There's no simplex solution... yet

Researchers hopeful that a new vaccine will lead
to a brave new herpes-free world

By Peter Woodford

Genital herpes is one of the most common STIs in North America, affecting about a quarter of adult females and a fifth of adult males. As bad as the local rate is, it's even worse in the third world. But there's a new inoculating kid on the block looking to give genital herpes its comeuppance.

Currently, two major studies are underway to test the efficacy of GlaxoSmithKline's Herpevac vaccine. University of Alberta Clinical Professor, Dr Barbara Romanowski is working on one study of the vaccine in female subjects aged 10 to 17, while the second study, under the aegis of the NIH, is based in the US and covers women aged 18 to 30. In both trials, test subjects have to be free of herpes simplex virus (HSV) 1 and 2. So far results have shown the vaccine to be very effective, successfully immunizing 75% of the uninfected women.

Dr Richard Novak, a professor of infectious diseases at the University of Illinois at Chicago is working on the NIH trial and thinks the vaccine being tested looks like the real deal. Before Herpevac, there'd been a number of failed attempts at a herpes vaccine. If the encouraging early results hold true and the vaccine is approved and widely used, Dr Novak foresees societal prejudices as the biggest obstacle in the eventual eradication of genital herpes.

"It really depends on how well the vaccine is accepted by society and how widely it's given to children," muses Dr Novak. "Under the best scenario, the vaccine is licensed and the main public health organizations like the CDC and American Academy of Pediatrics come out strongly as advocates for administering the vaccine. Then it becomes a routine part of the panel of vaccinations we give to kids so that there's acceptance. It's then conceivable that within maybe 10 years even, we might start to see a disappearance of herpes type 2." He adds, "I think that's optimistic but a goal worth striving for."

Dr Romanowski doesn't share Dr Novak's optimism, even in a hypothetical best-case scenario. "This vaccine does not eliminate herpes" she says, "what it does is provide protection against acquiring herpes." She adds "maybe in 500 years if you had everyone vaccinated you would see a decrease in the prevalence of this infection, but this is not a vaccine that's licensed to eliminate herpes."

Nonetheless, Dr Romanowski is quick to take stock in its value, "if I wasn't excited I wouldn't do the study. Yes, this does represent a major breakthrough."

When asked if she shares Dr Novak's concerns over societal acceptance of the herpes vaccine, Dr Romanowski notes, "I think if you marketed a vaccine against genital herpes and said 'you should give your child this vaccine because your child is going to have sex and therefore probably get genital herpes' �no one's going to get it." She adds "I think it's an opportunity for us to educate and what I would say is we now have a safe effective vaccine that will protect your child, or in this case your daughter, against acquiring an infection with HSV2 that currently affects one in five individuals. That's a very different message."

Dr Andrey Blitzer, an Ontario Family Physician, concurs saying, "everyone wants their kid to be healthy and I think parents would be very surprised at the rate of HSV2 infection." If the vaccine were indeed long lasting and harmless she "wouldn't have any trouble explaining the validity of the vaccine."

Dr Blitzer feels that "if the vaccine is safe and effective, the question is who pays for it." She adds, "there are so many vaccines that the government doesn't cover, like the bacterial meningitis vaccine that would save more lives than this." Even if the vaccine lives up to its early clinical trial reputation, Dr Blitzer sees room for improvement: "I would be happier with a vaccine that also protected against herpes type 1 and worked on boys."