Dr. Stanley Plotkin talks CMV vaccine research

Dr. Stanley Plotkin talks CMV vaccine research

Dr. Stanley Plotkin has such a storied vaccine development career that one might say he wrote the book on vaccines. In fact, he did and his book “Vaccines”, now in its 6th edition, is the standard medical reference. Dr. Plotkin’s background reads like a roadmap of 20th century infectious disease—polio, rubella, rotavirus, rabies, and varicella (chicken pox). His career has been spent on the development of these vaccines and he now advises and influences clinical practice, academia, vaccine policy, as well as industry. (Read below for more about Dr. Plotkin’s career.) Fortunately, Dr. Plotkin is also the leading advocate for a CMV vaccine and recently spoke with National CMV’s Janelle Greenlee about the status and future of CMV vaccine development.  

Greenlee: “Part of the CMV laymen’s mythology relates to a perceived parallel between rubella and CMV.  Why was the rubella vaccine so much faster to market than the CMV vaccine?”

Plotkin: “Rubella was associated with congenital abnormalities because of its characteristic rash. People recognized it as a disease since the 18th century, so when the rubella epidemic in the early 1960s damaged thousands of babies, it quickly became a disease we needed to prevent. The rubella vaccine was a high priority and needed to be done because of its recognition by everybody. With respect to vaccine development, there is not much of a parallel between Rubella and CMV. They both cause hearing loss, but they are two very different viruses. Rubella is a much simpler virus in terms of the number of proteins and the length of the genome.” 

Greenlee: “So then what is the current status of CMV vaccine research?”

Plotkin: “I just gave a talk in England where I argued that we know how to make a CMV vaccine. The difficulty, if you will, is that to make a perfect vaccine, we need 3 elements and each of those is being developed by different entities. If we could put together three of the elements: a gB (glycoprotein B), a Pentamer, and pp65, then we would have a CMV vaccine. It’s not a simple matter to combine those things and to go through the process of manufacturing and to make sure they are all compatible. Getting people together and getting collaboration is the issue. I’ve been working with the various manufacturers and am involved in many of the projects. Sanofi (Sanofi Pasteur) is the manufacturer that sponsored the three successful studies with the gB candidate in Alabama, Cincinnati, and London. The problem with gB is that the antibodies don’t last long enough,  which can be solved by using an adjuvant, and Glaxo (GlaxoSmithKline) has good adjuvants. Collaboration between companies would help a lot.  It’s going slowly but I’ve had some success—I’m optimistic.” 

Greenlee: “This all sounds feasible and hopeful, but what can the public do to encourage and advance CMV vaccine efforts?”

Plotkin: “Two things: one is the idea of universal screening of newborns for CMV so that you would have a better idea of the weight of CMV incidence and disease burden. The second thing is to constantly press the case to the manufacturers. Sanofi, GSK, Merck, and Pfizer all have CMV projects and several biotechs do, as well. It’s not that they don’t recognize the importance of a CMV vaccine, but they aren’t in a hurry and they aren’t quick to collaborate. But it we could get faster movement and more collaboration, then we could have a vaccine. They want to help the public health, but they have priorities and where they put their money, so to speak. I think that people can stress to manufacturers that the public is waiting for a way to prevent CMV infection and disease in pregnancy. On the medical side, the Institutes of Medicine (IOM), now the National Academy of Medicine, said years ago that CMV was the highest priority for vaccine development. So the medical world appreciates this problem and the CDC (Centers for Disease Control and Prevention) has devoted a lot of effort to this. But there are always pessimists, I have lived with them all my life. They say it can’t be done or it’s too difficult. In a way, we need to say that a CMV vaccine is possible and it can be done and it should be done.”

More about Stanley Plotkin
Dr. Stanley A. Plotkin is Emeritus Professor of the University of Pennsylvania, and Adjunct Professor of the Johns Hopkins University. Until 1991, he was Professor of Pediatrics and Microbiology at the University of Pennsylvania, Professor of Virology at the Wistar Institute and at the same time, Director of Infectious Diseases and Senior Physician at the Children’s Hospital of Philadelphia. He maintained laboratories at both CHOP and Wistar. In 1991, Dr. Plotkin left the University to join the vaccine manufacturer, Pasteur-Mérieux-Connaught (now called Sanofi Pasteur), where for seven years he was Medical and Scientific Director, based at Marnes-la-Coquette, outside Paris. He is consultant to vaccine manufacturers, biotechnology companies and non-profit research organizations as principal of Vaxconsult.

Dr. Plotkin attended New York University, where he received a B.A. degree, and then the State University of New York Medical School in Brooklyn, where he received an M.D. degree in 1956.  His subsequent career included internship at Cleveland Metropolitan General Hospital, residency in pediatrics at the Children’s Hospital of Philadelphia and the Hospital for Sick Children in London and three years in the Epidemic Intelligence Service of the Centers for Disease Control of the US Public Health Service.

He has been chairman of the Infectious Diseases Committee and the AIDS Task Force of the American Academy of Pediatrics, liaison member of the Advisory Committee on Immunization Practices and Chairman of the Microbiology and Infectious Diseases Research Committee of the National Institutes of Health.  Dr. Plotkin received the Bruce Medal in Preventive Medicine of the American College of Physicians, the Distinguished Physician Award of the Pediatric Infectious Diseases Society, the Clinical Virology Award of the Pan American Society for Clinical Virology, the Richard Day Master Teacher in Pediatrics Award of the Alumni Association of New York Downstate Medical College, and the Marshall Award of the European Society for Pediatric Infectious Diseases.  In June 1998, he received the French Legion of Honor Medal; in June 2001, the Distinguished Alumnus Award of the Children’s Hospital of Philadelphia, in September 2006 the gold medal from the same hospital; the Sabin Gold Medal in May 2002, in September 2004 the Fleming (Bristol) Award of the Infectious Diseases Society of America, in May 2007 the medal of the Fondation Mérieux, in 2009 the Finland Award of the National Foundation for Infectious Diseases and the Hilleman Award of the American Society for Microbiology, and in 2013 the Career Achievement Award from the Association for Clincal and Translational Medicine, as well as the Caspar Wistar Medal of the Wistar Institute of Biological Research    In 2014 he received the Charles Mérieux Award of the National Foundation for Infectious Diseases and the Sheikh Hamdan (Dubai) Award for Medical Sciences.  He was elected to the Institute of Medicine of the National Academy of Sciences in 2005, to the French Academy of Medicine in 2007, to the French Academy of Pharmacy in 2013, and to the Thai Pediatric Infectious Diseases Society in 1915. He is a Fellow of the Infectious Diseases Society of America, the Pediatric Infectious Diseases Society, the International Society for Vaccines, the American Academy of Pediatrics and the International Society for Vaccines. Dr. Plotkin holds honorary doctoral degrees from the University of Rouen (France) and the Complutense University of Madrid (Spain). Named lectures in his honor have been established at the Pediatric Academic Societies annual meeting, at the International Advanced Vaccinology Course in Annecy, France, and at the DNA Vaccines Society.  A professorship in his name was established at the Children’s Hospital of Philadelphia.  His bibliography includes over 700 articles and he has edited several books including the standard textbook on vaccines, now in its 6th edition.  He developed the rubella vaccine now in standard use throughout the world, is codeveloper of the pentavalent rotavirus vaccine, and has worked extensively on the development and application of other vaccines including anthrax, oral polio, rabies, varicella, and cytomegalovirus.