Two scientists at the National Institute of Child Health and Human Develpment (NICHD), John Robbins, MD, and Rachel Schneerson, MD, will receive the World Health Organization Children's Vaccine Initiative Pasteur Award for Recent Contributions in Vaccine Development for the landmark development of a polysaccharide-protein conjugate vaccine for Hemophilus influenzae type b (Hib).
The two NICHD investigators will share the award with two other scientists who worked independently of them as part of another team to develop the Hib vaccine, Porter Warren Anderson Jr., PhD, and David Hamilton Smith, MD. All four scientists recently received the 1996 Albert Lasker Clinical Medical Research Award for their work on the Hib vaccine.
The award will be presented on December 10 at the 6th Annual Children's Vaccine Initiative Consultative Meeting in Dakar, Senegal.
Drs. Robbins and Schneerson joined the NICHD in 1970. At that time, the leading cause of acquired mental retardation in the United States was brain damage from meningitis caused by Hib. Meningitis is a potentially fatal infection of the membranes surrounding the brain. Even with effective antibiotic treatment of Hib infection, 5 percent of those who contracted it died and about 30 percent had residual central nervous system damage, including mental retardation, deafness or seizures. Because of the development of the vaccine, however, Hib infection has been reduced by more than 95 percent in the U.S.
In 1974, Robbins and Schneerson left the NICHD for a number of years but returned in 1983 to set up NICHD's Laboratory of Developmental and Molecular Immunity, which was dedicated to preventing bacterial infections by developing effective vaccines. Their approach consisted of using bacterial polysaccharide coats as the antigen. At the beginning of this research effort, many scientists believed it was impossible to develop a vaccine for infants using a polysaccharide. In this early research, Robbins and Schneerson tested the Hib purified polysaccharide vaccine, and found that it was safe and stimulated protective levels of antibody in adults and older children. Scientists supported by NIH's National Institute of Allergy and Infectious Diseases did further testing and, with the added involvement of industry, three Hib polysaccharide vaccines were produced and licensed in 1985.
Although effective, the polysaccharide vaccine failed to stimulate protective antibody levels in infants, the age group with the highest incidence of serious disease. In work for which they would later receive their Lasker Award, the two NICHD investigators developed a new "conjugate" technology to create a vaccine. They linked a "weak" polysaccharide to a protein easily recognized by the immature immune system. The conjugate vaccine was soon found to be effective in infants as well as older children. Since 1987, Hib conjugate vaccines have been licensed and marketed, and have become part of the routine pediatric immunization series given to babies starting at age 2 months.
Since routine use of Hib conjugate vaccine began in the U.S., the number of cases of Hib meningitis or sepsis has fallen from 15-20,000 per year to less than 100. Hib conjugate vaccines are now also used routinely in Canada, Western Europe, and many other countries. Wherever these vaccines have been used, Hib meningitis has virtually disappeared.
Drs. Robbins and Schneerson and other investigators in NICHD's Laboratory of Developmental and Molecular Immunity have also developed improved vaccines for pertussis and typhoid fever, and their investigational vaccines for shigellosis (dystentery), and E. coli 0157, a life-threatening bacterial contaminant of foods (most recently implicated in epidemic illnesses in the United States and in Japan), are under study.