PRIVATE SECTOR, PUBLIC HEALTH
In the years since he backed away from the front lines of the superpowers' germ warfare front, Malinoski has worked as a private-practice physician, a research scientist who tested new vaccines for effectiveness and safety, a director of clinical research responsible for the licensure of pediatric vaccines and a senior executive in a medium-size biopharmaceutical company. At Wyeth-Ayerst he oversees clinical affairs for vaccines, administering research programs to evaluate the company's licensed products. The job is part science, part business management.

For a short time, Malinoski was vice president of a biotechnology start-up in the U.K. The company was developing vaccines that could be delivered through genetically engineered plants, a breakthrough that will someday allow antibiotics to be dispensed in wafers or juice instead of the standard injection. "The technology works," he attests. "We proved that while I was there." The company folded when investors pulled out in the midst of precipitous British reaction against genetically modified foods. "This is going to be a major way to improve the scale and cost of production, especially for developing countries. It's just ahead of its time right now," he said.

In the early 1990s Malinoski designed the clinical trials for Prevnar, the first new vaccine in a decade to become part of children's routine immunization. The drug was approved by the FDA in February 2000. "That's probably the product I identify most with," he confided. Prevnar prevents invasive pneumococcal disease, a bacterial infection of the blood or the lining of the brain and spinal cord. "Because pneumococcal disease globally kills about 1.2 million kids a year, the potential impact is enormous," he said.

Malinoski's career has followed an arc from basic virology research to its application in medicine to reducing morbidity and mortality by shepherding vaccines through the labyrinth of product licensing. "My day-to-day is definitely more administrative now," he said. "I'm comfortable with that because I can reach a lot more patients than I would if I were seeing maybe fifty a day in an office. I just wanted to get to the point where I have more impact on disease, and the best place to do that is prevention."