Montana
Path to a better TB vaccine runs through Montana
Jim Robbins
(KFF) A team of Montana researchers is playing a key role in the development of a more effective vaccine against tuberculosis, an infectious disease that has killed more people than any other.
The BCG (Bacille Calmette-Guérin) vaccine, created in 1921, remains the sole TB vaccine. While it is 40% to 80% effective in young children, its efficacy is very low in adolescents and adults, leading to a worldwide push to create a more powerful vaccine.
One effort is underway at the University of Montana Center for Translational Medicine. The center specializes in improving and creating vaccines by adding what are called novel adjuvants. An adjuvant is a substance included in the vaccine, such as fat molecules or aluminum salts, that enhances the immune response, and novel adjuvants are those that have not yet been used in humans. Scientists are finding that adjuvants make for stronger, more precise, and more durable immunity than antigens, which create antibodies, would alone.
Eliciting specific responses from the immune system and deepening and broadening the response with adjuvants is known as precision vaccination. “It’s not one-size-fits-all,” said Ofer Levy, a professor of pediatrics at Harvard University and the head of the Precision Vaccines Program at Boston Children’s Hospital. “A vaccine might work differently in a newborn versus an older adult and a middle-aged person.”
The ultimate precision vaccine, said Levy, would be lifelong protection from a disease with one jab. “A single-shot protection against influenza or a single-shot protection against covid, that would be the holy grail,” Levy said.
Jay Evans, the director of the University of Montana center and the chief scientific and strategy officer and a co-founder of Inimmune, a privately held biotechnology company in Missoula, said his team has been working on a TB vaccine for 15 years. The private-public partnership is developing vaccines and trying to improve existing vaccines, and he said it’s still five years off before the TB vaccine might be distributed widely.
It has not gone unnoticed at the center that this state-of-the-art vaccine research and production is located in a state that passed one of the nation’s most extreme anti-vaccination laws during the pandemic in 2021. The law prohibits businesses and governments from discriminating against people who aren’t vaccinated against covid-19 or other diseases, effectively banning both public and private employers from requiring workers to get vaccinated against covid or any other disease. A federal judge later ruled that the law cannot be enforced in health care settings, such as hospitals and doctors’ offices.
In mid-March, the Bill & Melinda Gates Medical Research Institute announced it had begun the third and final phase of clinical trials for the new vaccine in seven countries. The trials should take about five years to complete. Research and production are being done in several places, including at a manufacturing facility in Hamilton owned by GSK, a giant pharmaceutical company.
Known as the forgotten pandemic, TB kills up to 1.6 million people a year, mostly in impoverished areas in Asia and Africa, despite its being both preventable and treatable. The U.S. has seen an increase in tuberculosis over the past decade, especially with the influx of migrants, and the number of cases rose by 16% from 2022 to 2023. Tuberculosis is the leading cause of death among people living with HIV, whose risk of contracting a TB infection is 20 times as great as people without HIV.
“TB is a complex pathogen that has been with human beings for ages,” said Alemnew Dagnew, who heads the program for the new vaccine for the Gates Medical Research Institute. “Because it has been with human beings for many years, it has evolved and has a mechanism to escape the immune system. And the immunology of TB is not fully understood.”
The University of Montana Center for Translational Medicine and Inimmune together have 80 employees who specialize in researching a range of adjuvants to understand the specifics of immune responses to different substances. “You have to tailor it like tools in a toolbox towards the pathogen you are vaccinating against,” Evans said. “We have a whole library of adjuvant molecules and formulations.”
Vaccines are made more precise largely by using adjuvants. There are three basic types of natural adjuvants: aluminum salts; squalene, which is made from shark liver; and some kinds of saponins, which are fat molecules. It’s not fully understood how they stimulate the immune system. The center in Missoula has also created and patented a synthetic adjuvant, UM-1098, that drives a specific type of immune response and will be added to new vaccines.
One of the most promising molecules being used to juice up the immune system response to vaccines is a saponin molecule from the bark of the quillay tree, gathered in Chile from trees at least 10 years old. Such molecules were used by Novavax in its covid vaccine and by GSK in its widely used shingles vaccine, Shingrix. These molecules are also a key component in the new tuberculosis vaccine, known as the M72 vaccine.
But there is room for improvement.
“The vaccine shows 50% efficacy, which doesn’t sound like much, but basically there is no effective vaccine currently, so 50% is better than what’s out there,” Evans said. “We’re looking to take what we learned from that vaccine development with additional adjuvants to try and make it even better and move 50% to 80% or more.”
By contrast, measles vaccines are 95% effective.
According to Medscape, around 15 vaccine candidates are being developed to replace the BCG vaccine, and three of them are in phase 3 clinical trials.
One approach Evans’ center is researching to improve the new vaccine’s efficacy is taking a piece of the bacterium that causes TB, synthesizing it, and combining it with the adjuvant QS-21, made from the quillay tree. “It stimulates the immune system in a way that is specific to TB and it drives an immune response that is even closer to what we get from natural infections,” Evans said.
The University of Montana center is researching the treatment of several problems not commonly thought of as treatable with vaccines. They are entering the first phase of clinical trials for a vaccine for allergies, for instance, and first-phase trials for a cancer vaccine. And later this year, clinical trials will begin for vaccines to block the effects of opioids like heroin and fentanyl. The University of Montana received the largest grant in its history, $33 million, for anti-opioid vaccine research. It works by creating an antibody that binds with the drug in the bloodstream, which keeps it from entering the brain and creating the high.
For now, though, the eyes of health care experts around the world are on the trials for the new TB vaccines, which, if they are successful, could help save countless lives in the world’s poorest places.
MISSOULA — Four out of five members of Montana’s Public Service Commission were in a federal courtroom in Missoula Thursday morning, as the PSC’s former president challenges the disciplinary action taken against him earlier this year. Now, newly released documents are shedding more light on to what led up to this point.
(Watch the video for a closer look at the case.)
New documents shed light Montana PSC dispute
Commissioner Brad Molnar has sued President Jeff Welborn, Vice President Jennifer Fielder and Commissioner Annie Bukacek – the three PSC members who voted in May to require him to work remotely, after an investigation into complaints about his workplace conduct. Molnar has claimed he is being unfairly punished for constitutionally protected speech, and he asked Senior U.S District Judge Donald Molloy to allow him to return to the PSC offices.
Matthew Monforton, Molnar’s attorney, told the judge that barring Molnar from the building was limiting his ability to do his job.
“He has not been officially kicked out of office, but his voice has clearly been diminished,” said Monforton.
But Natasha Jones, an attorney representing the other three commissioners, said the findings were about behavior, not just speech, and that the PSC’s action was a reasonable response.
“These are serious concerns about a pattern of conduct that has made employees quit,” she said.
Jonathon Ambarian
On Tuesday, Molloy ordered the release of redacted versions of two full investigative reports into Molnar’s conduct – more than 100 pages of documents. Monforton had moved for the full reports to be made public, and Molloy ruled attorneys for the other PSC members hadn’t shown a compelling reason to keep the documents under seal as long as the names of people involved in the investigation were obscured.
While the names remained redacted in the investigation reports, the attorneys for Welborn, Fielder and Bukacek also filed additional documents – including a public declaration from Bukacek and from former PSC executive director Alana Lake, providing information about their allegations against Molnar.
The two reports, from an outside investigator, cover Molnar’s alleged actions over two periods: the first from February to August 2025, and the second from August to October 2025. The investigation began after the first formal complaint, filed by Bukacek in May 2025 – though the reports say employees had been bringing up concerns about Molnar’s behavior informally for several months prior.
Bukacek’s complaint claimed Molnar had repeatedly made what she called “sexualized and demeaning comments.” The examples she cited included saying the PSC should replace “Taco Tuesdays” with “Topless Tuesdays,” reminiscing about watching girls in bikinis as a teenager, and commenting about the beauty of women in areas of China who didn’t get “old and wrinkly.”
In her declaration, Bukacek also claimed Molnar had “maliciously disseminated false information” about her and “engaged in behavior that was dismissive, derisive and otherwise abusive.”
“My primary concern now is not for my safety nor my feelings, but for the rest of the staff who may not have the temperament to speak up or may feel too intimidated to speak up given concerns over job security,” Bukacek said in her declaration.
MTN News
The investigators determined Molnar had violated the PSC’s code of conduct by making comments of a sexual nature, and that it appeared his behavior had continued for some time after he was warned about it. They also found he had behaved unprofessionally and in a belittling manner toward Bukacek, though they said Bukacek herself had at times used “language that could be considered inappropriate” in emails to staff or other commissioners. Bukacek told MTN she “readily self corrected” any behaviors that were brought to her attention.
The investigation also found a violation in connection with a complaint from a PSC staff member, who said he “felt bullied” by Molnar when the commissioner sent an email complaining about his team not being “people with competence.”
However, much of the first report and the entire second report was focused on conduct after the initial complaints, when Molnar was accused of retaliating against people who participated in the investigation. Lake said in her declaration that she saw “an immediate and significant change in his behavior toward staff involved in the process.” She claimed he said he would use an attorney and private investigator to go after people who filed complaints, and she accused him of publicly criticizing her in interviews and removing her job responsibilities because of her handling of the investigation.
Lake said Molnar’s actions led to “declining morale within the agency,” undermined staff members’ ability to do their jobs and damaged her reputation. She said that led her to resign as executive director.
“I believe no employee should be forced to choose between reporting misconduct and protecting their career, reputation, or personal well-being,” she said in her declaration.
Lake has since become Helena city manager.
Jonathon Ambarian
The report said there was evidence to show Molnar had retaliated, including by “making disparaging statements about investigation participants” including Lake, by sending an email warning he could file complaints of his own against people involved, and by taking other actions investigators said could dissuade employees from reporting behavior in the future.
Monforton said during Thursday’s hearing that the initial comments Bukacek complained about were jokes Molnar had admitted were inappropriate, that he regretted saying them, and that he hasn’t made any similar comments in about a year. But he argued the vast majority of the findings against Molnar were about retaliation – and that those were primarily based on speech that the other commissioners don’t have the right to interfere with.
Monforton said it’s unreasonable to punish Molnar for what he said in the July news conference where he announced he was under investigation, in interviews with the media or in commission meetings. He said Molnar’s conduct doesn’t rise to the level of actual retaliation.
“This is an elected official, engaging in speech in his forum,” Monforton said.
He said Molnar may have made harsh comments toward staff, but that he had the right to raise objections about the way the agency does business.
Jonathon Ambarian
Monforton also argued the retaliation claims no longer justify keeping Molnar out of the office, since Welborn, Fielder and Bukacek voted to remove him as president in October and he no longer has the authority he’s accused of misusing. He said there haven’t been further complaints about his behavior since that time.
“We’re not asking for the moon and stars, we’re asking for the status quo as it existed for the last seven months,” he said.
Jones said there is enough evidence to show Molnar would have been punished regardless of whether any protected speech was excluded.
“This is not about a couple of jokes,” she said.
Jones said Molnar made maliciously false statements about people like Lake, and that type of statement isn’t covered by free speech protections.
She also said Molnar’s exclusion from the PSC offices is temporary, and that the PSC will reconsider whether to let him return if he apologizes for his actions, accepts the agency’s code of conduct and undergoes training.
Molloy indicated he saw indications that there was “acrimony” on both sides of the situation, and said he was skeptical it would be resolved easily.
“It would be nice if instead of juvenile behavior, there was professional behavior,” he said.
However, the judge said there was an avenue for Molnar to pursue if he wanted to reach a resolution.
Molloy took no immediate action Thursday. He told the parties he would rule as quickly as he could.
Carrie Gilbertson has been executive director of Cancer Support Community Montana for just under two months, stepping into the role in April with more than 15 years of nonprofit experience and a lifetime of Montana roots.
The organization provides psychosocial and mental health support to anyone affected by cancer — not just those with a diagnosis, but also family members and others walking alongside them.
WATCH: Meet the new leader of Cancer Support Community Montana 🎗️
Cancer Support Community Montana names new executive director
“This mission of providing psycho-social supports and mental health supports for anyone impacted by cancer, not just that person who has the diagnosis, but also family members, anyone who is walking alongside someone as they experience that often scary diagnosis, that’s just something that’s important to me,” Gilbertson said.
Gilbertson’s role extends beyond the Bozeman office. Cancer Support Community Montana’s Missoula location is already up and running, and a Helena location is expected to be operating soon. Each presents its own set of challenges.
“Each hospital is different. They might have different resources. Their social workers might be connecting to things in a different way. So understanding what those hospitals need, what different participants need in each community, is going to be different just because the communities are different, resources are different,” Gilbertson said.
The Bozeman office has been operating for more than 20 years, providing a foundation that supports the organization’s broader statewide efforts.
“I think this is a crew that looks at what does this community need what do our participants need what are some of the changing landscapes in cancer care what things are the gaps that we see that we can maybe just jump right in and you know let’s see if we can provide that for people so that’s something I really love about this crew that I work with and just this mission that there is some flexibility in being able to adjust and adapt as we learn more,” Gilbertson said.
Those adaptations show up in unexpected ways. The organization converts its parking lot into a pickleball court every Friday morning.
“I didn’t know there was a pickleball court. I pulled in actually with my daughter pulled in and she was is that pickleball court and I was like oh, it kind of looks like it is so yeah that’s fun, every Friday morning we clear out the parking lot and put up the net and I haven’t played yet I’ve been watching just to kind of see how that game works but they take it pretty seriously,” Gilbertson said.
This story was reported on-air by a journalist and has been converted to this platform with the assistance of AI. Our editorial team verifies all reporting on all platforms for fairness and accuracy.
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