October 12-18, 1997

STATEMENT

National Adult Immunization Awareness Week

Statement of Anthony S. Fauci, M.D.

Director, National Institute of Allergy and Infectious Diseases

National Institutes of Health

"The impact and importance of vaccines cannot be overstated. Vaccines are powerful public health tools that provide safe, cost-effective and efficient means of preventing illness, disability and death from many infectious diseases. Sadly, tens of thousands of adults in the United States, especially our older citizens, die needlessly from vaccine-preventable diseases or their complications each year, notably influenza and pneumococcal pneumonia.

"With National Adult Immunization Awareness Week, health agencies in both the public and private sectors emphasize the importance of determining whether adults have been appropriately immunized, and of having them immunized accordingly.

"National Adult Immunization Awareness Week also provides an opportunity to stress the importance of research in vaccinology. Such research continues to improve the safety and efficacy of existing vaccines, and provides us with new vaccine candidates to prevent diseases for which no vaccines currently exist.

"For instance, NIAID-supported researchers have developed a new-generation influenza vaccine, given as a nasal spray. The new vaccine promises to be easier to administer and more acceptable than injections, thereby increasing vaccination coverage. The new nasal vaccine, which protects against two different influenza A strains and one influenza B strain, has proven safe and effective in children. Large-scale trials will determine whether it protects older people most at risk of serious influenza disease, and if it reduces influenza-related health care costs and absenteeism in healthy adults.

"Important progress also has been made against pertussis (whooping cough). Pertussis is usually considered a disease of the very young; however, it also may occur in teenagers and adults, who may infect unvaccinated infants as well as suffer the sometimes severe consequences of the disease. NIAID played a central role in developing the new "acellular" pertussis vaccines now widely used in children because of their effectiveness and safety. The Institute currently is conducting a large-scale clinical trial to determine the epidemiology of pertussis in adolescents and adults, and to test acellular pertussis vaccines in this population. Depending on the results, an acellular pertussis vaccine booster eventually might be given routinely to all adolescents and adults, thereby reducing the burden of this disease.

"Much of the progress in understanding and preventing Lyme disease has been facilitated by discoveries supported by NIAID and other institutes at the National Institutes of Health (NIH). Notably, NIH-funded research helped to identify the OspA surface protein on the Lyme organism as a vaccine candidate. Phase III trials of Lyme disease vaccines based on OspA have shown them to be safe and effective in Lyme disease-endemic regions of the United States. When licensed, an effective vaccine could greatly reduce the incidence of Lyme disease, currently the most common tick-borne infection in the United States.

"With the notable exception of hepatitis B, vaccines are lacking for sexually transmitted diseases, which afflict more than 12 million people in this country each year. However, candidate vaccines for gonorrhea, chlamydia and syphilis are in various stages of preclinical development. NIAID-sponsored researchers also are determining the precise genetic structure of the organisms that cause these diseases, efforts that will not only help illuminate the pathogenesis of these infections but will also help identify new antigens for evaluation as vaccine candidates.

"The Institute employs a multi-pronged approach to human immunodeficiency virus (HIV) vaccine development. Basic research is helping to delineate the immune responses that protect an individual from infection or prevent the progression of disease. At the same time, NIAID and other groups are testing candidate vaccine products in small-scale trials around the world. Recent data suggest that a "prime-boost" strategy is safe and can elicit HIV-specific killer T cells and neutralizing antibodies in HIV-negative volunteers.

"Vaccines for both children and adults will continue to provide safe, effective and efficient means to prevent illness, disability and death. Vaccines not only improve public health, but greatly reduce both direct and indirect health care costs, thereby enabling resources to be directed to other sectors of the national economy. As has been the case for the past five decades, the NIAID will continue to make research leading to new and improved vaccines one of its highest priorities."