ideasIdea
A vaccine against H. pylori for children in high-risk regions
A childhood vaccine against the stomach bacterium behind most stomach cancer would prevent infection for life. One trial in China showed protection; the idea has stalled.
An oral recombinant urease B vaccine showed about 72% efficacy against infection in a Chinese phase 3 in children (published 2015) but was not developed further. Propose a renewed programme of mucosal or mRNA vaccines against urease, CagA and VacA with infection-prevention and gastric precancer endpoints in high-incidence cohorts.
Hypothesis
A vaccine reducing childhood H. pylori acquisition by at least 60% reduces atrophic gastritis at age 30 by at least 40% and, long term, gastric cancer incidence.
Rationale
The bacterium is a defined carcinogen; preventing chronic infection prevents the disease pathway, as HBV vaccination did for liver cancer.
What would test it
Phase 2 immunogenicity and infection-prevention trial in 5,000 children with three-year follow-up.
Maturity
early clinical
Who has to act
philanthropy
Cost to try
Large (over $50M)
Years to first evidence
12
Bottlenecks it attacks
- Prevention we already have is not deployed · Around four in ten cancers are preventable with tools we already own: vaccines, tobacco control, weight, alcohol, sun and infection control.