Kendall Hoyt

 

On her book Long Shot: Vaccines for National Defense

Cover Interview of March 19, 2012

The wide angle

My interest in this topic began in 1999 when I was sitting in the back of a bus in Japan, reading an article about Aum Shinrikyo, a cult that released Sarin gas in a Tokyo subway in 1995.  What I didn’t realize was that the cult had attempted numerous attacks with biological agents as well.  While these biological attacks had been unsuccessful, I was horrified by how easily things could have gone another way.  Biological weapons provide an asymmetric advantage to disgruntled groups and individuals.  It was clear to me that biological weapons-relevant materials and expertise would proliferate and that this threat would grow over time.

Meanwhile, I was aware that naturally occurring disease threats were increasing as well.  After decades of watching disease rates fall, experts recorded that the death rate from infectious disease had been on the rise in the U.S. since 1980, even if one excludes HIV/AIDS cases.

I was concerned that vaccine development was not keeping pace with these rapidly evolving threats from man and nature, so I tried to document vaccine innovation rates over time by plotting the number of new vaccine licenses per decade.

What began as a simple exercise was immediately complicated by the fact that vaccine license records were incomplete and inaccurate.  Many original licenses had been lost or re-entered at a later date and many licenses had been issued for non-innovative activity (i.e. name changes and license transfers) since the 1970s. As a consequence, publicly available data under-represented mid-century innovation rates and inflated late century innovation.

I restored original licenses that had been lost from federal records, corrected inaccuracies, and identified which licenses represented innovative activity.  These new data demonstrated that innovation had been falling, not rising since World War II.  This finding was at odds with market-driven theories of innovation.

Traditional market-based formulas for innovation in industrial settings predict that greater economic incentives, technological opportunities, and firm capabilities in the latter half of the century should have led to a corresponding rise in innovation rates. Yet the data demonstrate a decline.

To get a better understanding of the forces that drove vaccine innovation, I began to investigate the developmental history of individual vaccines.  I noticed that historically successful vaccine development programs often used a consistent set of integrated research practices.

“Integrated” is a catch-all term for research that is directed from the top down, coordinated across disciplines and developmental phases, and situated in a community that facilitates information transfer.  Thomas Francis Jr. used these techniques when he developed the first licensed Influenza vaccines in the 1940s, as did Jonas Salk when he developed the first licensed the first Polio vaccines in the 1950s, and Maurice Hilleman when he developed the Adenovirus, Measles, Mumps, Rubella, Meningococcal Meningitis and Hepatitis B vaccines.