Long Shot

Long Shot: Vaccines for National Defense

Kendall Hoyt
Copyright Date: 2012
Published by: Harvard University Press
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  • Book Info
    Long Shot
    Book Description:

    Despite large-scale government demand for new vaccines in the past decade, few have materialized. Vaccine innovation has been falling since World War II. Hoyt’s timely investigation asks why, and teaches lessons for our efforts to rebuild biodefense capabilities when the financial payback for a vaccine is low but the social returns are high.

    eISBN: 978-0-674-06315-0
    Subjects: Health Sciences, History

Table of Contents

  1. Front Matter
    (pp. i-vi)
  2. Table of Contents
    (pp. vii-xiv)
  3. Introduction
    (pp. 1-10)

    America faced a host of biological threats to health and security at the turn of the twenty-first century. Between 1990 and 2009, the United States contended with a foreign biological weapons program, bioterrorism, and a pandemic. Concerns about Saddam Hussein’s biological weapon caches sent the U.S. military scrambling to immunize troops against smallpox and anthrax. The 2001 anthrax attacks demonstrated that non-state actors could terrorize civilian populations with biological weapons as well. A strange outbreak of severe acute respiratory syndrome (SARS) in 2002 and new avian and swine flu strains provided further reminders of the pandemic potential of infectious diseases....

  4. 1 Disease, Security, and Vaccines
    (pp. 11-31)

    Well before the anthrax letter attacks in 2001, a series of events in the 1990s alerted security experts to the growing risk of biological attacks on U.S. soil. In 1992, Ken Alibek, a bioweapons scientist from the former Soviet Union, defected to the United States and provided hair-raising accounts of biological weapons (BW) development in his country. Working under the cover of a government pharmaceutical agency (Biopreparat), the Soviet Union had operated an offensive biological weapons program since 1972, the same year it signed a treaty banning the development of these weapons.¹

    Russian President Boris Yeltsin banned this program in...

  5. 2 Historical Patterns of Vaccine Innovation
    (pp. 32-48)

    The midtwentieth century is studded with glittering achievements in vaccine innovation, ranging from the development of the first influenza and pneumococcal vaccines in the 1940s to the first polio, measles, mumps, and rubella vaccines in the 1950s and 1960s. By the late 1970s, however, innovation began to taper off and vaccine manufacturers began to exit the industry in droves.

    In many respects, vaccines are a public good. Each individual vaccinated for a communicable disease confers a benefit to society by building a firewall of immunity that can interrupt disease transmission to the unvaccinated. Aside from clean water, vaccines are also...

  6. 3 Vaccine Development during World War II
    (pp. 49-80)

    War and disease have gone hand in hand for centuries. As one historian has observed: “More than one great war has been won or lost not by military genius or ineptitude, but simply because the pestilence of war—from smallpox and typhoid to cholera, syphilis, diphtheria, and other scourges—reached the losers before they infected the winners.”¹

    Training camps and battlegrounds magnify the spread and severity of disease.² They bring men from different geographical regions into close contact with one another. These men are often physically stressed, or wounded, and disease spreads easily. Prior to World War II, soldiers died...

  7. 4 Wartime Legacies
    (pp. 81-109)

    The birth and expansion of research and development–based firms after World War II is a common theme in twentieth-century U.S. industrial history.¹ Just as wartime research in electronics, aircraft design, and jet propulsion provided a foundation for the expansion of postwar industries, it seems axiomatic that vaccine research would have transformed what was formerly a cottage industry into a full-scale research and development enterprise. In the immediate aftermath of World War II, however, the growth of the U.S. vaccine industry was far from assured.

    Prior to the war, U.S. manufacturers would often look to their European counterparts for new discoveries...

  8. 5 The End of an Era
    (pp. 110-141)

    By 1979, a highly productive era of vaccine innovation was drawing to a close. Many manufacturers had either exited the vaccine business or seriously considered getting out. While several factors discouraged private sector vaccine investments at this time, industry observers often credit the swine flu affair with setting a wave of industry consolidation into motion.¹

    In 1976, an army recruit at Fort Dix died of an upper respiratory ailment after an overnight hike. The New Jersey Health Department isolated an unusual strain of influenza that was normally found in pig populations from this soldier and many others at Fort Dix....

  9. 6 Biodefense in the Twenty-First Century
    (pp. 142-159)

    Biodefense initiatives boomed after the airliner and anthrax attacks of 2001. While the overall budget to fight terrorism doubled after 9/11, the bioterrorism budget quadrupled.¹ New vaccines “to fight anthrax and other diseases” were featured in the 2002 State of the Union address, and the Bush administration championed a biodefense vaccine development campaign that seemed destined to rival the successes of World War II programs.²

    Yet, a decade after these attacks, the United States has licensed only one new biodefense vaccine—the ACAM2000 for smallpox.³ Notably, this vaccine was developed before post-9/11 vaccine development programs took effect. Why are twenty-first-century...

  10. 7 The Search for Sustainable Solutions
    (pp. 160-178)

    Biological weapons “received serious consideration on the part of all the combatants,” cautioned Leroy Fothergill, technical director of the Chemical Warfare Service during World War II.¹ Fothergill predicted that enemy nations facing heavy industry and armament restrictions would “explore more subtle methods of warfare” by “prostitut[ing] facilities in the medical and biological fields for the purposes of developing biological warfare.”² Despite these warnings, the national security community largely turned its attention away from biological threats after the 1960s.

    By the turn of the twenty-first century, however, biological threats had become impossible to ignore. Fothergill’s prediction proved correct, and several countries,...

  11. Appendix 1 Vaccine License Data, 1903–1999
    (pp. 180-228)
  12. Appendix 2 Developmental History of Vaccines Licensed in the United States, 1903–1999
    (pp. 230-242)
  13. Appendix 3 Twentieth Century Military Contributions to Licenses Representing Innovative Activity
    (pp. 244-250)
  14. Notes
    (pp. 251-286)
  15. Acknowledgments
    (pp. 287-288)
  16. Index
    (pp. 289-300)