Vaccine Successes in Global Health with Matthew Laurens, MD, MPH

• Laurens says his family’s legacy of global service inspired him to join the Peace Corps after undergraduate school, where his firsthand encounters with malaria and vaccine-preventable diseases set him on a path toward pediatrics and vaccine research.
• His work with the Vaccine and Treatment Evaluation Unit at the University of Maryland  helped pioneer early malaria vaccine trials in Mali. Now, he now leads an mRNA malaria vaccine trial with BioNTech — a potential game changer for disease prevention in Africa.
• He has also conducted research in Malawi exploring how HIV and Malaria interact and how continued prophylactic treatments can protect vulnerable populations.
• As Director of the Typhoid Vaccine Acceleration Consortium (TyVAC), Laurens details how large-scale trials in Malawi, Nepal, and Bangladesh led to WHO approval and rollout of the typhoid conjugate vaccine — now reaching children in multiple endemic countries.
• Through his work with COVID-19 vaccine clinical trials for children, Laurens draws parallels between pandemic preparedness and neglected tropical disease research, emphasizing how global investment and collaboration can accelerate vaccine innovation.
• He encourages students who are interested in global health to pursue curiosity-driven research, collaborative projects, and a vision for equitable global health systems.

Dr. Rob Murphy: [00:00:00] Welcome to the Explore Global Health Podcast. I'm Dr. Rob Murphy, executive director of the Havey Institute for Global Health here at Northwestern University Feinberg School of Medicine. My guest today, Dr. Matthew Laurens, is an internationally recognized pediatric infectious diseases specialist who has built a career over the past two decades researching diseases that disproportionately affect people who live in resource limited settings. He has a professor of pediatrics at the University of Maryland School of Medicine center for Vaccine Development and Global Health, and he is the coordinating investigator in the world's first clinical trial of an mRNA based malaria vaccine This year, he is the keynote speaker at our own Global Health Day here at the Havey Institute for Global Health at Northwestern. We're delighted to have him on the podcast today, especially since [00:01:00] it's before our big Global Health Day. Um. Affair. we're very interested to talk to him about his career in global health and the experiences that set him on a path to combine frontline clinical care with vaccine science. Welcome Matt.

Dr. Matt Laurens: Thanks for having me. Wonderful to be with you.

Dr. Rob Murphy: Follow us on Apple Podcasts or wherever you listen to podcasts, to hear the latest episodes and join our community that is dedicated to making a lasting positive impact on global health.

Let's start at the beginning. You received some of your education at the universities in the southern part of the United States. You have an undergraduate degree from Oglethorpe University then you got a master's degree from Johns Hopkins. Then you went to Mercer University School of Medicine in Macon, Georgia. And ultimately did a residency at Tulane University in New Orleans. Were you raised in the [00:02:00] south ? Can you tell us about where you were raised and what your childhood was like?

Dr. Matt Laurens: Sure. So I was born in Huntsville, Alabama. I was a space child. My father worked for Northrop uh, subsidiary of NASA at the time. So I had early education there. And then we moved to West Palm Beach, Florida, where my father took another job in aerospace engineering, and then ultimately moved to Atlanta when I was 10 years old, which is where my parents met and grew up. So most of my family is from Atlanta, and that's what I call home.

Dr. Rob Murphy: In 1992, after undergraduate school, you joined the Peace Corps as a disease eradication specialist in Benin. In West Africa. Can you take us back to that experience? What led you to the Peace Corps? How did you land in West Africa? And you've publicly stated, or it's written about that experience launched you into a career in global health. Can you tell me about that?

Dr. Matt Laurens: Absolutely. So my first recollection of early influences for wanting to join the Peace Corps or do [00:03:00] something outside of my comfort zone was hearing about a trip my grandparents went on when I was 15 years old. They had gone to Monterey, Mexico for the 100th anniversary of a school that my great-great-great grandfather had started following his fighting in the Mexican American war. So he returned to Monterey, Mexico about 40 years later to start a bilingual school sponsored by the Methodist Church, and it had a vision of wellness and prosperity based on secular and bilingual education. And on his death they renamed the school after him Institute to Loren. So my, my grandfather gave a speech at that school and came back really energized and inspired by what he saw that this work was continuing even after 100 years. And it still continues today. So that. Really helped me to think outside of my sphere of influence and the thought that I could do something that was much bigger than where I [00:04:00] lived and much greater than the people that I interacted with on a daily basis, maybe even on a global basis. That was a very first inspiration that I had. And I always wanted to go to medical school eventually, and I idolized my pediatrician at a young age and had lots of experiences babysitting in my teenage years. But I ultimately joined the Peace Corps after. Graduating from Oglethorpe because I did have that idea that I wanted to do something that would influence more than just my hometown and where I lived, but wanted to also experience things that I hadn't experienced before and also do something to kind of help the world

Dr. Rob Murphy: so after that you get your Master's in Public Health from Johns Hopkins. Is that correct?

Dr. Matt Laurens: That's right. I was, working in the Peace Corps and then extended for a year working with UNICEF on a research project. And the project had a visit with Sandy, Karen Cross, who was at the London School at the time and he was very inspiring and really encouraged me to consider public health. So I applied [00:05:00] from Benin when I was a US Peace Corps volunteer, and was accepted and came back stateside and directly enrolled in the program.

Dr. Rob Murphy: Did you end up in Benin? Do you mind telling us It's uh, not, it's a little bit off the radar screen. Benin, west Africa, Are you on Kanu or.

Dr. Matt Laurens: I was in COO very often, but I was stationed in a village of 1100 people, three to four hour taxi ride outside of Conu. I had never heard of Benin before I was assigned to the Post, but I knew that I wanted to do something in healthcare, something in Sub-Saharan Africa. I'd heard a lot about the AIDS epidemic and how that was particularly devastating to communities in Africa and thought that I might be able to have a part in that. So I, again, not knowing much about that part of the world. I decided to focus on French language and became a minor in French and undergraduate thinking that might help position me to be stationed ultimately in Francophone, west Africa. So that part worked, but working in Guinea worm eradication again was [00:06:00] something I had never even heard of so that, that was an eyeopener to me and all very exciting.

Dr. Rob Murphy: What was it about working with children in the Peace Corps that made you choose pediatrics as your specialty? Because this was of course before medical school.

Dr. Matt Laurens: The part. Being assigned to Guinea worm disease eradication in the Peace Corps is all true. But when I arrived to my post in a village in Benin I found out right away when I did a census that there was actually no Guinea worm where I was stationed, even though that was my primary job was to help. Do community education and track cases and eradicate Guinea worm as best as I could, distribute nuts for people to use to filter their water. So after that was sorted and we figured out that there was indeed no Guinea worm, that communities reported Guinea worm because they thought it would bring more resources to them. I set out to maximize my time and figure out what I could do there from a public health standpoint and really got excited about vaccination programs. I saw firsthand how [00:07:00] families and children in particular disproportionately suffered from vaccine preventable diseases and worked with a local physician to establish a registry of children born in the village. Document their birth date so that when vaccination teams came, come through, they would know exactly which children needed what vaccinations. And I saw the power of vaccines from the very local level. And saw measles and saw what it could do to children and families and their health and saw also what vaccination and prevention. How that could benefit communities and really got excited about it. So that's when I decided that I wanted to pursue that as a career. And because most vaccines for preventable diseases are administered to kids, that kind of reinforced my earlier leaning toward pediatrics as a specialty.

Dr. Rob Murphy: In 2005, you started a fellowship in pediatric infectious diseases and tropical pediatrics at the University of Maryland School of Medicine. Where you began working with the vaccine and treatment evaluation unit, [00:08:00] helping develop a controlled human malaria infection model. Today you're leading the world's first clinical trial of an mRNA based malaria vaccine from BioEnTech. explain your interest in malaria and how much progress has been made since the early two thousands to change the trajectory of malaria prevention?

Dr. Matt Laurens: Absolutely. My experience with malaria is, is firsthand as a Peace Corps volunteer. I, I did contract malaria. I had it multiple times. I saw friends and acquaintances who were also sick with malaria and saw what it could do to the health of population. So that, where I had a firsthand experience of how terrible it can make you feel. And, how it really can cause death, particularly in children. When I started my fellowship training at the University of Maryland at the Center for Vaccine Development, I immediately found a mentor, Dr. Christopher Plow, who was at the time working on malaria vaccine development, and he was just starting malaria vaccine trials in a remote [00:09:00] area of Mali and Bendiga, Mali, and. These were studies that had started in adults, but he was just about to embark on the first pediatric vaccine trials of that candidate vaccine. So he had that project and needed a hand a. To help with that and because of my experience in Francophone West Africa and my high interest in malaria vaccines, that allowed me to work as a US trained pediatrician on those clinical trials in Bandi Gar Ali. So that's really where my interest in malaria vaccines began. And in terms of where that vaccine trial went, we were able to demonstrate. What we call allele specific efficacy of that malaria vaccine, but it basically only worked against malaria strains that were similar to the vaccine and not against most of the strains that circulated in the community. So we learned a lot from that study. But in the meantime, we've got other malaria vaccines that have since been. Prequalified and approved by the World Health Organization. The first was in 2021 and that was the [00:10:00] RTSS vaccine. And now we have a second vaccine, the R 21 vaccine. With these two vaccines we are seeing. Many countries in Sub-Saharan Africa implement these vaccines even though they require four doses as a means to decrease morbidity and mortality associated with malaria. So not only do we have preventive. Methods with vaccines. We also have rapid diagnostic tests. We have highly effective anti-malarial therapy in terms of Artemis and combination therapies. And all of these things have provided a very huge boost to malaria control programs. And we've seen significant decreases in malaria incidents. In mortality.

Dr. Rob Murphy: Did you say you had malaria yourself?

Dr. Matt Laurens: A few times I've had, yes.

Dr. Rob Murphy: Yes. The same thing happened to me. I was working in southern Kenya for a while. I just couldn't tolerate the prophylaxis like for as long as I was there, just impossible. And of course, as soon as I stopped taking it, I got malaria. I had it a few times. The [00:11:00] first time was very rough. I didn't know what was gonna happen to me, but yeah, no, it's a very scary disease, even in adults, especially if it's the first time.

Dr. Matt Laurens: I would completely agree. The last episode I had was just before I started medical school. I went for a return visit to the village where I was Peace Corps volunteer. And I took prophylaxis while I was there, but I failed to continue when I returned. And sure enough, few weeks into medical school, I had malaria and tried to convince my mentor at the time who was mentoring us in small group discussions that I had malaria. And he was an infectious disease specialist. They couldn't find it initially on the blood smear. So I was sent home for a few days until I mounted enough of a fever and had enough parasites for them to find it. So it's, it was quite scary.

Dr. Rob Murphy: Very scary. Very scary indeed. I think it brings up a point. You have to be careful over there. I always carry, like for malaria I always carry at least one pack of uh, coard with me and just self-medicate.

Dr. Matt Laurens: Absolutely. No that's, that's quite smart. Yeah, I, I, I know several other investigators who do that.

Dr. Rob Murphy: You've studied the complex relationship [00:12:00] between HIV and malaria, so my background is actually in virology and HIV. What do you know about how those two infections interact particularly in children? Do they actually interact or is it just a collision?

Dr. Matt Laurens: Certainly when one infectious disease piles on top of another the complications can be quite serious. In the case of HIV and malaria. Also do studies in adults, and this was a study we did in Malawi with a very large team. I was a just a part of it. But we looked to see that in adults who were successfully controlled in terms of their HIV on antiretroviral therapy, how important was it to continue? sulfamethoxazole prophylaxis in developed countries in Europe. We often continue that trimethoprim sulfamethoxazole prophylaxis until the CD four count reaches 200. But in many areas of Sub-Saharan Africa, they continue it indefinitely because they see continued benefits in terms of prevention of diarrhea and prevention of [00:13:00] malaria. So we looked to see if it was important to continue in that group because after. You take antiretroviral therapy. As you likely know, your immune system is reconstituted and the opportunistic infections that you were once susceptible to you were no longer at high risk after that viral suppression occurred. So what we found was that indeed. Taking Trimethoprim sulfamethoxazole every day to prevent infections, continued to prevent infections in this population. But even in the group that stopped taking the trimethoprim sulfamethoxazole, it didn't really affect their HIV control. In other words, they continued to have viral suppression at the same level as the group that continued to take Trimethoprim sulfamethoxazole. So there was benefit in terms of fewer infections, but we made the argument that perhaps anyone in the community who took Trimethoprim sulfamethoxazole, even if they were HIV negative, would also encounter fewer infections just because they're taking. An antibiotic every day. So ultimately we [00:14:00] fed this information back to the Ministry of Health and they felt that because this was a vulnerable population, that it was worthy to continue that prophylactic antibiotics every day in all people with HIV.

Dr. Rob Murphy: Typhoid vaccine research is also one of your areas of expertise, and you directed the Typhoid Vaccine Acceleration Consortium Trials in Malawi, Nepal, and Bangladesh leading to TCV and introduction into national immunization schedules. You are now the director of ty, Ty what lessons have emerged from these large scale rollouts?

Dr. Matt Laurens: Sure. So the Tyvek is the Typhoid Vaccine Acceleration Consortium, and as you said, we are a group that's formed by a very large consortium with many members across the globe, and we seek to advance introductions of this novel. Conjugate vaccination method to prevent typhoid fever in endemic areas. And I mostly participated in the clinical trials in Malawi. We had colleagues who directed the trials in Nepal [00:15:00] and Bangladesh. And the consortium is sponsored by the Gates Foundation. And I'm now the overall director of the consortium that continues to advance these introductions in countries. What we're seeing is that when we started in 2018, the WHO. Pre-qualified and approved the very first typhoid conjugate vaccine, which has advantages over other typhoid vaccines in that you can give it to children younger than two years of age. Up to then only two years of age and older were able to receive other typhoid vaccines and while typhoid vaccine had been recommended by the World Health Organization it was never adopted in countries in terms of routine vaccinations because it required multiple doses. And for other reasons, countries just didn't implement that as a control strategy for typhoid. But with these conjugate vaccines, WHO pre-qualified, the first product, we have Gavi that provided funding and a window that. Countries could apply and achieve funding. And then we helped to direct the [00:16:00] very first phase three randomized control trials in the three countries you just mentioned. And this demonstrated efficacy of a typhoid conjugate vaccine, which is a single dose vaccine in children of 75 to 85% that lasted at least four years. So this. Allowed us to encourage countries and show them this data. And where Typhoid exists. We've helped to with partners, we've helped to introduce typhoid conjugate vaccine in seven different countries. We have two more countries that are slated to introduce later this year. Bangladesh is planning to introduce just in a couple of days, and then later this year Niger will also introduce. So it's been quite satisfying to see the data that we've generated on the ground with the clinical trials work to convince policymakers and countries to adopt this vaccine and incorporate it into their routine vaccination schedules.

Dr. Rob Murphy: Data-driven public health responses as they say. The COVID-19 pandemic really changed how we do global health work. Some [00:17:00] of it stopped much during virtual. During the time your work shifted to include involvement in phase three trials for Moderna and Novavax vaccines in children, what parallels do you see between pandemic preparedness and malaria, typhoid

vaccine development.

Dr. Matt Laurens: The important parallel, especially with the COVID-19. Vaccine development is that resources can really do a lot to advance vaccine development and implementation. And we saw the record speed with which the COVID to 19 vaccines to were developed and eventually used in target populations. And it is a matter of resources because if we had similar resources and similar drive for some of these diseases. That largely affect resource limited settings. I feel strongly that we could do a lot more to advance our efforts to eradicate these diseases.

Dr. Rob Murphy: Your keynote talk and thank you very much for accepting our invitation to speak at our Global Health Day. November 19th of this [00:18:00] year is entitled Your Talk is entitled, vaccine Successes in Global Health, typhoid Fever, and Malaria, which of course we've just been talking about. What message do you hope to share with those in attendance?

Dr. Matt Laurens: Vaccines are one of the greatest public health successes of our time. After the provision of safe drinking water, they are the single most important intervention for public health As someone who works daily in vaccine development in the many facets that it incorporates. I'm excited to share the successes and a vision for how we can continue these successes despite the multiple challenges in global public health. So thank you very much for the invitation, for the lecture, and I, I very much look forward to working and interacting with your group.

Dr. Rob Murphy: Well, We're very happy to have you. Uh, join us, that's for sure. . Final question, and I ask everybody, I interview the same question considering our audience, what advice do you have for young people who [00:19:00] are just now embarking or wanting to embark on a career in global health?

Dr. Matt Laurens: Absolutely I, I would encourage them to continue on this journey and to continue to look for opportunities to ask scientific questions, to join studies, to work with collaborators. To have a vision for how we can reinvigorate and reimagine global public health so that we can achieve the maximum benefit possible. A fresh set of eyes and new ideas is always welcomed and everyone has something to contribute. So I am inspired and encouraged by all who are desiring to go in public health.

Dr. Rob Murphy: thank you very much for joining me today and for telling your incredible story. Thank you.

Dr. Matt Laurens: Thanks so much. Very great to talk with you.