'AIDS Vaccine Fails in Trials,' Los Angeles Times
'Vaccine for AIDS Fails Test Trial,' The Atlanta Journal-Constitution
'AIDS Vaccine Trial Deemed a Flop,' Chicago Tribune
'Big Setback for AIDS Vaccine,' The Boston Globe
'AIDS Vaccine Fails Test,'' San Jose Mercury News
'AIDS Vaccine Fails in Test,' Newsday
What's wrong with this picture? In February, VaxGen, a Brisbane, Calif.'based biotech firm, released data from its AIDSVAX trials. According to the company, black and Asian participants in the study responded differently to the vaccine than the whites and Latinos who participated. The trials were the first to test the effectiveness of an AIDS vaccine. They found that the vaccine did not work overall, but it was more than 75% effective in protecting black volunteers from infection with HIV.
San Francisco Chronicle columnist Tom Abate realized he had a failure to communicate when he received a flood of E-mails taking him to task for a headline that called the vaccine 'mostly a failure.' Some of his readers felt the headline suggested that only white people count.
A reporter for The [Cleveland] Plain Dealer echoed the sentiments of many African-Americans: 'The vaccine did work. It just didn't work on white people.'
'People are saying this trial failed because it didn't protect all the [white] people, as they hoped it would,' Michael Para, MD, a professor of medicine at Ohio State University and one of the independent researchers who reviewed the trial data, told the paper. 'But the company has found something worth pursuing.'
After preliminary discussions with the FDA, Abate reported, VaxGen's president, Donald Francis, MD, said, 'I think they want us to do additional field studies with African-Americans.' Francis has also said the company plans to seek FDA approval of the vaccine for African-Americans. Although the results released by VaxGen are very interesting, it is too early to make any firm conclusion about the ultimate impact of AIDSVAX on the AIDS pandemic.
But as Loretta Green, an African-American journalist with the pointed out, that's not the only point. Green first heard the news that the VaxGen vaccine had 'failed,' prompting the company's stock price to plummet, while listening to an NBC stock market report at 6:30 in the morning on February 24. 'Did I miss something?'' she asked her husband. 'Didn't the commentator also say that the vaccine worked on us? Didn't we matter?' Green wrote, 'Like most things, perspective is a powerful lens. Things that seem harmless and slip under the radar of some are a direct hit for others. From a definitely nonscientific and purely personal vantage, I thought that [a 78% reduction in HIV] was significant.'
Given the disproportionate impact of the HIV pandemic on people of African descent in Africa, the Caribbean, and the United States, the VaxGen announcement further underlines the need for black people to be involved in vaccine development on every level, every step of the way. There must be black vaccine researchers, black clinical-trial sites, black volunteers, black reporters covering the vaccine beat, and black analysts and clinicians evaluating the results.
As with most medical studies, this test featured too few black volunteers (314 out of 5,009 overall) to reach any sweeping conclusions. And that raises a huge question: What if this trial had reflected the demographics of the AIDS epidemic? And why didn't it?
Because we suffer disproportionately from AIDS, black people should be more involved than others in demanding more research and making sure the research is applicable to us. The possibility'no matter how remote'of a vaccine that works for African-Americans should jump-start black America's involvement in the vaccine development and approval process.
But the hope for a vaccine should not distract us from the work needed today to spread the word about AIDS in black communities. However promising this vaccine may look for black people, it is a promise for tomorrow. Today, African-Americans have work to do. We still have to focus on getting people tested, getting them informed, getting those who are infected treated, and getting everyone in our community involved.
The ultimate weapon against HIV will be a vaccine. A preventive vaccine is critical for Africans, African-Americans, and other people of color who are already disproportionately affected by other chronic illnesses. Vaccines are also essential for individuals, communities, and countries that cannot afford expensive therapies. Only a vaccine has the potential to eradicate an illness from the face of the earth. To this end, African-Americans must participate in vaccine development, trials, and readiness. We must prepare our communities for vaccines by educating each other about the benefits and limitations of vaccines. In the meantime, we have to find out who's infected, get them into treatment, and keep those who aren't infected free of HIV.
Nevertheless, the quick claim that it has been a failure has been hurtful in black communities. As Loretta Green put it: 'To paraphrase an old saying: All of us looked out of a window. Some of us saw stars while others saw mud.'
Wilson is director of the African-American HIV University, a two-year fellowship program, and founding director of both the Black AIDS Institute and the AIDS Social Policy Archives at the University of Southern California.
