Infectious Disease, Respiratory
Development of an Improved Vaccine to Prevent and Treat the Tuberculosis Virus
2015 Oxford-Harrington Scholar
Five thousand miles separate Dr. Helen McShane's laboratory at the University of Oxford in the UK and the small African villages and cities where she hopes to make an impact on children's health.
A specialist in infectious disease, Dr. McShane, a Professor of Vaccinology at the University of Oxford, has devoted more than 15 years to developing a vaccine for tuberculosis (TB).
BCG, the only available vaccine against TB, was developed in 1908. Administered at birth, it protects children against severe disease and TB meningitis until age 10 but offers no immunity against lung disease, the form of TB that accounts for most of the TB-related illness and death worldwide. “We know that boosting with BCG (giving it repeated times) doesn't make any difference and doesn't make it any better,” Dr. McShane adds.
Since 2002, Dr. McShane's research team has conducted more than 20 clinical trials of new TB vaccines in the UK, The Gambia, Uganda, Senegal and South Africa. In 2013, they completed an efficacy trial of the most-promising vaccine, MVA85A, given as a booster after BCG. In the first efficacy trial of a new TB vaccine since 1968, researchers administered the MVA85A to nearly 2,800 infants in South Africa.
The results made headlines around the world: MVA85A was not any more effective at protecting infants from TB than BCG alone. “It was disappointing because it made clear that we do not know the immunology – why the vaccine didn't work,” Dr. McShane notes.
As a researcher, Dr. McShane's reaction has been fascination rather than frustration and an intensified motivation to find the answers. “You do a clinical trial and get results and evaluate why it did or didn't work,” she explains. “It's a fascinating process and it shapes the next steps.”
Dr. McShane traces her career-long absorption with infectious disease to her residency at a hospital in Brighton, UK, where she cared for HIV patients in the 1980s. At that time, patients were very ill and died soon after admission. This grim experience led to a career-changing decision for Dr. McShane – to combine clinical care with infectious disease research. With the field of HIV research already crowded, she selected TB, a “more interesting bug,” as her concentration.
Her unflagging pursuit of a better TB vaccine coupled with the expertise of Harrington Discovery Institute's Innovation Support Center hold the promise of both kinds of rewards.
“I like the balance of the immediate gratification in treating patients and the long-term gratification of research.”