Anyone who has seen movies like Contagion, or watched the news during coverage of the Ebola or Zika crises knows how scary infectious diseases can be and the panic they can set in motion. The heroes of these stories are the people developing the vaccines. What you might not know is that some of these heroes are right here in our backyard at the Vaccine Testing Center at the Larner College of Medicine at UVM.
In the interview that follows, Ross Colgate, PhD, MPH, a faculty scientist with the Vaccine Testing Center, describes the group’s work.
What is the Vaccine Testing Center?
Ross Colgate: The Vaccine Testing Center started back in 2002 under the direction of Dr. Beth Kirkpatrick. She’s still our director.
There are three prongs to what we do. We do international research field studies, and we do a whole set of domestic clinical trials to move vaccines through the vaccine development process. Here in Vermont right now we’re testing the Zika vaccine. All of our Flavivirus vaccine studies are under Dr. Kristen Pierce. She’s an infectious disease doctor. And then we also have a human immunology core led by Dr. Sean Diehl, who’s our PhD immunologist. He studies how people respond to the vaccines that we’re testing, both in the international setting as well as here in Vermont.
How does VTC’s work affect Vermonters?
Ross Colgate: That’s a great question. I think it affects Vermonters in a few ways. One, I would say that Vermont is pretty well-known for being full of people who are community-minded, people who take a large view of their role in the world. So, participating in one of our studies that might be testing a vaccine that’s not immediately relevant to the health of Vermonters, but helps get vaccines through the development process to populations that need it the most really contributes. It’s a major contribution to global health. So, there’s that piece. There’s also the reality that some of these diseases, though they may not be immediately present today, may be on their way.
Dengue is a great example of that. Just within the past six years, the mosquito that carries the Dengue virus was detected in New Hampshire, just over the border. And it was not carrying Dengue. But if the mosquito is there, then the potential is there. So, we are seeing expansion of mosquito habitats. People have heard about Zika in Florida, Dengue in Florida. So, those dynamics are changing. And then you also have traveler and military populations who originate in Vermont. We’ve got a strong National Guard presence here, lots of military families, and a lot of people traveling the world who would benefit from having some of these vaccines available before they travel overseas.
Tell us about your work on a vaccine for the Zika virus?
Ross Colgate: This is hot off the presses, very new work, actually. We started testing the current Zika vaccine a few weeks ago. We just dosed the first six volunteers . And so it’s early in terms of what we’re seeing. But it was developed, again, at the National Institutes of Health, and it’s a chimeric vaccine. That means we took proteins from the Zika virus itself and we put them into what you could call the backbone or the structure of the Dengue viruses that are in our Dengue vaccine. And the Dengue vaccine has been tested for 10 years, it’s safe, it gives a good, strong immune response. So, we’ve taken some key proteins from Zika and put them into that structure so that hopefully the immune system will be able to recognize the Zika virus as well. Dengue and Zika are in the same family.
Stay tuned! Hopefully we’ll preliminary results to the FDA within 28 days and then we’ll see from there.
What has VTC done to develop a vaccine for West Nile?
Ross Colgate: West Nile is a great example of an infectious disease that potentially has pretty immediate impact for Vermonters. Working with our partners at the NIH, we tested a West Nile vaccine that follows the same strategy as the Zika vaccine. We took some proteins from West Nile and put it into the structure of the Dengue vaccine. And we did our trial here in older adults, meaning 50 to 65 year olds. And at John Hopkins, they tested the vaccine in 18 to 50 year olds and found that it was safe and immunogenic. We found the same here. It’s particularly relevant for the populations in the 50 to 65 age range because the virus itself has a severe form called, “Neuroinvasive disease,” and it can lead to encephalopathy or swelling in the brain, or even something that kind of resembles Polio where patients actually become paralyzed.
It can also be life-threatening. And the highest risk for those complications is in the older population. So, it’s really important that we tested it. The immune responses that we saw in the older population were as strong as those seen at John Hopkins in the 18 to 50 year olds. So, that’s all great news. At this point, the vaccine is nearing licensure.
When is the vaccine available and how does somebody get it?
Ross Colgate: They can go to the travel clinic, their general practitioner, or whoever their primary care provider is. They can certainly see the infectious disease group here at the University of Vermont Medical Center. So, lots of ways that they could potentially access the vaccine once it’s licensed.
You have spent a lot of time in Bangladesh. Tell us about your work there.
Ross Colgate: My focus is on the Enterics or the gut pathogens that cause a significant burden of disease and illness in children in particular in low and middle income countries. The overall focus of my research is ameliorating that burden in young children. I was over in Bangladesh as part of a Gates Foundation-funded study looking at oral vaccine performance in children who we enrolled in their first week of life in the slums of Dhaka. We followed them for two years. We looked specifically at Rotavirus vaccine and the oral Polio vaccine.
These two vaccines, and especially the Rotavirus vaccine, are well-known to underperform in kids in these low and middle income countries. And it’s the exact same vaccine that we give to our kids here. So, whereas here it’s 95 to 100 percent effective, in kids there it’s more like 18 to 60 percent. And we really don’t understand why. So, the impetus for that study was trying to understand why is there a difference in response to these vaccines.
The children that we’re working with, they’re exposed to a lot of pathogens in that first year of life. Most of them are carrying around two to three diarrheal pathogens at any time, whether they have diarrhea or not, so we’ve learned that. They’re living in really difficult water and sanitation environments. Nutrition is an issue for the infants as well as for their mothers, so how much of this is related to the mothers is still a question that needs to be answered. And so you can imagine, the gut environment is a really complex place and the answer to this question is turning out to be equally complex. So, we’re still very much working on it.
What is your hope for this research?
Ross Colgate: One of the immediate hopes is to inform vaccine development science. If we can better understand some of the factors that contribute to having a poorer response to the vaccine, then we can redesign vaccines potentially that will be more effective in children who are facing this set of circumstances. So that’s certainly one hope.
Other possible interventions that could come out of this work would be nutritional. Obviously, if zinc deficiency is a problem, that’s something that can be corrected. So, if we have enough data to support intervening with zinc supplementation, that may help. Eventually, I would love to see diarrhea fall from being the second leading cause of death among children aged five and under globally to not being an issue anymore.
That is an outstanding statistic.
Ross Colgate: It really is. It’s second only to pneumonia after the first month of life. So, from the post-neonatal stage through age five, diarrhea is the second leading cause of death in children worldwide. So, really important questions that we’re very actively working on trying to answer.
How can Vermonters get involved in the work of VTC?
Ross Colgate: We do have a full-time recruitment staff. Once people are in touch with our recruitment folks, we see which studies we have open and, depending on the population that we’re looking at and the potential risks, what stage the vaccine is at in terms of development, may have some inclusion and exclusion criteria. So those would be reviewed with each person and they would be given an idea about what’s entailed.
Some of these studies, for example, we’re gonna start a Polio study soon and that really is only four visits over the course of 28 days. Some of our Dengue studies have been upwards of 13 visits of the course of a year and a half. So it really depends, study to study, in terms of time commitment. But, assuming that someone is eligible, then they would come meet with our studies staff at the medical center in the clinical research center and review the consent form.
So there are three great ways to contact us. One is to call 802-656-0013. You can also email our team at UVMVTC@UVM.EDU, or access a link on our website for a contact form at UVMVTC.ORG.