Sunday, June 01, 2003

By Daniel Q. Haney, The Associated Press

Fifteen or 20 years to create a new vaccine is considered quite speedy. So the federal government's blueprint for a shot to stop the SARS epidemic in a mere three years seems positively head-snapping.

Can it be done?

Certainly, says Dr. Gary Nabel, chief of the Vaccine Research Center at the National Institute of Allergy and Infectious Diseases. "If everything went perfectly," he qualifies. "If all the stars were aligned."

The stars almost never align precisely in medical research. But if they do, Nabel says scientists will finish all the basic lab work, creating the vaccine, testing it in animals, in just one year.

Then they will spend two more trying it out on people to make sure it works, turn the results over to the Food and Drug Administration and be done.

No vaccine in modern times has gone from start to finish nearly that fast. But even if Nabel's time line proves unrealistic, his willingness to state it out loud shows how seriously the government takes SARS.

The strategy for changing the pace from glacial to galactic: Forget solving problems one at a time.

At Nabel's institute, two teams are working separately to create possible vaccines. One sticks to the time-tested approach of making them with dead or weakened viruses. The other builds them with up-to-the-second gene-splicing tools.

Instead of dealing with big technical issues in the usual one-by-one order, scientists will jump into all of them at once. For instance, they are gearing up production of newly minted vaccines at the same time they figure out how to test them in animals and tease apart exactly how the human immune system does the job of fighting off SARS on its own.

"Parallel tracking," Nabel calls this. It's also called science in a hurry.

Why the rush? Why work so hard to defend against a disease that is just a few months old, that has yet to kill a single person in the United States?

No one knows how bad SARS will become, whether it will burn out or continue to spread, even exactly how it makes people so sick. But the consensus among the country's top health officials is that it would be foolish to wait and see.

Even if SARS is somehow contained in China and Taiwan, many experts doubt it will ever be wiped from the planet, even though this is the World Health Organization's goal. More likely, they say, the virus will come and go, perhaps in some seasonal pattern, maybe by chance.

No matter what happens in the next few months, federal officials promise to keep working on a vaccine so the world will be ready whenever, wherever SARS returns.

"We need a vaccine. There's no question about it," says Dr. Anthony Fauci, head of the infectious disease institute. "This is potentially disastrous enough that we can't just hope it will go away and stay away."

The government is not alone in this. It is encouraging private vaccine makers to take a crack at SARS. In April, Health and Human Services Secretary Tommy Thompson hosted a meeting of vaccine scientists where government researchers shared what they knew about the virus and promised them samples to work with.

"They more or less said, 'We want your entrepreneurial brains working on this,' " says Una Ryan, president of Avant Immunotherapeutics.

Labs from Hong Kong to Canada are also tackling SARS vaccines, and Fauci said his institute will sign contracts with up to a dozen companies to help with development.

At this point, however, the single biggest question is still unanswered: Is a SARS vaccine even possible?

Dr. Emilio Emini, head of vaccine development at Merck, is among those trying to answer this. For now he refuses even to hazard a guess.

"This is a new virus. So much is not understood," he says. "It's a big black box."

Still, Nabel says he knows of at least three major pharmaceutical companies besides Merck, the world's largest vaccine maker, that have gone to work on SARS, even though no one can be sure whether there will ever be a market for a vaccine.

Their success will depend on figuring out a way to train the body's immune system to see the SARS virus quickly, to recognize it as dangerous and to kill it before it makes people sick.