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  • Title: Vaccination for contraception.
    Author: Jones WR.
    Journal: Aust N Z J Obstet Gynaecol; 1994 Jun; 34(3):320-9. PubMed ID: 7848209.
    Abstract:
    Vaccination for birth control has several advantages over currently available methods of family planning and should prove an attractive addition to the contraceptive armamentarium both in developing countries and in a developed country such as Australia. Concerns have been voiced by consumer health advocates that vaccines, like other long acting contraceptive methods, may be abused by health authorities in developing countries and by their use in vulnerable groups such as aborigines in our own country. These concerns need to be recognised and addressed. More difficult to accommodate are the anxieties expressed by feminist groups about the 'loss of control' and 'lack of body awareness' inherent in a method, such as a vaccine, that is relatively easily administered and has no overt side effects. There is no evidence that these concerns are shared by women in general. The antifertility vaccine that will most likely be applied first in family planning programmes is one directed against the pregnancy hormone hCG. A WHO vaccine directed against the C-terminal peptide of beta-hCG provokes a specific and safe immune response and will enter Phase 2 trials in Sweden this year. Subsequent developments with this vaccine will include the replacement of the current emulsion vehicle by a delivery system based on biodegradeable microspheres which will give a more sustained antigen release and duration of effectiveness. Considerable progress in the development of antigamete vaccines has been made. Potential targets are sperm acrosomal antigens and the ZP3 glycoprotein of the zona pellucida. Researchers aim to effect an immune attack on events linked to sperm-ovum contact and fertilization. Consumer health advocates are concerned that health authorities in developing countries may abuse contraceptive vaccines and that those in developed countries will use them in vulnerable groups, e.g., aborigines in Australia. Some women's groups worry that loss of control and lack of body awareness are inherent in these vaccines. Sperm vaccine research is not as advanced as that of ovum vaccine research. Almost all sperm vaccine research has occurred in animals with varying degrees of success. Research in zona pellucida vaccine development must overcome the risk of immune damage to ovarian oocytes, subsequent development of autoimmune oophoritis, and disturbed ovarian function. Some research is examining the development of contraceptive vaccines against embryonic and placental antigens. The contraceptive vaccine that is the most developed is a vaccine against the pregnancy hormone human chorionic gonadotropin (hCG). This vaccine will probably be the first vaccine available in family planning programs worldwide. The WHO vaccine directed against the C-terminal peptide of beta-hCG incites a specific and safe immune response. The Phase I trial showed that the hCG vaccine exceeded the threshold of antibody production needed to achieve protection against pregnancy in all 5 subject groups with antibody titers in the higher dose groups reaching 5-7 times the level assumed to produce antifertility efficacy. Phase 2 clinical trials of this vaccine will begin in 1994 in Sweden. Further developments with the hCG vaccine are replacement of the current emulsion vehicle by a biodegradable microsphere-delivery system which will allow a more sustained antigen release and duration of effectiveness.
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