The baby wiggles without care on his mother’s lap as the world’s most promising hope for the first new tuberculosis vaccine in 90 years is injected into his arm.
The infant is one of 2,784 pint-sized volunteers in a two-year-trial in South Africa’s winelands that scientists hope will lead to a more effective inoculation against the lung disease, which kills one person every 20 seconds worldwide.
“There are 12 different vaccines in clinical trials, but this is the most advanced,” said Michele Tameris, who manages the trial at the South African Tuberculosis Vaccine Initiative (SATVI) site. “This is the first time you’re actually testing to see if a vaccine is effective in real life. Now we’ve got to show that it’s actually protecting against TB in humans.”
South Africa is a prolific testing ground, with the world’s second-heaviest rate of TB after Swaziland, according to SATVI. The disease preys on weakened immune systems, and consequently saw a surge here thanks to one of the world’s highest HIV levels, which affects 5.7 million of the country’s 48 million people.
In the Western Cape region, the airborne bacterial infection is rife at 900 per 100,000 people, compared with 15 people per 100,000 in the US.
In the Worcester area, a mountainous grape-growing center 120km northeast of the provincial capital, Cape Town, one in 100 people develop TB every year.
Mothers readily brought their babies to the testing site at a local hospital for the one-off inoculation of either the vaccine or a placebo, with the final shots to be administered late next month.
Typical was Marlene Abrahams holding her tiny son Malico in the waiting area.
“I want to know if he’s healthy,” she said.
The vaccine tested in Worcester, developed at Oxford University and known as MVA85A, is hailed as the most exciting advance since a 1921 shot created by two French doctors, which is the sole TB vaccine in use today.
That vaccine, the BCG, is not necessarily effective against all strains of TB, for all age groups or for people with HIV.
“We do absolutely need a preventative vaccine if we want to get rid of tuberculosis,” said Uli Fruth, a WHO scientist working on TB inoculations.
He gave a ball-park cost for developing a new vaccine at US$150 million to US$250 million.
“This is the most advanced of all the new TB vaccine candidates by far,” he said of the trials at Worcester. “There’s a lot of hope about it.”
Even in the best case, scientists doubt a new vaccine could be ready before 2016 to 2020.
“We say around 2018 if everything goes well,” Fruth said.
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