Nice work for everybody except the patient: Gordon Skinner opens discussion on the future of vaccine development

Abstract

Preventative medicine is a difficult field in which to work and feint heart never won vaccine product licence. In one Northern town in the UK, the authorities reduced the rate of enteric-borne epidemics to a commendably low level but were then pilloried because there was an epidemic in the following year; the greater the achievement, the greater the expectations. Vaccine production is a particularly delicate issue as vaccine recipients are generally healthy persons who, without vaccination, are not necessarily going to contract disease. Vaccines are not accorded equivalent ‘peer-review’ as are therapeutic drugs; a drug which helps 30% of people in terms of relief of duodenal ulcer symptoms or discomfort from rheumatoid arthritis will probably be considered worth using whilst a completely safe vaccine which protects 30% of people from contracting AIDS will not reach the market. In simple words, vaccines are given too tough a time in comparison to therapeutic drugs or provenly harmful products like cigarettes and alcohol. This commentary considers three current problems and suggest strategies towards their solution. Firstly, large amounts of money are spent on the development of drugs and vaccines pursuing objectives that are not necessary for the safety of the product. Secondly, these objectives arise not from reasonable scientific consideration but from fear. Finally, such factors are seriously hampering the development and availability of safe and efficacious drugs and vaccines particularly in areas where the number of potential recipients is not sufficiently large to ensure the commercial viability of product development.