Ingelise Gordon, a registered nurse who is the VRC’s clinical operations manager, would tell me later that few volunteers appeared to be driven solely by the promise of compensation, and that some were “pleasantly surprised” to receive any money at all. (Compensation varied from $2,125 to $7,375, depending on the number of visits required by NIH. I received about $5,000.)
“They were fun, everybody had different personalities, and I loved that most of the volunteers were doing it because they wanted to help,” she said of the participants in this Phase I trial. “[Most of them] have a big heart.”
People often worry that the government will subject volunteers to a harmful product or that the vaccine will cause the illness, Gordon said. But if any of the doctors or nurses suspect the protocol or product is hazardous, the trial won’t proceed.
“Would I allow my 16-year-old daughter to do this study is a question that’s always in the back of my head when I’m participating in this clinic or anywhere,” Gordon said as she sat in her NIH office, which was bursting with photos of family members and friends. An impressive collection of cactuses decorated her windowsill, and a betta fish swam lazily in his bowl. A drawing hung on her office wall. “Do What Brings You Joy,” it said.
It wasn’t the vaccine that worried me. It was the idea of letting malaria-ridden mosquitoes suck my blood, discharging the Plasmodium parasite into my body and leaving their itchy marks behind.
But the day of the crucial test arrived quickly, and I headed to Walter Reed Army Institute of Research in Silver Spring, which was breeding thousands of malaria-ridden Anopheles gambiae mosquitoes (one of the species that transmits the parasite) for the NIH trial. It was Oct. 23, and I worried that I’d fall deathly ill on Halloween—or worse, a few days after that on my birthday, which I hoped to celebrate with friends.
The scientists had warned the volunteers to avoid showering for at least a day—preferably longer—since the scent of soap, perfume and shampoo repels mosquitoes. So for the last of my three showerless days, I stayed away from the grocery store and invented excuses to keep friends from visiting. My unbathed body would be an irresistible banquet for a thirsty mosquito, but to anyone else, I was a smelly mess.
When I arrived in the waiting room at Walter Reed, I saw the other volunteers for the first time. There were couples who had joined the trial together, NIH staffers from other labs, students, young professionals and former Peace Corps volunteers. Some wore sweatpants and baggy T-shirts; others were dressed for office jobs and carried briefcases.
An odor of human sweat saturated the chamber, and the fluorescent lights illuminated the unwashed skin and greasy ponytails of the volunteers who had taken the guidelines about bathing a bit too seriously. This is a time when it really pays off to be a freelancer, I thought, pitying the poor souls who were forced to share an office cubicle with the other volunteers.
Some people had already formed friendships in the group. Others, like me, quietly read a book as they waited, too sleepy—thanks to the 5 a.m. hour—to make an effort to meet new people.
Finally, my name was called. I left the waiting room and was escorted through several airtight doors to the insectary. Before reaching the fluorescent-lit, windowless room, I was hit by a powerful blast of air that shot down from a vent in the ceiling—one of the many mechanisms to prevent the voracious insects from escaping.
I was instructed to join four other volunteers at a small, rectangular table where I would offer myself to five ravenous female mosquitoes that had previously feasted on contaminated blood. (Male mosquitoes survive by feeding on nectar and plant juices, but females gorge themselves on blood to obtain the protein needed to produce their eggs.) A scientist delivered a netted plastic cup that imprisoned the malaria-ridden pests. I placed my forearm over it, covered my arm with a dish towel to provide darkness for the nocturnal predators, and waited.
A timer set for five minutes was placed next to me. I fought the urge to swat the cup away as I waited impatiently for the timer to beep. At times, it felt as if the five tiny insects were coordinating their attacks, quenching their insatiable thirsts at the same time. I looked around the room, half-expecting the other volunteers to cry out in pain or pull their arms away from their cups, but they hardly reacted.
Later, Dr. Lee-Jah Chang, allergy and immunology fellow at NIH, would tell me that “no one freaked out. They could feel the pinch of the mosquitoes biting them, but it went smoothly. No one fainted, no one refused to partake in the challenge.”
Some volunteers were dismissed from the insectary within minutes of being bitten. But those who had made the mistake of showering or washing their hands had to wait around for hours, repeating the procedure until at least five mosquitoes had a “full feed.”
I tallied more than a dozen tingly bites on my forearm, but many didn’t count in the view of the researchers, and I repeated the process several times.
Dr. Robert Seder, chief of the cellular immunology section at the VRC and principal investigator of the malaria trial, later explained the process. “The subjects received ultimately five bites where the mosquito has been documented to actually have gotten into a vein and has evidence of a blood meal,” he said. “Each mosquito must also have a sufficient number of sporozoites in its salivary gland. That’s done by a number grading system. We tried to deliver roughly the same amount to all the subjects, so we have it controlled in the best manner we can.”
After being subjected to three cups of parasite-ridden mosquitoes—spread out over the course of about an hour while a scientist analyzed the results—I took a cab home and tried to forget the ordeal.
A week and a half later, I checked into NIH’s inpatient unit, where I was required to sleep for up to 11 nights as the doctors monitored me and drew blood to see if I was developing the disease. I was convinced that I’d be immune, and hopeful—not just for my sake, but for the doctors who had dedicated years to potentially groundbreaking research.
