The global fight to develop antipoverty vaccines in the anti-vaccine era

Abstract

Antipoverty vaccines are the vaccines targeting a group of approximately 20 neglected tropical diseases (NTDs), as currently defined by the World Health Organization (WHO). The “antipoverty” moniker refers to the fact that NTDs trap populations in poverty due to their chronic and deleterious effects on child intellect and worker productivity. Therefore, NTD vaccines can be expected to promote both global health and economic advancement. Unfortunately, antipoverty vaccine development has lagged behind vaccines for major childhood infections and pandemic threats, despite evidence for their cost-effectiveness and cost-savings. Currently, the only licensed vaccines for NTDs include those for yellow fever, dengue, and rabies, although several other NTD vaccines for hookworm disease, schistosomiasis, leishmaniasis, and Zika and Ebola virus infections are in different stages of clinical development, while others are at the preclinical development stage. With the exception of the viral NTD vaccines there so far has been minimal industry interest in the antipoverty vaccines, leaving their development to a handful of non-profit product development partnerships. The major scientific and geopolitical hurdles to antipoverty vaccine development are discussed, including a rising antivaccine (“antivax”) movement now entering highly populated low- and middle-income countries.

Enlisting the mRNA Vaccine Platform to Combat Parasitic Infections

“…These infections often occur in tropical countries with weak economies. Mostly, the poorest of the poor are affected because they typically live in inadequate conditions with poor hygienic conditions and an increased risk of exposure to insect and other disease vectors [18]. In addition, access to healthcare in these regions is often limited, making the development of anti-parasitic vaccines even more important.…”

“Running the Gauntlet”: Formidable challenges in advancing neglected tropical diseases vaccines from development through licensure, and a “Call to Action”

“…[21][22][23] In addition, the studies have focused on health-care costs, and the impact on human capacity, especially for agricultural workers and women and children, 18,24 while others look at cost-effectiveness in the context of the PDP ecosystem. [25][26][27] Additional efforts have modeled the cost-effectiveness of NTD vaccines, 19,20 or vaccines linked to chemotherapy. 28,29 For example, a modeling study to evaluate a hookworm vaccine delivered with preventive chemotherapy has the potential for positive societal benefits, while at the same time be cost-effective.…”

“…29 Therefore, more cost-economic studies are needed to investigate the mechanisms by which NTD or "antipoverty" vaccines could prevent debilitating disease and improve long-term economic outcomes. [23][24][25] The framework of Texas Children's CVD Similar to what was presented by Denee, et al in 2012, 26 for the past two decades, Texas Children's CVD has adapted and refined an operational framework with guiding principles ( Table 2) and objectives (Box 2) that allows to measure indicators of success as well as recognize, early on, the challenges of each vaccine development program:…”

The Mix of Science, Community Beliefs and Health Practices Affecting Children: Part 1

“…This declaration directed the Washington State Comprehensive Emergency Management Plan be instituted to contain and halt the spread of the measles outbreak (Office of the Governor, State of Washington, 2019). In a WA county considered to be the focal point of the measles outbreak, unvaccinated children and staff were not allowed to attend school for three weeks in an effort to protect them from contagious measles exposure (Lambert, 2019).…”

“…The factors influencing vaccine hesitancy and refusal are complex and difficult to unwind. Parental protectiveness, the influence of the antivax movement, inaccurate content on the Internet, the lack of access to care, the social determinants of health, and the social media are contributory to this current public health dilemma (Broniatowski et al, 2018;Finnegan, 2011;Hotez, 2018;Lo & Hotez, 2017). Nurses have important roles as clinical experts, parent and child advocates, community members and policymakers to address and confront this national and global public health concern.…”