Anatomy of a Failure

Most of the new infections occurred in men. Does anyone know why?
About 40 percent of the people we recruited for the study were women. But for whatever reason, only one of the new cases of HIV infection occurred in a woman. We're still uncertain as to what that means.

What is being done for the trial volunteers who haven't been infected with HIV but now may be more susceptible to infection?
There's extensive counseling, and that counseling is effective over time. Risk practices went down in the course of the trial. When we first realized the vaccine wasn't working, we instituted some additional counseling efforts. If someone thought they had gotten the vaccine and they were going to be protected, we wanted them to know as quickly possible that this wasn't the case. Now that's even more important.

What does this trial mean for other efforts to use a similar vaccine against HIV? And what does it mean for Merck—will you be pursuing another HIV vaccine strategy?
Those kind of questions—many questions like that—are things that the whole field is going to have to grapple with going forward. To be honest, there are still a lot of data coming out. On the drug side we're extremely active, but as for vaccines, despite 20 years of research, at the moment we don't have any other candidates in development. Our primary focus right now is conducting the extensive analyses for the results from this trial. We really need to understand what happened here to inform our approach and help the overall field in the search for an effective vaccine.

© 2007