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Life-changing research - By Peter Rice
Somewhere in Albuquerque, a sprawling building,
built in the uniquely bland federal government
style, stands behind a well-maintained perimeter
fence. It's the sort of place where you have to
drive up to the entrance, push a button and then
talk to people inside before the robotic arm
swings up to allow access.
For security reasons, officials at the U.S.
Department of Veterans Affairs, which operates
the facility, asked that it be described only as
"near the airport." You may have driven past it
without knowing.
Despite its low profile, the building has, in
the past few years, served as a kind of national
vortex for a major - and successful - study
testing the effectiveness of a new vaccine for
shingles that is hitting the open market. The
study started in 1999 and officially ended last
month, although research continues as more
questions are raised, such as how long the
vaccine will be effective.
Shingles is a severe, adult form of the chicken
pox virus that crops up in half of all people
who reach 85. The virus causes nasty rashes and
nerve pain that in some cases turns chronic.
Nearly 2,000 Albuquerqueans, and 36,000 of their
fellow Americans, participated in the study.
Logistical challenge
The pharmaceutical giant Merck manufactured the
test doses in Pennsylvania, but that VA center
somewhere near the airport coordinated the
massive logistical challenge of keeping an eye
on the stuff and distributing it to the local
hospital and 21 other sites around the country.
The job may sound simple, but everything has to
be just right, said Kathy Boardman, the center's
assistant director who also works as a professor
at the University of New Mexico Health Sciences
Center. The vaccine, stocked in vials and
costing $130 each, takes form as a white fluffy
powder. Doctors must add a special liquid, also
developed by the company, to dissolve the
substance before injecting it into patients. The
vaccine must be stored in a freezer at about 20
below zero. Out of the super cold environment,
it would last 30 minutes before becoming
useless.
The VA installed a special power line to tap an
emergency generator in case of a loss of power
to the center. The center guarded the
inoculations, and then as needed, overnighted
them to 22 study locations around the country.
They sent one or two boxes of 96 doses not sure
if the doses are the vials (value: up to $12,480
per box) at a time. Dry ice is packed with the
doses, some of which were actually placebos.
Boardman was one of three people in the country
who knew which vaccines were active and which
were not.
Success
The results are in: The vaccine, given to people
over age 60, cut the incidences of the shingles
rashes by 50 percent. It proved even better at
preventing the nerve pain: 67 percent had no
problems. Those who did come down with the virus
had less severe symptoms. As the new vaccine
hits the market under the name Zostavax, the
learning experience continues, said Nancy
Hampshire, who ran one of the study groups in
Durham, North Carolina.
The inoculation prevented shingles during the
five-year test period, but people live longer
than that, and there's no telling if they might
need some sort of booster shot eventually. "We
want to see how long the vaccine is effective,"
Hampshire said.
Question: What is the Department of
Veterans Affairs doing studying a shingles
vaccine?
Answer: The VA is chartered by Congress
to conduct this sort of research. The department
does focus on projects that are likely to
benefit veterans, and many veterans are seniors
and likely to come down with shingles.
Question: What else does the Albuquerque
research facility do?
Answer: It also recently participated in
a study of the osteoarthritis medicine
glucosamin and chondroitin sulfate. It even
operates a drug manufacturing facility on site.
Question: What did the shingles study
cost?
Answer: About $30 million, split between
the VA, Merck and the National Institutes of
Health.
Question: How do viruses do their dirty
work?
Answer: Viruses survive by invading
hosts, but they can't get too carried away in
what they do to the hosts. Kill too many hosts,
and the virus dies. In the case of the varicella-zoster
virus, it causes chicken pox, then hibernates in
your spine. In your senior years, it wakes up
and returns as shingles.
Source: Department of Veterans Affairs |
