Long gone are the days when there is no known cure for any medical condition. Vaccinations especially, have grown by leaps and bounds in trying to cure and eradicate preventable diseases. A great success story to credit vaccines is the eradication of smallpox from the world. Scientists around the world are endlessly trying to find every cure possible for any disease; cancer, HIV and addiction included.

The concept of herd immunity, whereby when a majority of the population is vaccinated, significantly reduces the chances of contracting the disease. However, while the treatment is available, there are challenges in getting it to the recipients.

Pretty pricey problems

Vaccines have undoubtedly increased in prices over time, making it inaccessible for those in developing countries and almost impossible to vaccinate practically everyone. This creates a flaw in creating long-term immunisation programmes. The cause for not being able to bring down the prices are many, among which is due to the lack of suppliers to create competitive prices, the avail of technology to create the vaccine and the length of time the product has been available.

While traditional vaccines are inexpensive, like the measles vaccine that costs no more than USD0.30 per dose, the new vaccines in the past decade or so are definitely not. Rotavirus vaccines, which protect against forms of diarrhoea, cost a minimum between USD5 and USD10.50 per child. The request for new vaccines continue to rise, with the high prices, low-income countries continue to be deficient.

Such is the case with HPV vaccines, which have been rolled out since 2006. Since then, only 1.4% of the global female population has been immunised against HPV, with 70% of them being women from high income countries. Resistance to the virus is almost non-existent as roughly 85% of new cervical cancer cases are reported in developing countries.

The HPV vaccine, administered in three doses, costs a whopping USD450 – and remains to be the barrier that prevents eradication of the disease. Apart from introducing more manufacturers, especially in the developing countries to combat the high prices, better negotiations by Global Alliance for Vaccines and Immunisation (GAVI) and UNICEF will also need to come into play. GAVI negotiates for lower-priced vaccines and buys them in bulk and channels these vaccines through UNICEF, while also providing financial support to countries like Indonesia and Bangladesh.

Vaccinating against addiction

Apart from curing traditional known diseases, scientists have also been researching vaccinations against substance addiction in the past two decades. Addiction to nicotine, cocaine and heroin have killed more Americans than traffic accidents. This makes the prospect of curing addiction with vaccines incredibly exciting.

However, it is not without its set of complications. According to Dr Ivan Montoya, acting director of the division of Therapeutics and Medical Consequences at the National Institute on Drug Abuse, “the biggest challenge is to get enough antibodies to soak up a surge of drug injected into the bloodstream, so that the molecules that causes euphoria will stop from entering the brain.”

The other challenge is to get the patient to come back for more vaccinations. Unlike the measles vaccine which provides lifetime immunity, the addiction vaccine needs to be administered multiple times per year. This modus operandi will most likely only be successful for those who are serious about overcoming addiction. That is also perhaps if the patient does not turn to other opioids in the meantime as the vaccines are drug-specific.

Testing of the vaccine have also only been carried out in monkeys and rodents, without any clue how it will do in humans. Testing on humans are very costly, easily in the range of tens of millions of dollars. Regardless of the funding, researchers are still unsure if the vaccines are safe and effective for humans. When proven successful, these vaccines will go hand in hand with current treatment of addiction, instead of replacing them. MIMS

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Sources:
https://www.asianscientist.com/2017/08/print/tale-two-vaccines/
http://www.npr.org/sections/health-shots/2017/08/10/542605039/a-vaccine-for-addiction-is-no-simple-fix
https://www.historyofvaccines.org/multilanguage/content/articles/ethical-issues-and-vaccines
https://www.msfaccess.org/our-work/vaccines/article/1377
https://www.msfaccess.org/our-work/vaccines/article/1378
https://www.msfaccess.org/our-work/vaccines/article/1379