Hunein Maassab witnessed a transformational moment in public health when he was a young doctoral student at the University of Michigan. It happened on April 12, 1955, the day his mentor, Dr. Thomas Francis Jr., announced that he had completed a vast field trial involving nearly two million children to determine the effectiveness of what at the time seemed like a miracle drug: a vaccine for polio.
The vaccine had been developed by one of Dr. Francis’s former lab researchers, Jonas Salk, and Dr. Maassab had worked on the field trial, studying blood samples. Listening as Dr. Francis, a renowned virologist who had developed some of the first flu vaccines, described the study in a campus auditorium, Dr. Maassab knew the direction he wanted his life to take.
“That was his initial inspiration, that he wanted to develop something like that for humankind,” Dr. Rashid L. Bashshur, a close friend, said in an interview. “That would make his life worthwhile.”
Nearly half a century later, in June 2003 — after decades of starts and stops, of tinkering and test trials, of government reviews and patent applications and corporate twists — Dr. Maassab’s work came to fruition when the Food and Drug Administration declared a nasal-spray flu vaccine he had developed safe for healthy people ages 5 to 49 who are not pregnant. It carried the brand name FluMist.
Not long afterward, the vaccine was approved for children as young as 2. It is now commonly administered in doctor’s offices and elsewhere, with many people choosing it over an injection.
Dr. Maassab, who was born in Syria and began using John as a first name after he moved to the United States in the late 1940s, was 87 when he died on Feb. 1 in North Carolina. His death, which was not immediately reported by his family, was confirmed by the University of Michigan.
Unlike previous flu vaccines, Dr. Maassab’s spray used a live version of the influenza virus that had been attenuated, or weakened, so as not to cause the flu. He also adapted the vaccine so that it would activate quickly upon entering the body in the relatively cool region of the nasal passages. Getting it right, and getting it approved, took a long, long time.
As early as 1960, he isolated a strain of flu virus for developing a vaccine. By 1967, he had written about his work in the journal Nature. Over the next three decades, working with several colleagues, particularly Dr. Brian R. Murphy at the National Institute of Allergy and Infectious Diseases, part of the National Institutes of Health, he completed the hard work of science — developing dozens of live attenuated viruses, documenting the genetic makeup of certain flu viruses, developing ways of quickly adjusting vaccines to the variants of the flu that emerge each year.
More than 70 studies and trials were conducted, covering more than 9,000 volunteers. By the late 1990s, tests showed that the vaccine successfully prevented the flu 85 percent of the time, a better rate than that for the injected, nonliving vaccine. (Tests since then have shown the nasal spray to be even more effective.) Pharmaceutical companies soon bought rights to develop the drug and made plans to market it as more tolerable to children.
“I feel in a sense that I have accomplished my life’s dream,” Dr. Maassab, who had retired, said after FluMist was finally approved. “I spent all my lifetime developing this vaccine.”
Dr. Maassab was born on June 11, 1926, in Damascus. His father was a jeweler. He enrolled at the University of Missouri, where he received a bachelor’s degree in biology in 1950 and a master’s in physiology and pharmacology in 1952. He then moved to Michigan, where he earned a master’s degree in public health in 1954 and his doctorate in epidemiology in 1956.
Survivors include his twin sons, Sammy and Fred. His wife, the former Hilda Zahka, died in 2006.
Dr. Maassab said he was motivated to study the flu by Dr. Salk, by Dr. Francis and by the mysteriousness of the deadly 1918 flu pandemic, which killed tens of millions of people worldwide, including many soldiers fighting in World War I.
“He had to make sure that it meets all kinds of criteria,” Dr. Bashshur, a professor at the University of Michigan School of Public Health, said of Dr. Maassab’s long pursuit of FluMist. “He would succeed on one thing and then have to pursue another. He always thought at the end of the day he was going to be able to perfect it. He just knew it. And he had to get the scientific data to support his position.”
He added: “You have to be smart, that goes without saying. But I think his unique characteristic was perseverance. Scientific discovery doesn’t come easy. It’s easy to give up, but he would just never give up.”
Hunein Maassab (b. June 11, 1926, Damascus, - d. February 1, 2014, North Carolina) was the developer of nasal spray flu vaccine. He was born on June 11, 1926, in Damascus. His father was a jeweler. He enrolled at the University of Missouri, where he received a bachelor’s degree in biology in 1950 and a master’s in physiology and pharmacology in 1952. He then moved to Michigan, where he earned a master’s degree in public health in 1954 and his doctorate in epidemiology in 1956.
"John" Hunein F. Maassab was a Professor in the Department of Epidemiology at the University of Michigan since 1960 and served as the chairman from 1991-1997. He founded and directed the Hospital and Molecular Epidemiology program in the Department of Epidemiology. Dr. Maassab was a member of several scientific organizations including the American Public Health Association and the American Society of Microbiology and was a Fellow of the American Academy of Microbiology. Dr. Maassab had over 170 publications that range from studies on the basic biology of viruses to research on the development of methods to control viral infections.
Dr. Maassab was awarded patents for the development of a cold-adapted influenza virus and for an attenuated respiratory syncytial virus. Dr. Maassab received the 1997 Award for Science and Technology from Popular Science for the development of the cold-adapted influenza virus. This discovery led him to develop a flu vaccine that can be administered by a nasal spray as an alternative to the "flu shot."
Influenza, commonly called "the flu," is an infection of the respiratory tract caused by the influenza virus. Compared with most other viral respiratory infections, such as the common cold, influenza infection often causes a more severe illness. Most people who get the flu recover completely in one to two weeks, but some people develop serious and potentially life-threatening medical complications, such as pneumonia. Between 25-50 million people in the United States are infected each year with the influenza virus. In an average year, infection with influenza virus is associated with 20,000 deaths nationwide and more than 100,000 hospitalizations. Approximately 90 million workdays are lost and 30 million school days are missed each year as a result of influenza.
Vaccination can prevent disease caused by influenza. Unlike vaccines used against other viruses such as measles, mumps, rubella and varicella, people need to be vaccinated annually against influenza. This is because the influenza virus often changes its genetic composition to evade the immune system of its host. Thus, people are susceptible to influenza virus infection throughout life. The current vaccine used for flu is a "killed" virus vaccine that is administered by injection. The Centers for Disease Control and Prevention recommends a flu shot for healthy adults over age 50 and high-risk children and adults. Unfortunately, less than one percent of healthy children and less than 30 percent of healthy adults, are routinely vaccinated. Achieving adequate flu protection is difficult because each year a new vaccine must be developed that is appropriate for the specific strainsof influenza likely to circulate. Currently, there is concern n the public health community regarding the timely supply of vaccine for the coming flu season.
In 1967, Dr. Maassab published a paper in the journal Nature describing the adaptation of an influenza virus for growth at a low temperature in culture. Importantly, this "cold-adapted" virus does not grow at higher temperatures such as those found in the lungs. However, the cold-adapted virus can replicate in the nasal passages where the temperature is lower. The cold-adapted virus cannot survive in the lungs where the body temperature is higher, and therefore cannot cause disease. The limited viral growth seen in the nasal passages may stimulate an immune response that may protect a person from infections from influenza viruses. This protection also prevents the spread of influenza to others.
Dr. Maassab developed an intranasal cold-adapted live virus vaccine that may provide promising alternative to the "flu shot." Using a nasal mist, an attenuated (weakened) live form of the influenza virus is sprayed into the nasal passages, where influenza viruses enter the body.
The public health significance of this finding for the development of an influenza vaccine was apparent. By using nasal mist technology to eliminate the fear of injections, this method may offer the first practical way to immunize children and adults on a large scale annually in the near future.