The Bill & Melinda Gates Foundation has awarded grants of $20 million each to the Johns Hopkins University School of Public Health and the University of Maryland School of Medicine to develop a new type of measles vaccine that, for the first time, would protect infants younger than 9 months old and dramatically reduce the suffering and death rate from measles in developing countries.
"Finding a safe and effective vaccine to protect the world's youngest children against measles is an urgent global health priority," said Bill Foege, senior health adviser at the Bill & Melinda Gates Foundation. "We are tremendously hopeful that this collaboration between two major research facilities will speed the development of this important vaccine and ultimately help save millions of children's lives."
Measles kills more than 900,000 children each year in less developed parts of the world, the World Health Organization says. While widespread use of the current injected measles vaccine has saved the lives of millions of children, the disease is far from eradicated in the developing world because a window of vulnerability exists among infants from 5 to 8 months of age.
Newborns are protected against measles by antibodies passed to them from their mothers, but those antibody levels drop steadily over time, increasing the infants' susceptibility to measles. At the same time, low levels of the mother's antibodies neutralize the effectiveness of the measles vaccine. For that reason, the WHO recommends that the current measles vaccine be administered when children are at least 9 months old.
"A safe, effective vaccine for younger infants will save lives and help eradicate measles worldwide by dramatically decreasing the size of the susceptible population," said Diane E. Griffin, chair of Molecular Microbiology and Immunology at the School of Public Health and co-principal investigator on the grant to Johns Hopkins. "We are all convinced that a coordinated vaccine development and testing effort is the smartest, fastest approach. We are grateful to the foundation for making this project possible."
"We are pleased that the Bill & Melinda Gates Foundation has asked us to take on this ambitious five-year project. It will involve laboratory work as well as clinical testing in Africa and South America," said Myron M. Levine, professor of medicine and pediatrics and director of the University of Maryland Center for Vaccine Development. "Our goal is to close the window of vulnerability for infants by developing a safe and effective vaccine, despite the presence of maternal antibodies."
Researchers at each institution will use their individual strengths and expertise to reach the common goal. Previous attempts to develop a safe measles vaccine for infants younger than 9 months were not successful, but the scientists believe that several new technological advances can be used to overcome the earlier obstacles.
At the University of Maryland Center for Vaccine Development, researchers will use their experience in creating oral and nasal spray vaccines to investigate the potential of a new "DNA vaccine," which uses only the genetic material of the virus rather than the whole virus to stimulate the immune system. Such a vaccine would be much easier to administer than an injection, especially in the least developed areas of the world.
A DNA vaccine would be made by placing genetic material from the measles virus inside weakened typhoid (Salmonella Typhi) bacteria or dysentery (Shigella) bacteria. The University of Maryland Center for Vaccine Development is acknowledged as a world leader in this innovative "bacterial live vector" approach.
Researchers at the Johns Hopkins School of Public Health have shown that a DNA vaccine can stimulate an effective immune response against measles in animals. Their approach will be to deliver the DNA vaccine by itself or through viruses unrelated to the measles virus. This will allow the genetic material of the measles virus to target the most important parts of the immune system without being eliminated by measles antibodies from the mother.
Once the most promising viral and bacterial vaccines have been developed, researchers at both institutions will test the different approaches in humans to determine which works best. The Johns Hopkins Center for Immunization Research, led by director and co-principal investigator Donald S. Burke, will play a major role in testing the effectiveness of the vaccines.
The presidents of both universities and the deans of the two schools say the grants recognize the tremendous pool of expertise available in Baltimore to address this important public health challenge.
"With these generous gifts to two Baltimore-based research groups, the Bill & Melinda Gates Foundation expresses enormous confidence in our city's scientific community and its ability to resolve a major world health problem," Johns Hopkins president William R. Brody said. "We're grateful for that confidence and eager to justify it."
"The health of the world depends on developing new strategies for fighting infectious diseases, improving nutrition and advancing reproductive health. With these grants, and previous grants in nutrition and family planning, the foundation has greatly enhanced the ability of the Johns Hopkins School of Public Health to aggressively pursue its traditional goal of improving health around the world," said Al Sommer, dean of the School of Public Health.
The Johns Hopkins grant is the foundation's fourth to the School of Public Health in just over three years. The first, $2.25 million announced in May 1997, established a training and research program for family planning and reproductive health specialists from developing nations. The second, a $20 million grant announced in May 1999, built on the first by establishing the Bill & Melinda Gates Institute for Population and Reproductive Health. The third, announced earlier this summer, awarded $20 million for an effort to find the most effective combination of vitamins and other micronutrients to save lives and prevent illness among impoverished mothers and children in the developing world.