AIDS VACCINE: Expert Predicts Unintended Side Effects

      Unless an AIDS vaccine is highly effective and "can be feasibly administered to nearly all sexually active and intravenous drug users, it could result in substantial side effects contradictory to its intended purpose," according to Jon Ungpakorn, director of Access, an AIDS counseling center in Thailand. Speaking to national and international scientists at a conference on HIV vaccine efficacy trials in Thailand, Ungpakorn said both the vaccinated population and unvaccinated individuals might "misunderstand and overlook the continuous need to avoid risky behavior." Among vaccinated populations, "many of whom may become infected due to the low efficacy of the vaccine or may remain unaware of their infection," HIV testing could become more difficult as well as expensive, he said. And while employing a vaccine "is considered the second best means for controlling the epidemic," its very availability "could weaken political will" because governments' interest would wane in funding prevention and education programs. Further, Ungpakorn asserted that those with "low risk," but who are "highly anxious" and part of "influential sections of the population," would rush out to get the vaccine, pushing aside "those who should be given higher priority." He added, "In fact, it may be difficult to avoid vaccinating nearly the whole adult population due to the pressures of a chain reaction in population demand. This may result in substantial decrease in cost-effectiveness of the vaccine." In addition, many people could feel "a severe demoralizing effect" if before receiving vaccination, they realized they were HIV positive. Ungpakorn said that "this could also lead to further discrimination against the non-vaccinated, HIV-positive population, who also would have difficulty keeping their HIV status a secret if employers, educational institutions and insurance companies demand vaccination certificates." However, there might not be anything to worry about for a few years, as Jose Esparza of UNAIDS said, "The sad reality is that after more than 15 years of HIV research, there are very few candidate vaccines available for effective evaluation" (Bhatiasevi, Bangkok Post, 10/19). Ungpakorn's statements come just week's after NIH Vaccine Research Center Director Dr. Gary Nabel said that clinical practices should begin integrating a "partially protective AIDS vaccine" (see Kaiser Daily Report, 10/7).