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Army Col. Paul Keiser, director of Walter Reed Army Institute of Research’s Viral Diseases branch, holds one of the insectary’s mosquito habitats at WRAIR in Silver Spring, Md., May 31, 2017. Around 250 adult mosquitos live in each bucket. Photo: DoD/Rick Docksai

Americans rely on the U.S. military to keep them safe from humans who would do them harm.

What they might not know is that some service members work around the clock to protect them from microscopic bad guys, as well -- i.e., deadly viruses and bacteria.

Personnel at the Walter Reed Army Institute of Research, a Defense Department biomedical facility in Silver Spring, Maryland, are researching and developing vaccines that can save military and civilian lives.

Disease Prevention

The military has a personal interest in disease prevention. U.S. service members deploy to areas rife with malaria, Zika and other dangerous pathogens. Troop infections happen, and when they do they require costly, time-consuming medical leave and hospitalizations. Effective new vaccines can consequently be the key to healthier troops and better-operating units.

But civilians get these treatments, too. Glaxo-Smith-Kline and Sanaria are both close to rolling out new vaccines for malaria, a disease responsible for 300,000 deaths worldwide every year. And WRAIR was a research partner for both. WRAIR was additionally a research partner in the development of every existing malaria medication on the market today, according to Kevin Modjarrad, WRAIR’s associate director for emerging infectious diseases.

“Every single licensed therapy for malaria has somehow made its way through Walter Reed Army Institute of Research at some point in its development: It was tested, validated and developed within our institution,” Modjarrad said.

Important Vaccines

WRAIR developed the first effective licensed vaccine against meningitis in the 1970s. And in recent years, according to Modjarrad, WRAIR has tested several vaccines against Ebola. One of them went into use in Nigerian communities during the West African Ebola outbreak of 2014 with highly positive results.

“It did save lives,” Modjarrad said. “Wherever we tested it, those people did not get Ebola.”

Modjarrad is co-leading a WRAIR program to develop a Zika vaccine. The program has made rapid progress, moving from an initial experimental vaccine in early 2016 to a preliminary human trial last November that is still screening new volunteers. Modjarrad attributed the fast turnaround time to earlier work WRAIR researchers had done on vaccines for dengue and encephalitis, which are in the same family of viruses as Zika.

“We were able to use the knowledge we had gained from that platform and make a Zika vaccine with the same methods and the same general platform,” Modjarrad said.

Military-Civilian Partnership

WRAIR is also finishing trials of a vaccine for Middle East Respiratory Syndrome, or MERS, and is planning another malaria vaccine trial that will start in fall of this year. And it is partnering with Themis-GmbH, an Austrian-based pharmaceutical company, to test a vaccine for chikungunya, a mosquito-borne disease that has appeared in countries in Africa, Asia, Europe, the Indian and Pacific Oceans and islands in the Caribbean. Although rarely fatal, it can leave infected persons with long-lasting joint pain. And its vast geographic spread causes military leaders significant concern for their troops.

“When you take a whole bunch of personnel and put them in an area where there’s ongoing disease transmission, a lot of them will get sick at the same time. And then you can’t carry out your missions, because too many of your soldiers are having joint pain and can’t march,” said Paul Keiser, director of WRAIR’s viral diseases branch. “Not only do you have short-term mission compromise, but you have long-term disability.”

Themis-GmbH CEO Erich Tauber praised WRAIR’s expertise at vaccine testing, which he said greatly accelerated the chikungunya research. Tauber forecasts that the vaccine could be ready in less than five years, thanks to WRAIR.

“The test that we used was very well established at WRAIR, and they have done this testing for us with exceptional expertise. WRAIR’s involvement has greatly helped us to advance the project,” Tauber said.

PaxVax, a U.S.-based pharmaceutical company, is working on its own chikungunya vaccine but will work with WRAIR to carry out its next human clinical trial, according to John Smith, chief scientific officer at PaxVax. Smith credited WRAIR with providing “significant funding to further this vaccine effort.”

Networks of Support

WRAIR is DoD’s largest disease-research center. But it doesn’t work alone. Fort Detrick, Maryland, hosts the U.S. Army Medical Research Acquisition Activity, which also researches new pharmaceuticals and is aiding WRAIR and PaxVax’s vaccine-development efforts.

“It takes all of these activities working in concert to efficiently develop new vaccines,” Smith said. “PaxVax very much appreciates the expertise that has been made available from each of these activities, and has a high level of confidence that effective vaccines will result from the close interaction that has been possible in this partnership.”

Developing vaccines is expensive, and private-sector pharmaceutical companies are not always in a position to pursue them on their own. Private investment is often sparse, Keiser noted, since the profit margin for a vaccine, which a patient takes only once, is typically lower than that of a maintenance drug that a patient takes repeatedly. WRAIR mitigates this problem, he added, by providing resources and support to jumpstart a vaccine research program and get it far enough advanced that large private companies will be interested in acquiring them.

“By us funding further studies of these vaccine candidates, we can generate more data on how safe and effective they are. And that will make it more likely that a drug company may pick them up,” he said.

As long as infectious diseases threaten us, WRAIR will continue to support the rollout of effective safeguards against diseases, both for U.S. troops and for the civilians those troops protect.

“What we do is meant to be directly relevant for the warfighter. But our work doesn’t stop there. It's very much integrated into global health. The products that we develop are broadly relevant not just to our service members, but the communities they’re serving in, as well,” Modjarrad said.

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