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Sean, a 33-year-old gay man, is one of the participants in Merck 002, the first human trial of the company’s AIDS vaccine. On a morning in April 2001, a nurse at Massachusetts General Hospital (Harvard Medical School’s largest teaching hospital) fills two test tubes with his blood, which she will then send to Merck for analysis. Like others in the study, Sean, who asked that his last name not be used, classifies himself as low risk for becoming infected and says he has joined the trial for altruistic reasons. Like all initial human trials of vaccines, this one is not designed to test the preparation’s effectiveness. But the 17 blood samples that Sean will give during Merck 002 will help establish whether the vaccine is safe and how it affects the immune system. “Maybe this isn’t the be-all and end-all of it, but hopefully it will lead to something they don’t know now, and it will give them a better starting point for the next one,” he says. “The epidemic didn’t just happen, and it’s not going to just go away.”

These words are music to Emini’s ears. Emini well understands that the excitement about Merck directly ties into the bleak reality that AIDS vaccine researchers have become accustomed to-a diet of confusion, dashed hopes and promising leads that go nowhere. But he knows, too, that every AIDS vaccine developer hoping to reach the marketplace likely will meet up with the scientific, social and ethical equivalent of Hydras, man-eating horses and birds that can use their feathers as arrows. “Understand, two years from now, we may be working on plan B,” says Emini. “I hope we have a plan B. I just don’t know.”

Emini shrugs his wide shoulders when asked whether he’s beginning to feel competition from the intensified efforts of other companies, NIH, the International AIDS Vaccine Initiative and EuroVac. “The competition isn’t anyone else in this field,” he says. “It’s that virus.” And Emini cringes at the congratulations he has been receiving from people who have learned the details of Merck’s program. “Even though they don’t overtly say it, you can hear that there’s hope there,” he says. “And you say, Well, yeah, thank you, but I don’t know if it’s going to work.’ I keep on saying, If all this works, God willing.’ I don’t say it because I’m superstitious. I mean it. I certainly don’t have the answers here.”

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