Polio Vaccine Experience May Offer Lessons for HIV Research

Last week, we observed that a group of deeply dedicated physicians are offering themselves for use in a live-HIV vaccine trial, as they view a vaccine as the world's only real hope in controlling the AIDS epidemic. The more conservative scientific establishment, however, says "not yet."

One researcher, Dr. Richard Marlink, executive director of the Harvard AIDS Association of Physicians in AIDS Care. He applauds the president's goal of an AIDS vaccine by 2007 and says that the example of the polio vaccine should show researchers how to overcome at least some of the barriers to the successful development of an HIV vaccine. A perfect-or-forget-it vaccine approach may not be the optimal route, given the world-wide stakes.

When Jonas Salk developed the polio vaccine in the mid 1950s, he used killed whole virus in a technique that critics argued would not be fully effective. However, the Salk vaccine reduced polio-related paralysis by 72%. Several years later the Sabin oral vaccine was more effective, but the Salk vaccine had already turned the epidemic tide. The lesson to be learned, urges Marlink, is that 72% effectiveness is better than nothing, and researchers should not abandon uncertain HIV vaccine development efforts just because a better solution may come in time.

The second lesson from the polio experience is that the existence of traditional research should not shut out new approaches that might prove more effective. In the case of polio, for example, the March of Dimes campaign pushed both the Salk and the Savin vaccines, despite the skepticism of many academic research groups. The willingness to dare made a difference, as this writer well remembers.

Given the enormous impact of AIDS on world health, perhaps this is a time when the research establishment should be more aggressive. Even a partial solution could save hundreds of thousands of lives each year.

(For more information, see Journal of the International Association of Physicians in AIDS Care, Vol.3, No.11)

-- Sandy Bartlett,

Information/Education Coordinator

AIDS Services of Austin