It seems that vaccine development has never had such a high profile. With vaccines available against smallpox and anthrax, how exactly they should be used to combat the threat of bioterrorism has been a subject of debate in the US press. A feature in The Washington Post pointed out that existing vaccines to potential bioterrorism agents were “developed decades ago and can cause severe side effects or even death” and advised its readers against investing in vaccine development.
Although acknowledging the risks, Warren Leary, writing in The New York Times, advocated voluntary vaccination against smallpox — “even if only part of the population were vaccinated, the bang for the terrorist's buck could be drastically curtailed”.
Meanwhile, ongoing efforts to develop vaccines for the big killers — HIV, malaria and tuberculosis — have not hit the headlines. Although the BBC World Service did report on a “promising” new malaria vaccine undergoing clinical trial in the Gambia. The low-key tone was perhaps appropriate given that the vaccine only protected 47% of individuals. Another report from the BBC News provided a timely warning that “Weak vaccines strengthen disease”. This story covered the predictions of Edinburgh-based epidemiologists (originally published in Nature 13 December 2001) that, in the case of chronic diseases, such as malaria, vaccines that are less than 100% effective have the potential to do more harm than good. Specifically, vaccines that only protect a proportion of the population could lead to outbreaks of more virulent forms of disease and the news article claims that this “could kill more people that any vaccination programme would save”.