Thoughts on a visit to Aeras

By: Andrea Brush

As a public health graduate student, I jump at any chance I have to get involved in my future field. The other day, I was given an opportunity to visit Aeras and tour their facility. With an academic background that is strictly social science, I was initially intimidated by the hard science that would soon be thrown my way via chemical compounds, acronyms, and scientific processes used to develop Tuberculosis vaccines. But then I thought to myself, Tuberculosis vaccines! How can I pass on an opportunity to meet with people that could potentially save millions of lives (approximately 1.4 million per year, according to Aeras)? Bolstered by the fact that my classmates back in Oregon were jealous of my opportunity to visit a place that we had discussed in classes, I took my new found confidence to Rockville, Maryland.

The scientists and researchers that we met with at the Aeras facility were wonderful. It was a humbling experience to watch these brilliant minds try to contain their excitement about their work and also try to use terms that non-scientists would understand. Admittedly, there was quite a bit of information that went over my head, such as using a matched prime boost and an adenovirus as delivery vehicles. These words mean little to me. But enough of the tour made sense for me to be in awe for my entire time at the facility. The most fascinating thing that I took away - something I had no idea was even happening in the research world - is that Aeras uses equipment for lyophilization, or freeze drying.  Freeze drying! An aerosol vaccine is the ultimate goal with this technology, which is an oral dosage that would be administered directly to the lungs for faster and more efficient outcomes. An aerosol vaccine would be given through an inhaler rather than a syringe which would lead to more cost-effective production, easier access of the vaccine to most of the world, and easier storage, in that a it would not need to be kept at a specific temperature.  This technology, if successful, could also be used for future vaccinations against other infectious diseases as well.  The benefit of having a vaccine that does not need to be refrigerated is integral for low-income nations that may not have access to refrigeration or are prone to sporadic power outages. The current BCG vaccine requires refrigeration and has shown varying degrees of protection against TB in certain areas of the world.

Something else that affected me while on the tour was the collection of photographs hanging on the walls in the hallway outside of the laboratories. The photos, taken by David Rochkind, documented several lives affected by TB in South Africa. There was one picture, of a doctor surrounded by white buckets holding up a bag. The caption said the bag contained the heart and lungs of a deceased TB patient. All the buckets contained them as well. Gold mine workers often have their hearts and lungs preserved and examined to determine if TB killed them so their families could receive compensation. Even though TB is the killer the majority of the time, very few families are compensated. 

The facts and figures surrounding TB and the need for a new vaccine are astounding. There are around 2 billion people in the world infected with TB, and the current vaccine (Bacille Calmette-Guérin (BCG), created in 1921) has little impact on the pandemic. In addition, 90% of people living with HIV that contract TB will die within three months. These facts, coupled with the new findings of totally drug resistant-TB, should be enough for anyone to want to join the fight against TB, regardless of understanding the science behind the vaccine development.