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Patching Gaps In Global Pneumococcal Vaccination

Since 2000, U.S. infants have been routinely immunized against pneumococcal (Streptococcus pneumoniae) infection, but the existing vaccine"s expense puts it out of reach for most developing countries, where almost one million children die from pneumococcal infections each year. Richard Malley, MD, of the Division of Infectious Diseases at Children"s Hospital Boston, is at work on a pneumococcal vaccine that meets developing countries" needs it can be made cheaply, withstands high temperatures without refrigeration, and can be given without needles, avoiding the need for sterile procedures and medical professionals to administer it. Also, because it is a whole-cell vaccine, it should provide protection against virtually all of the 91 pneumococcal serotypes that infect people worldwide. (The U.S. vaccine covers only seven.) Although a nasal form of the vaccine has already been tested in animals, there is concern that it may irritate infants" nasal passages and create breathing problems. Also, children in developing countries frequently have chronic nasal discharge and sinus infections, which may complicate nasal delivery. The laboratory is also investigating an oral vaccine, with promising results. But more recently, Malley and his team have been funded to create a heat-withstanding skin patch that could be placed on infants" backs (safely out of reach) for several hours, immunizing them transdermally. If this works, similar patches could feasibly be developed for many other vaccines. "This is a revolutionary and simple way to administer vaccines," Malley says. Preclinical studies of the patch in mice have had encouraging results. With human trials in mind, Malley"s team is working with a Brazilian vaccine manufacturer to produce it under Good Manufacturing Practice, with support from the Program for Appropriate Technology in Health, a nonprofit group funded largely by the Bill and Melinda Gates Foundation. Children"s Hospital Boston is home to the world"s largest research enterprise based at a pediatric medical center, where its discoveries have benefited both children and adults since 1869. More than 500 scientists, including eight members of the National Academy of Sciences, 12 members of the Institute of Medicine and 12 members of the Howard Hughes Medical Institute comprise Children"s research community. Founded as a 20-bed hospital for children, Children"s Hospital Boston today is a 397-bed comprehensive center for pediatric and adolescent health care grounded in the values of excellence in patient care and sensitivity to the complex needs and diversity of children and families. Children"s also is the primary pediatric teaching affiliate of Harvard Medical School. Children"s Hospital Boston


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