Prof. Daniel Floret
(CTV) emeritus professor of pediatrics at Claude Bernard University in Lyon
What do you think of the initiatives of the Vaccinology CIC at Cochin Hospital?
It really seems very important to me that academic players be able to conduct clinical trials on vaccines. There are very few in France and the CIC piloted by Professor Odile Launay is a perfect example. In the clinical trials launched to develop a new vaccine, only healthy people are included, and we still lack data on specific populations, who potentially may, in fact, need this vaccine more. It is precisely in them that we have to see whether the vaccine works, whether it is well tolerated or not. I am thinking in particular of the immunocompromised. The recommendations of the Technical Committee on Vaccinations for these populations are based almost exclusively on expert advice, as there are hardly any clinical trials in this area. The pharmaceutical industry does not usually take this type of population into account, so it is the academic world’s mission to carry out this type of study. The university hospital world has access to patients and it is precisely in hospitals that these trials, which are not of interest to the industry, can be carried out. There is a lot of missing and the Vaccinology CIC at Cochin Hospital is quite unique in this area. How to vaccinate people with leukemia? When to vaccinate them with which vaccines? Which ones can professionals use? We need scientific data to answer them and academic research and the only one that can establish them.
What are the main progress recorded for the last fifty years, who benefit everyone today?
Today we protect against diphtheria, tetanus, polio, pertussis, hepatitis B, measles, rubella, mumps, pneumococcus, hemophilus, rotavirus, papillomavirus and influenza. A dozen vaccines are available, but today the outrageous information circulating about the risks is causing people who did not ask themselves questions to have doubts. Today, we must keep in mind the immense progress made in this area. The incidence of infectious diseases speaks volumes. Polio has almost disappeared, tetanus boils down to a few cases to a few dozen cases per year. Pneumococcal meningitis was reduced by 33% in infants. The 500,000 cases of measles that caused around 100 encephalitis with deaths and sequelae now amount to a few hundred cases per year. Pertussis has not gone away, but the hundreds of thousands of cases are now reduced to a few hundred cases a year, thanks to vaccines.
Why do you think it is so important to continue testing vaccines?
Knowing and understanding the mechanisms of vaccines allows us to move forward. The next vaccines to come are those for dengue fever and possibly malaria. We have nothing against hepatitis C, concerning Ebola two vaccines are in clinical trials. We don’t have anything about cytomegalovirus (or CMV). This virus is responsible for infections that usually go unnoticed and whose pathogenicity manifests itself especially in patients with weakened immune defenses. These are people being treated with immunosuppressants or who have AIDS. Cytomegalovirus infection in pregnant women can cause damage to the fetus. It is the most common congenital fetal infection in industrialized countries. This vaccine appears, even today, to be very complicated to develop. Globally, we are moving away from strict prevention of infectious diseases. The safety of vaccines has improved significantly, and those being developed today are targeted to the chosen antigen. There are no more impurities. The best example is the pertussis vaccine. Its tolerance is incomparable with the first generation vaccine comprising the entire bacteria. But research must also facilitate access to vaccines for as many people as possible. New vaccines are very expensive and there is also progress to be made to make vaccines cheaper. Their price should not become an obstacle.