Americas for both years.
The WHO report also highlights that noncommunicable diseases (NCDs) such as ischemic heart disease and stroke, cancers, chronic obstructive pulmonary disease, Alzheimer's disease and other dementias, and diabetes were the biggest killers before the pandemic, responsible for 74% of all deaths in 2019. Even during the pandemic, NCDs continued to account for 78% of non-COVID deaths.
The world faces a massive and complex problem of a double burden of malnutrition, where undernutrition coexists with overweight and obesity. In 2022, over one billion people aged five years and older were living with obesity, while more than half a billion were underweight. Malnutrition in children was also striking, with 148 million children under five years old affected by stunting (too short for age), 45 million suffering from wasting (too thin for height), and 37 million overweight.
The report further highlights the significant health challenges faced by persons with disabilities, refugees and migrants. In 2021, about 1.3 billion people, or 16% of the global population, had disability. This group is disproportionately affected by health inequities resulting from avoidable, unjust and unfair conditions.
Access to healthcare for refugees and migrants remains limited, with only half of the 84 countries surveyed between 2018 and 2021 providing government-funded health services to these groups at levels comparable to their citizens. This highlights the urgent need for health systems to adapt and address the persisting inequities and changing demographic needs of global populations.
Despite setbacks caused by the pandemic, the world has made some progress towards achieving the Triple Billion targets and health-related indicators of the Sustainable Development Goals (SDGs).
Since 2018, an additional 1.5 billion people achieved better health and well-being. Despite gains, rising obesity, high tobacco use and persistent air pollution hinder progress.
Universal Health Coverage expanded to 585 million more people, falling short of the goal for one billion. Additionally, only 777 million more people are likely to be adequately protected during health emergencies by 2025, falling short of the one billion target set in WHOs 13th General Programme of Work. This protection is increasingly important as the effects of climate change and other global crises increasingly threaten health security.
While we have made progress towards the Triple Billion targets since 2018, a lot still needs to be done. Data is WHOs superpower. We need to use it better to deliver more impact in countries, said Dr Samira Asma, WHO Assistant Director-General for Data, Analytics and Delivery for Impact. Without accelerating progress, it is unlikely that any of the health SDGs will be met by 2030.
The World Health Statistics report is WHOs annual compilation of the most recent available data on health and health-related indicators. For inquiries, contacthealthstat@who.int
