Global Health and Mass Vaccination: Current Challenges and the Best Way Forward (in French) - with Pierre Druilhe, MD

Main points

Unequivocal support for vaccines (examples of tetanus and yellow fever)

Criteria for good vaccination

• The degree of difficulty increases incrementally: (1) Against viruses, bacteria and parasites, and (2) For chronic diseases (examples: TB, HIV/AIDS, malaria)
• Progress in empirical. Examples: Big for conjugated vaccines but small for adjuvants
• Strong and fast immunity induced by a germ translated into very good vaccines (examples: tetanus, diphtheria)
• Future: Molecular ecology of human-germ interaction

Problem of misinformation on the internet (examples: aluminum hydroxide, measles)

International vaccination requirements protect first and foremost a country not the individual

Mass vaccination and COVID-19

• Speed of action to produce the vaccine was worrisome for some people
• Live attenuated vaccine would have been “universal” and not variant-specific like with the spike protein but less efficient
• The vaccine winner was the fastest and easiest to manufacture (1 week on the computer / Available in 6 months)
• Nationalism, politics and capacity to conduct clinical trials and of production played a role in the choice of the technology
• RNA vaccines have been known for years 

Variants are selected by immunity pressure coming from mass vaccination and immunity gained from infection (asymptomatic or not)

Possibility of the emergence of more virulent strains: Usually, in a pandemic the evolution is toward less pathogenic mutants 

Low mortality in Africa may be due to protective immune cross-reaction between the COVID-19 virus and coronaviruses causing seasonal rhinitis (4 different types)

The current vaccines protect much more against death and severe forms of the disease than infection

One should stop talking about antibodies

A “universal” vaccine would take 3 years to develop

There is a need for both vaccines and antiviral drugs

Malaria

• 5,800 parasitic molecules. Over 30 years, 20 have been studied. Only 5 in details
• Usual approach: hypothesis verified by studies (examples: GPI-anchored and surface proteins). All the studies failed. In the global North they used models with rats. However, for example, malaria mortality is 0% in African tree rats but when a vaccine-candidate is studied in lab mice mortality is 100%. Similarly good results in animals do not translate into the same in humans 
• Other approach based on reality and molecular ecology 
• Vac4All studied 12 molecules that have shown no antigen variation
• Vaccine results with children in Mali and Burkina Faso have been encouraging (good efficiency and good tolerance)
• Immunogenicity has been increased with adjuvants
• Trials have been almost completed in adults 

BIO

Dr. Druilhe is a physician, immunologist, parasitologist, inventor and entrepreneur. He started his research career at the Department of Tropical Medicine of the Pitie Salpetriere Hospital, where he initiated many first-of-a-kind malaria research experiments, including the first cultures of the pre-erythrocytic stages of the malaria parasites, characterization and cloning of P. falciparum liver stages antigens, and the investigation of natural immunity to malaria blood stages through passive transfer of African adult immunoglobulin in Thai individuals with malaria. 

For over 20 years (1987-2011), he led the Laboratoire de Parasitologie Bio-Medicale at the Institut Pasteur in Paris, France, where he pursued his scientific strategy of analysis of immunity to malaria in humans and where he and his team made major discoveries, identified novel mechanisms, not foreseen in animal models, and important molecules believed to be responsible for malaria immunity in humans.

His work covers the wide breadth of vaccine research and development, including involvement in the organization and conduct of 8 vaccine clinical trials. He has authored around 330 Scientific Publications and holds more than 23 patents on inventions.

His main scientific interests have been and remain the analysis of host-parasite immune interactions in human beings, and the pre-eminence of clinical investigations over those performed in animal models.

In December 2010, using a combination of private funds and public grants, he created Vac4All with the aim of capitalizing on >25 years of experience in malaria research, and speeding-up malaria vaccine development.

Dr. Druilhe directs and oversees all company strategic, scientific and technical direction.

https://www.vac4all.org/home/about-us/