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Barriers to HIV Vaccine Development

Creating an Effective HIV Vaccine is Harder than it Sounds

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Updated October 18, 2009

Ideally, scientists would put their heads together and create an effective vaccine against HIV. This vaccine would prevent new HIV infections and for all intensive purposes, halt the HIV epidemic in its tracks. It would be cheap, easily distributed to all parts of the world, and safe for kids and adults alike. Sounds great doesn't it? Unfortunately, it's not that easy. The fact is there are many barriers and roadblocks to an effective and affordable HIV vaccine. Let's look at those barriers.

Vaccine vs. Infection

In the event an HIV vaccine is developed, there will be a method to assess if the body did creat antibodies that will prevent HIV after getting the vaccine. The problem with that is any effective HIV vaccine will create a positive serologic response; in other wards after an HIV vaccine is taken, the person will forever have a positive HIV test. So the question is, how will medical people tell the difference between a positive HIV test due to vaccination or infection. Obviously it will be important to know the difference because one group will be protected against HIV and one group will need HIV care. So for an HIV vaccine to be effective, an HIV test that can tell the difference between HIV infection and HIV vaccine will have to be developed.

HIV Positive and the Prejudice that Goes With It

We are all aware of the discrimination, stereotyping and prejudice faced by people living with HIV. Just like people who are HIV-positive due to infection, people who are HIV-positive due to vaccination will most likely face the same social prejudices and injustices. At least in the early stages of a vaccination program, people will continue to be labeled HIV-positive and will be mistreated as is the case with HIV-infected people. However, as the number of people vaccinated grows, and HIV-positive label will lose some of its stigma, and hopefully stereotypes and prejudices will slowly fade away. One possible scenario is that many people will choose not to get vaccinated due to their fear of facing the same prejudices and injustices as HIV-infected people do.

Finding Volunteers for Trials

I hear all the time that people are refusing their flu vaccine or hepatitis b vaccine because they fear the vaccine itself will cause the very illness it is trying to prevent. In fact, many people telling me they will not get the H1N1 vaccine because they fear it will make them sick. So you can imagine how people will react to he HIV vaccine. Fear of getting the flu is one thing; fear of getting HIV is another. It may be very difficult to recruit volunteers for vaccine trials and if developed, it may be hard to find people willing to take the vaccine in those first days and months of a vaccination program.

Prevent Transmission but What About those Already Infected?

While the goal of HIV vaccination is to provide effective, long-term protection from HIV, scientists realize the challenge is to develop a vaccine that protects HIV-negative people from HIV and benefits those who are already infected. Most agree that vaccines currently in development will probably be better at preventing transmission from one person to another but probably will not offer long term benefits for those already infected. As research dollars shrink this fact may affect long-term funding of vaccine trials sometime down the road.
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