In the summer of 2016, Mass. Senator Edward Markey visited the laboratory of Dan Barouch, M.D., Ph.D., at Beth Israel Deaconess Medical Center. His purpose in visiting was of utmost importance: he needed to report back to Congress the current state of Zika vaccine research and the urgency of providing federal funding for this global health threat.
Today, Barouch and his team are addressing one of today’s most pressing global health priorities: finding an effective Zika vaccine. As the Director of the Center for Virology and Vaccine Research at BIDMC, Barouch spent more than a decade investigating HIV before studying Zika. His team tested three Zika vaccines in mice and subsequently in monkeys. Remarkably, each one produced 100 percent protection—the world’s first-ever demonstration of Zika vaccine efficacy in animals. Today, his team is conducting a first-in-human clinical trial evaluating one of these Zika vaccines at BIDMC. Here, Barouch talks with Giving Matters about the critical nature of his Zika work and the pivotal role of philanthropy.
GM: How did you decide to study Zika virus after more than 12 years of investigating HIV?
DB: Our interest in studying Zika began in January 2016, when we saw headlines about its explosive spread and devastating consequences in infants and pregnant women. It was immediately clear that a vaccine was needed as a key global health countermeasure. We reasoned that the development of a Zika vaccine would also be a tractable target—which means it will likely be successful—for several reasons. First, Zika virus has very little variability: each virus particle is nearly genetically identical, unlike HIV. There is also clear evidence of natural protective immunity in humans: most adults infected with Zika make a full recovery.
GM: You recently began a Phase 1 clinical trial evaluating a Zika vaccine in humans, one of few internationally. Tell me more about the trial.
DB: Yes, our study is one of three first-in-human studies evaluating a Zika-inactivated virus vaccine. We started in November 2016, and we have enrolled a total of 36 participants. This inactivated virus vaccine—the same type of vaccine as a flu shot—is promising because: (1) it’s a well-established, effective vaccine for this class of viruses, (2) it can be manufactured quickly, and (3) it allows for rapid development. The Clinical Principal Investigator is Dr. Kathryn Stephenson, and the trial is being conducted here at BIDMC in the Center for Virology and Vaccine Research’s clinical trials unit. This study is a collaboration with the Walter Reed Army Institute of Research, which manufactured the vaccine.
GM: The speed of your progress in investigating possible Zika vaccines has been incredible considering you started just one year ago. In the scientific world, that kind of progress can take years, even decades.
DB: We were able to make very rapid progress. It took just four months to demonstrate vaccine proof-of-concept in mice, six months to establish proof-of-concept in monkeys, and ten months to begin a clinical trial in humans—for a virus that had never been studied before. Our goal was not only to test candidate vaccines, but also to understand the science behind how the immune system can block Zika infection. Dozens of groups around the world were racing to show Zika vaccine efficacy in animals.
GM: What do you attribute your fast progress to, and does it relate to your many years studying HIV?
DB: Absolutely. We could never have made these rapid advances for Zika without the laboratory infrastructure and knowledge we had from our HIV work. Zika is a very different virus than HIV, but much of the laboratory technology to make and test vaccines is the same. In my lab, we have experts in all the different areas required to produce and to study vaccine candidates. Over the years, we have received significant support from philanthropy that has allowed us to make rapid progress for both our HIV work and our Zika work.
GM: So has philanthropy had a role in catalyzing your work?
DB: Funding through philanthropy was fundamental to our success in developing and testing Zika vaccine candidates. When we started our Zika work, we relied on flexible philanthropic support, because the timeline to obtain federal grants is long, and those funds were absolutely critical to our ability to engage rapidly in this important research area. Philanthropy is vitally important for researchers to conduct high risk, high reward work, which isn’t typically eligible for NIH funding. Zika is the perfect example: the World Health Organization declared Zika an international public health emergency in February 2016, but Congress took more than seven months to approve NIH funding for Zika research. It will take roughly another full year from that time before grants are awarded. Flexible philanthropic support that allows scientists to do creative and timely work is essential.
GM: If you received philanthropic funding for your Zika work tomorrow, what would be the first thing you do with it? How would additional support advance your work and its potential impact?
DB: With more funding, we would be able to immediately test more Zika vaccine candidates. We would also conduct larger-scale clinical trials in regions of the world that are most burdened by Zika—where these vaccines are the most relevant. Though initial testing for safety and immunogenicity of a vaccine can be conducted at BIDMC, ultimately we aim to test vaccines with more participants in field trials. The more vaccine candidates we test, the better. The impact could be tremendous in protecting infants worldwide from Zika virus and its devastating effects. That’s our mission through our work on HIV and Zika: to tackle the most critical global health problems and to make a lasting impact on human health. We want to help eradicate the Zika epidemic at a faster pace than any prior vaccine development effort in history.