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Ebola’s spread hastens preparations for vaccine testing

August 28, 2014 at 6:23 PM EST
An Ebola vaccine may be ready for human testing as early as next week. Though the vaccine is in its first stage of testing with humans, it showed favorable results in an infected monkey. Gwen Ifill learns more from Dr. Anthony Fauci of the National Institute of Allergy and Infectious Diseases.
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GWEN IFILL: Adding to the difficulty, a different strain of Ebola has appeared in the Democratic Republic of Congo, causing 13 deaths so far. 

Here at home, the National Institutes of Health announced today it will start testing an experimental Ebola vaccine next week.

For more on that development, I’m joined by Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases at NIH.  He will oversee those trials.

Dr. Fauci, thanks for joining us again.

What would trials like this look like?

DR. ANTHONY FAUCI, Director, National Institute of Allergy and Infectious Diseases: Well, first of all, it’s an early phase one trial.

And by phase one, we mean this is the first time this vaccine has been put in humans.  So safety is paramount, so you take a very small number of people, 20 in total, three at a time, and you use the vaccine to determine if there are untoward effects, any inflammation, any idiosyncratic or hypersensitivity reactions, pain or anything that might be a red flag about safety.

And also you learn whether it induces the kind of response in a person that you would hope would be protective against Ebola infection.  The reason why we chose this vaccine is that it showed very favorable results in an animal model, a monkey model, in which it protected monkeys very well against a challenge with lethal Ebola.

So this is a first, because it’s the first time this has been in a human, in now what will be a series of steps to ultimately develop it to determine if, in fact, it is effective.

GWEN IFILL: This has been in development for some time.  You called this an uncontrolled outbreak in West Africa.  Dr. Tom Frieden for the CDC said it will get worse before it gets better.  Is it this West African outbreak which is moving this from development to trial?

DR. ANTHONY FAUCI: We have been working on an Ebola vaccine for a number of years now.  This has been one of the priorities of the hemorrhagic fevers, of which Ebola is actually the worst of those.

This is kind of the culmination of an iterative process of developing it.  It was certainly accelerated by what we’re seeing now with this extraordinary outbreak in certain West African countries.  So we were on the track of an Ebola vaccine, but we accelerated it.  We didn’t cut corners, but we really put the afterburners on to get things done much more quickly, so that we could get to the point where, next week, we will put this first time in a human, in a normal volunteer right here in our clinical center in Bethesda.

GWEN IFILL: We have spent a lot of time trying to figure out ZMapp, the small dosage which has been experimented on humans in this latest outbreak.

This plan that you’re talking about developing would be working with a large drug company, GlaxoSmithKline.  Does that make a difference in the timetable, how quickly we would see it come to market if it worked?

DR. ANTHONY FAUCI: Gwen, it makes an extraordinary amount of difference.  It really is the game-changer in that.

When you have a company like GlaxoSmithKline, who partners fully with the NIH, with our science and their capability of producing this, that’s how you get things done.  And, in fact, one of the reasons why we had not gotten the vaccine up to now or even drugs is that there was relatively little interest on the part of many pharmaceutical companies for either drugs or vaccines.

And I think the extraordinary, dramatic situation which we’re going through right now is going to really get people’s attention and we will see a lot more interest in that, which I’m very pleased about because we really do need a vaccine and some therapeutics.

GWEN IFILL: Because Ebola is such a dangerous virus, how do you ensure the safety not only for those taking it in the trial, but also for those handling the virus?

DR. ANTHONY FAUCI: Well, that’s a good question, Gwen.

And it’s important to point out there’s no chance at all of the vaccine giving Ebola to anyone, because we’re not giving them the Ebola virus.  We’re giving them a vaccine that has a very small component of the genetic material from Ebola that will make a protein that is again an important component of the virus, but not a virus that can actually replicate.

So there’s no chance.  When we say safety, which is the first part of phase one, we’re not talking about safety of giving someone Ebola.  We’re talking about safety of an adverse reaction to the vaccine itself.  That’s an important difference.

GWEN IFILL: If we’re talking about the possibility of 20,000 cases before this thing begins to subside, how do we know the vaccines are the right solution, or even are they the right solution?

DR. ANTHONY FAUCI: Well, again a great question, because the solution, right now, is what we know can stop an outbreak, and that is the ability and the infrastructure to deliver infection control by isolation, by quarantine, by contact tracing, and by protecting the health care workers with proper personal protective equipment.

The difficulty in those West African countries is, they don’t have that kind of infrastructure in place, and it’s truly a struggle to be able to do that kind of infection control.  Historically, under other circumstances, there have been now about 24 outbreaks of Ebola, usually in geographically-restricted areas, where it was much easier to contain it.

You can contain it with good hospital and infection control capabilities.

GWEN IFILL: Dr. Anthony Fauci at the National Institutes of Health, thank you very much.

DR. ANTHONY FAUCI: You’re quite welcome.