Harris Jeffrey E
Massachusetts Institute of Technology, 77 Massachusetts Avenue, Cambridge, MA 02139, USA.
Eisner Health, Los Angeles, CA 90015, USA.
Health Policy Technol. 2022 Jun;11(2):100619. doi: 10.1016/j.hlpt.2022.100619. Epub 2022 Mar 21.
The decades-long effort to produce a workable HIV vaccine has hardly been a waste of public and private resources. To the contrary, the scientific know-how acquired along the way has served as the critical foundation for the development of vaccines against the novel, pandemic SARS-CoV-2 virus. We retell the real-world story of HIV vaccine research - with all its false leads and missteps - in a way that sheds light on the current state of the art of antiviral vaccines. We find that HIV-related R&D had more than a general spillover effect. In fact, the repeated failures of phase 2 and 3 clinical trials of HIV vaccine candidates have served as a critical stimulus to the development of successful vaccine technologies today. We rebut the counterargument that HIV vaccine development has been no more than a blind alley, and that recently developed vaccines against COVID-19 are really descendants of successful vaccines against Ebola, MERS, and SARS. These successful vaccines likewise owe much to the vicissitudes of HIV vaccine development. We then discuss how the failures of HIV vaccine development have taught us how adapt SARS-CoV-2 vaccines to immune escape from emerging variants. Finally, we inquire whether recent advances in the development of vaccines against SARS-CoV-2 might in turn further the development of an HIV vaccine - what we describe as a reverse spillover effect.
数十年来研发可行的HIV疫苗的努力绝非浪费公共和私人资源。相反,在此过程中积累的科学知识已成为研发针对新型大流行SARS-CoV-2病毒疫苗的关键基础。我们讲述HIV疫苗研究的真实故事——包括所有的错误线索和失误——以阐明抗病毒疫苗的当前技术水平。我们发现与HIV相关的研发产生的影响不止是一般的溢出效应。事实上,HIV候选疫苗2期和3期临床试验的反复失败对当今成功疫苗技术的发展起到了关键的推动作用。我们反驳了那种认为HIV疫苗研发只是一条死胡同,以及最近研发的针对COVID-19的疫苗实际上是针对埃博拉、中东呼吸综合征和SARS的成功疫苗的衍生产品的观点。这些成功的疫苗同样很大程度上归功于HIV疫苗研发的变迁。然后我们讨论HIV疫苗研发的失败如何教会我们使SARS-CoV-2疫苗适应新兴变体的免疫逃逸。最后,我们探究针对SARS-CoV-2疫苗研发的最新进展是否反过来又可能推动HIV疫苗的研发——我们称之为反向溢出效应。