“Somebody asked me: ‘if you think MS is caused by EBV why don’t you simply vaccinate the population against EBV and see what happens?’. This is easier said than done. In addition, population vaccination is a ‘hot potatoe’; you just have to read the political fallout of the HPV vaccine for cancer of the cervix prevention to gain some insights into how political the topic of ‘population vaccination’ can be.”
“The theoretical and logistical hurdles in relation to EBV vaccination is why finding successful drug treatments that target EBV is so important. May be we won’t need vaccination if we can take a simple over the counter safe anti-viral to treat IM and possibly MS. This is why our Charcot project is so important. If you haven’t donated money yet please consider doing so now. We have almost reached our target for phase 1 of next antiviral agent we want to test in MS.”
Cohen et al. The need and challenges for development of an Epstein-Barr virus vaccine. Vaccine. 2013 Apr 18;31 Suppl 2:B194-6.
Epstein-Barr virus (EBV) is the major cause of infectious mononucleosis and is associated with several malignancies including nasopharyngeal carcinoma, gastric carcinoma, Hodgkin lymphoma, Burkitt lymphoma, and lymphoma after organ or stem cell transplant. A candidate vaccine containing soluble EBV glycoprotein gp350 protected cottontop tamarins from EBV lymphoma after challenge with EBV. In the only phase 2 trial of an EBV vaccine in humans, soluble gp350 in alum and monophosphoryl lipid A adjuvant reduced the rate of infectious mononucleosis in EBV seronegative adults, but did not affect the rate of EBV infection. A peptide vaccine corresponding to EBV latency proteins has been tested in a small number of adults to prevent infectious mononucleosis. Some of the barriers to development of an EBV vaccine include (a) whether viral proteins in addition to gp350 would be more effective for preventing mononucleosis or EBV malignancies, (b) the difficulty of performing clinical trials to prevent EBV associated malignancies in the absence of good surrogate markers for tumor development, and the long period of time between primary EBV infection and development of many EBV tumors, (c) the lack of knowledge of immune correlates for protection against EBV infection and disease, (d) the limitations in animal models to study protection against EBV infection and disease, and (e) the need for additional information on the economic and societal burden of infectious mononucleosis to assess the cost-benefit of a prophylactic vaccine.