Future shot against Valley fever won't face the same pushback other vaccines have, doctor says

The Arizona Department of Health Services reported more than 10,000 reported cases of Valley fever so far this year; there were nearly 11,000 cases in 2023, the last year for which data are available.

But research into treatment for the fungal disease continues, as does work on a vaccine to prevent it.

Dr. John Galgiani is director of the Valley Fever Center for Excellence at the University of Arizona College of Medicine in Tucson. He joined The Show to talk about that research, as well as its future, with federal research dollars more uncertain now.

Full conversation

MARK BRODIE: John, where are we right now in learning about this ailment and how to prevent and treat it?

JOHN GALGIANI: Well, the vaccine is probably the most exciting. We do many things. As you said, the vaccine is well along in its development towards a veterinary vaccine. We're working with Anivive Lifesciences, which is the company that licensed the discovery we made, maybe, 12 or 13 years ago.

And they are a veterinary product company, and they have been working with us to take this discovery through what's called the “valley of death,” the really difficult part of taking something that might be good into something that is really useful. And they're on their way to probably have a vaccine approved by the USDA for dogs in veterinary clinics, for use within a year.

BRODIE: At what point then, like how much clinical research and trials do you have to go through before you get the kind of data you need to get to see if this is going to be effective in humans? 

GALGIANI: Yes, so the vaccine for humans is approved through the FDA, whereas the veterinary vaccine goes through USDA. And all of the information in the USDA file becomes available to FDA, but frankly, it is primarily pre-clinical data. It becomes efficacy in a different species.

But really, other than that, you pretty much start over. You need a new manufacturing process, and then you have to do additional safety tests, and then you start doing clinical trials.

BRODIE: Well, so when you talk about vaccines and needing to go through the FDA, I mean, I kind of feel compelled to ask about the current situation we're in in terms of some changes with vaccines, not for Valley fever, but for other vaccines. 

Does it make you nervous maybe that the current environment, the current administration might be less receptive, for example, to a Valley fever vaccine than others? 

GALGIANI: I think it's very much worthwhile reading the newspapers about what's going on around the country. But that said, this disease, Valley fever, is considered an equal opportunity disease. It's been supported by Republicans. It's been supported by Democrats.

And no, it doesn't really, and I think people are interested in it regardless of the overall thought about vaccines, and this vaccine is sort of interesting in that it's not for a contagious disease. So in fact there's no compelling reason to get the vaccine other than if you think you want to be protected.

BRODIE: And probably if you live in a place where you might be more susceptible to getting Valley fever, right? 

GALGIANI: That's right, absolutely. It's of no value if you live in Alaska, where in fact it turns out there are no Valley fever cases, at least endemically. But if you live here, where two-thirds of all U.S. infections come from Arizona, then the risk is about 4% per year of getting infected. And if you're of the mind that a vaccine makes sense, then it'd be wonderful to have the vaccine.

If you don't have the vaccine, you don't have that option, whereas people who really don't want to take the vaccine, there's no compelling public health reason for you to do it other than, for your own personal health.

BRODIE: Is your research or the research of some of the folks with whom you work affected at all by reduced grant funding from the federal government, from the National Institutes of Health?

GALGIANI: So the original work we did was on a grant several years ago, which is where we showed that the vaccine was very effective in preventing Valley fever in dogs. And since then last year, the company I mentioned, Anivive Lifesciences, got a contract from the National Institute of Allergy and Infectious Diseases from NIH, to take the vaccine from where we are now into the first human trial. And so far that contract has been going through. We've been continuing to work under that.

BRODIE: Are you concerned that that contract might be canceled at some point? 

GALGIANI: Well, I'm concerned that that would be a problem if it did, but at the moment it hasn't been, and we think there's really no reason it should be, and I think there's support for the work to be done.

BRODIE: I'm curious about the sort of the general work that the center is able to do. It sounds like maybe some of the support, some of the infrastructure might also have been affected or might be affected by some of the changes coming from Washington, D.C. 

GALGIANI: Well, that's a complicated question that the infrastructure at the UA is whatever, and I actually have very little to know about that, but our offices are open and we continue to do our work.

The work that is being done on the contract is not, at least we are subcontractors on that contract to Anivive Lifesciences, but at this point it has not really been affected. And I've gotten, you know, support. In fact, the center itself has been primarily supported, on philanthropic support.

And then the other thing that we are really interested in doing is not so much bench research, which we do quite a bit of, but also to get people aware of this disease. And this year I’ve actually completely come to the obvious conclusions, after I realized that it was pretty obvious, that awareness is where it all starts. If you don't know about a problem, you're not going to worry about it.

And it turns out with Valley fever, if you know about Valley fever before you get sick, and this is AZDHS data, you're going to get a diagnosis sooner than if you don't know about Valley fever, because people ask, “don't you think you should test me?”

And it turns out that's a very important question because many physicians don't remember to test for Valley fever even when they should. And so we're really working on that and then if you don't get the diagnosis and you're sick with Valley fever, you're being treated for all sorts of things you don't have, none of which helps you. And so once you get a diagnosis, then you get precise care for the diagnosis you have.

And the final thing is, once you know there's a problem here, you start asking, “wait a minute, why are the diagnostics so slow to get results back?” And it turns out it would be really nice if we had a point-of-care test. And well, these drugs don't cure this disease. They help, but they don't cure it.

“So why don't we have a cure for this disease yet? And, I heard about a vaccine that was invented at the UA.” We really should promote. So I mean awareness leads not only to better health for the individual, but I think it also leads to the basis for doing support for a disease that's very important to the state's economy, not just public health. But managing this problem is really, really important.

BRODIE: Well, it sounds like what you're saying is awareness is important both for patients and health care providers, but also for policymakers so that they continue to support the kind of research that leads to better outcomes.

GALGIANI: I think that's absolutely right. And not only policymakers, but I think there are constituent stakeholders. I think professional sports, for example, real estate, if you want to attract new industry to the state, I think you need to manage this problem. And there was a news report in Money Inc. in February 2024 where they talked about if you're thinking about relocating to Arizona, there are a few things you should know about just before you make that decision, nine things they went through. The number one problem that they identified was Valley fever.

Now I think that's misguided. I think the more you know about Valley fever, the less anxiety producing it is, but it is a management issue, and I think not only for managing the message but also actually doing the best we can. And if you have a managing program, it's better than pretending it doesn't exist.