In Rochester history

Medical Center researchers tackled ‘Hib,’ created a new kind of vaccine and helped save the lives of thousands of children.

As recently as the 1960s, bacterial meningitis infected thousands of children each year in the United States. Five percent of infected children die and 30 percent of the survivors are left with a long-term disability, including mental retardation, acquired deafness and learning disabilities.

Three Rochester pediatric researchers—the late David Smith, M.D. (M ’58, HNR ’92), Porter Anderson, Ph.D., and Richard Insel, M.D.—took on the challenge of finding a way to prevent the disease. They were among the first to develop and test the concept of a "conjugate" vaccine, a method to make a vaccine more effective by linking it to a protein that would spur an infant’s immune system to fight an infection especially vigorously.

Smith had begun his research as a young physician at Harvard University. When he became chair of the University of Rochester Medical Center’s Department of Pediatrics in 1976, he increased the effort and recruited researchers.

The team of Smith, Anderson and Insel first used the technology to target bacteria known as Haemophilus influenzae type b (Hib). By the early 1980s, the first Hib vaccine had been tested, licensed, and was being produced in a small laboratory within the Medical Center. After successful initial tests, the team tried to persuade a pharmaceutical firm to license the technology.

Vaccine research was not a favorite product of the pharmaceutical industry then, and the offer was declined. So the group headed by Smith, who stepped down as chair of the Department of Pediatrics, went into business together and created a company, Praxis Biologics, to make the vaccine.

The HIB vaccine was approved by the Food and Drug Administration in 1990. At the time, it was the first vaccine in 20 years to be recommended by FDA for universal use in children.

“During my training in the 1970s,” Insel has said, “you could walk into any pediatric ward anytime and guarantee that there would be at least one child with invasive Haemophilus influenzae. Now, there are so few cases, a doctor will go years without ever seeing a case.”

Illnesses caused by the disease in the United States have fallen from 20,000 each year to about 200 cases since the introduction of the HIB vaccine.

In 1988, Praxis was purchased by a company called American Cyanamid. In 1994, American Cyanamid was bought by Wyeth, which is now part of Pfizer Inc.

Another vaccine based on the conjugate technology, Prevnar, was introduced in
2000. It prevents invasive infections by pneumococcal bacteria, which cause meningitis, ear infections, pneumonia and other diseases.

One study showed that the rate of infection among children less than two years of age in seven cities around the nation, including Rochester, fell 69 percent in a three-year period. The rate of infection in unimmunized adults dropped as well, probably because the vaccine eliminated or reduced the number of germs in children who normally serve as reservoirs of Pneumococcus.

“The vaccine’s real-world performance is remarkable,” said Insel, who now is the chief scientific officer of the Juvenile Diabetes Research Foundation.

The facility built in 1993 by American Cyanamid to continue the commercial development of the Hib vaccine was purchased by the University in 2004 from what was then called Wyeth-Lederle Vaccines and Pediatrics. After a $14-million upgrade that was completed in 2007, the facility is now the home of the Medical Center’s Aab Cardiovascular Research Institute.