Why An Imperfect HIV Vaccine Could Be Better Than None At All

published on March 21, 2018 in npr

When Health and Human Services Secretary Margaret Heckler announced that scientists had discovered the virus that caused AIDS at a press conference in 1984, the disease was still mysterious and invariably fatal.

Perhaps with a vaccine, AIDS could be ended like smallpox or contained like polio, two scourges that yielded to intense public health interventions. Heckler suggested that experimental vaccine trials were just two years away.

We now know that HIV is rarely curable, though it can be managed with antiviral medicines. And more than 30 years later, HIV vaccine research has produced mainly a string of failures.

Onlyone major HIV vaccine trial has shown anyprogress to date. In that study, done in Thailand, a two-stage vaccination approach called RV 144 resulted a roughly 30 percent reduction in HIV infections after several years. These results were hailed as proving the concept that an HIV vaccine could be protective, but the results weren't strong enough to pursue regulatory approval.

Public health officials still say that a vaccine is essential to vanquishing HIV and AIDS.

"Development of an effective HIV vaccine will likely be necessary to achieve a durable end to the HIV pandemic," Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, wrote in JAMA, the journal of the American Medical Association, in October.

And Fauci is optimistic that it can happen because the vaccines don't need to be perfect to be helpful. An incremental improvement over the one tested in the Thai trial could have a major effect on spread of HIV, he says.

The best case scenario is a vaccine that is at least 60 percent effective, Fauci says in an interview, "but I'd settle for from 50 to 55." With a HIV vaccine that stops a little more than half of all transmissions, "you could really nail down the end of the epidemic," he says.

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BC Centre for Excellence in HIV/AIDS

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Why An Imperfect HIV Vaccine Could Be Better Than None At All

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