Vaccines are the single most effective way to prevent infectious diseases, which is why so much time, energy, and money are invested into the research and development of vaccines, especially for those that protect against the flu.
During the 2017-18 flu season, an estimated 48.8 million people in the United States became ill with influenza, there were almost 1 million hospitalizations and 79,400 deaths—the worst since the 2009 flu pandemic. While there are many ways to fight the flu—the most effective is getting a seasonal flu vaccine.
As one of only nine research centers in the U.S. recognized by the National Institutes of Health (NIH) as a Vaccine and Treatment Evaluation Unit (VTEU), the Saint Louis University School of Medicine’s Center for Vaccine Development has been tasked by the National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health, with developing a number of flu vaccines for the past 30 years, including the universal flu vaccine, which is expected to provide broad, durable protection from the flu.
Center Founder, Dr. Robert Belshe, Professor Emeritus, Division of Infectious Diseases, Allergy and Immunology, is on the forefront of the innovative field of influenza study. Dr. Belshe not only founded the Center but served as the Principal Investigator for nearly 25 years.
Influenza Vaccines for Older People
After his work on the attenuated vaccine for children, Dr. Belshe’s team participated in clinical trials demonstrating an increased dose of flu vaccine in people over 65 elicits a better immune response (i.e. higher antibody levels). “Most people over the age of 65 receive a high dose influenza vaccine...we know they get a better immune response, and a better immune response means better protection,” explains Dr. Belshe. This research led to the high-dose flu vaccine for adults 65 and over.
Less is More: Intradermal
Flu Vaccine Success
The Center for Vaccine Development has worked closely with the NIH to find ways to reduce the quantity of vaccines needed. Because it can be difficult to make enough of the influenza vaccine, one solution is to use a lower dose of the vaccine. One of the lower doses that was approved is an intradermal vaccine for younger people, which is injected between the layers of the skin—this requires significantly less antigen to elicit the same immune response.
Prevention of Croup
Dr. Belshe, jointly with the NIH, holds the intellectual property on a live attenuated parainfluenza vaccine that was developed by his laboratory at SLU. This vaccine is administered through the nose and is designed to protect against the virus that causes croup and pneumonia in children.
Recognized for Vaccine Leadership
Over the past 30 years, the relationship between the Center for Vaccine Development and Saint Louis University has remained steadfast. “The deans and presidents during my time here have been very supportive of our research,” says Dr. Belshe. The Center’s work has been recognized by the broader medical community as well. The Center for Vaccine Development has received commendations from the NIH for its work on smallpox vaccines after 9/11, and for its work on preventing the bird flu. The Secretary of Health and Human Services has visited the Center.
In the words of Dr. Belshe, “SLU is making a real contribution to our future by helping develop these vaccines. An important corollary to that idea is that it takes years. Vaccine development is something that occurs not in just a year or two, but over many, many years of research and careful clinical trials.”
“I’ll put it this way—all the easy vaccines have been made.”
Looking Ahead: Universal Flu Vaccine and the Future of Influenza
While many think of the flu as a yearly nuisance, the effects of influenza can be deadly—leading to 79,400 deaths in the U.S. alone in the 2017-18 flu season. The 2017-18 season was especially severe—with more than 22.7 million medical visits and more than 959,000 hospitalizations, and affecting all ages of the population.
The Center for Vaccine Development at Saint Louis University School of Medicine is currently researching ways to broaden the immune response so that people would not have to receive a vaccination every year to protect against the flu, but instead would receive a universal flu vaccine. A universal flu vaccine would protect against multiple subtypes of the influenza virus and may need to be administered only every 10 years or so—similar to tetanus—eliminating the need to update and administer the seasonal flu vaccine each year.
T Cell Response Targets
The current Director of the Center for Vaccine Development, Dr. Daniel Hoft, and his colleagues are developing novel vaccines that target the T cell response which are designed to protect against all influenza strains, past and future. So far, they have developed vaccines that work against multiple influenza types (both H3N2 and H1N1 viruses) in humanized mouse models. These new vaccines induce immune responses against parts of influenza A that are present in all pandemic streams throughout history, as well as in current concerning threats like the H5 and H7 bird flu viruses.
Volunteers Make The Difference
New research being conducted at the Center involves trials with volunteers at the Extended Stay Research Unit, which was created to provide a facility for testing the protective effects of novel vaccines in human volunteers against diverse influenza viruses. Located on the 5th floor of the Salus Center at Saint Louis University, this unit functions like a hotel and can accommodate up to 23 individuals at a time. The standard testing protocol first involves vaccination of participants with novel vaccines or placebo at its Vaccine Center Clinic in the Doisy Research Center. Then, after vaccine immune responses develop these subjects are quarantined within the Extended Stay Research Unit, challenged with influenza virus and monitored carefully for an average of 8 days to determine whether the novel vaccine protects against influenza infection. This work can greatly accelerate vaccine development by identifying the most promising candidates very early in the pipeline.
In addition to testing flu vaccines, Dr. Hoft is currently working on developing the Extended Stay Research Unit for use in testing novel vaccines for other illnesses, such as RSV (respiratory syncytial virus), and for drug development. Researchers will be able to challenge a volunteer with either influenza or RSV, then see if an investigational drug works as a therapy.
Another major area of research at the Center for Vaccine Development is pandemic influenza, which is caused by a flu virus that has undergone an antigenic shift, resulting in a virus that is easily spread from person-to-person. When this happens, most people have little to no immunity to the new pandemic flu virus, which can lead to global outbreaks associated with massive mortality and morbidity. Both the T cell targeting vaccines being developed at SLU and the influenza challenge studies conducted at the Extended Stay Research Unit have the potential to revolutionize our ability to protect against future influenza pandemics. The research and development around pandemic influenza is funded by the National Institutes of Health and the Department of Defense—because of the potential for the virus to be used in biowarfare.
Another major area of research at the Center for Vaccine Development is pandemic influenza, which is caused by a flu virus that has undergone an antigenic shift, resulting in a virus that is easily spread from person-to-person
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