Dr. John B. Robbins, a pioneer in vaccinology and one of the inventors of the first effective defense against a form of meningitis that once killed more than a thousand infants a day worldwide, died on Nov. 27 at his home in Manhattan. He was 86.
The cause was prostate cancer, his son Robert said.
By some estimates, Dr. Robbins’s vaccine against the illness, called Hib meningitis, has saved seven million lives since it was licensed in 1989.
Pediatricians who worked in the pre-vaccine days remember feeling their hearts sink when they saw Hib bacteria under a microscope in a baby’s spinal fluid. It meant that, even with antibiotics, the child was at risk of permanent brain damage, deafness or death.
Before the vaccine, Hib meningitis killed about 400,000 children a year, according to the World Health Organization.
Since then, the disease has been largely relegated to the medical history books. The vaccine is now given in more than 180 countries; in the United States there is now only about one case of Hib meningitis a year for every million children under age 5, according to the Centers for Disease Control and Prevention.
The chief discovery made by Dr. Robbins and his longtime collaborator, Dr. Rachel Schneerson, is also now used to strengthen vaccines against typhoid fever, whooping cough, lethal E. coli bacteria, Clostridium difficile and anthrax.
That discovery, known as conjugation, involves attaching proteins to the polysaccharides — complex sugars — on the bacterium’s outer capsule. Conjugated pairs of proteins and sugars are much more visible to infants’ immature immune systems and help them generate protective antibodies.
Two weeks before Dr. Robbins died, the first large rollout of a conjugate typhoid fever vaccine he also helped invent began, with 10 million children in Pakistan inoculated, according to Dr. Anita Zaidi, an expert on intestinal diseases at the Bill and Melinda Gates Foundation, which funded research on that vaccine.
Dr. Robbins and Dr. Schneerson also conceived of an unusual vaccine for stopping malaria outbreaks: Instead of attacking malaria parasites in a person’s blood, the vaccine would be picked up from recipients by mosquitoes who bit them. The vaccine would then attack the parasites in the mosquitoes’ midguts, making them unable to infect anyone else.
Unlike some vaccine researchers, Dr. Robbins and Dr. Schneerson never got rich from their inventions.
“We had a notion — a wrong notion, maybe — that public money went into making it, so it should be free to the public,” Dr. Schneerson said in a telephone interview. “Why wrong? Because immediately someone else did a little modification and applied for a patent.”
Also, she added, in the days when they did their breakthrough research, “the N.I.H. had only one single lawyer, who was not interested in vaccines. Now there’s lots of lawyers who say every day ‘What can we patent?’”
Dr. Robbins conducted research on the Bethesda, Md., campus of the National Institutes of Health from 1970 until his retirement at age 80 in 2012, either for the Eunice Kennedy Shriver National Institute of Child Health and Human Development or in the Food and Drug Administration’s biologics laboratories there.
He won many awards jointly with Dr. Schneerson, including the 1996 Albert Lasker Clinical Medical Research Award, the 2006 Pasteur Award from the World Health Organization and Thailand’s 2017 Prince Mahidol Foundation Award for Public Health. (Some were also shared with Porter W. Anderson and Dr. David H. Smith, who developed the polysaccharide components of the Hib vaccine.)
Until the 1980s, vaccines against bacterial diseases were often made from whole bacteria or their toxins that had to be killed or weakened.
They could be dangerous: Some occasionally induced high fevers that could trigger convulsions. Worse, if a manufacturing failure left any full-strength bacteria alive, children could die.
The next generation of vaccines, made of just the surface polysaccharides, were safer. But they rarely worked in children under age 2, who were the most at risk. Dr. Robbins’s conjugate Hib vaccine protected babies as young as 2 months old.
Hib stands for Haemophilus influenzae type b. Hib bacteria got their name because they were first isolated during the 1889 flu pandemic and, until 1933, were believed to be the cause of influenza. Flu is actually a virus; Hib is a common secondary infection that may be lethal if it reaches the bloodstream or brain.
John Bennet Robbins was born in Brooklyn on Dec. 1, 1932, to Harry Robbins and Matilda (Bender) Robbins, owners of the Cornell Paper and Box Company in the borough’s Red Hook section.
His paternal grandfather, Philip Rabinowitz, who immigrated to America, was the last of a line of prominent rabbis from Minsk, in what is now Belarus. However, Robert Robbins said, he lost his American rabbinical post for publicly advocating unions, which some members of his congregation opposed.
“My grandfather was one of eight children of an out-of-work rabbi, so he dropped out of school to work,” Mr. Robbins said. He took a job in the Brooklyn dockyards.
Harry changed his surname to Robbins, Dr. Schneerson said, because at 16 he was beaten up by co-workers after winning a promotion.
“It’s O.K. to be Jewish but you don’t have to die for it,” she said Dr. Robbins quoted his father as saying.
Robert Robbins said that the family’s box company survived until 2012, when Hurricane Sandy flooded Red Hook, wiping out much of its inventory.
Dr. Robbins received his undergraduate and medical degrees from New York University and did his residency at Massachusetts General Hospital in Boston. While trained as a pediatrician, he soon gravitated toward research, working at the Weizmann Institute of Science in Israel and teaching at Albert Einstein Medical School in the Bronx before joining the National Institutes of Health.
In 1956 he married Joan Cannon, who survives him. Besides his son Robert, he is also survived by two other sons, Daniel and David; a daughter, Ellen Taxman; a brother, Marc; nine grandchildren; and two great-grandchildren.
Ms. Taxman said he was such an advocate of vaccines that he made sure his children received every new one to be invented. “I felt like a human pincushion,” she said.
During the 1976 swine flu scare, she remembered, when an experimental new vaccine was scarce, he brought vials of it to the annual staff holiday party he gave at his house.
Every attendee was offered an injection and a T-shirt with a picture of Porky Pig saying “I got my shot!” on it.
“That was his idea of a holiday gift,” she said.
On one important ethical issue for vaccinologists, so-called challenge trials, friends remain divided on Dr. Robbins’s position. In those trials, healthy volunteers are given an experimental vaccine and then “challenged” by being deliberately infected with the target disease to see if the vaccine works. Challenge trials can speed up vaccine approval, but of course they may be done only with curable diseases.
Dr. Schneerson and another former colleague, Dr. Roger I. Glass, the director of the N.I.H.’s Fogarty International Center, said that Dr. Robbins had always been morally opposed to challenge trials.
“Why take people and put them in a position of potential harm?” Dr. Schneerson said. “Besides, a challenge is not exactly what happens in nature, and what you want to prevent is what happens naturally.”
But Dr. Myron M. Levine, a former Robbins protégé now at the University of Maryland Medical School who has conducted many clinical trials, said that at one time Dr. Robbins had supported challenge trials, and that he had “twisted his arm” to do one such trial of a struggling predecessor of what ultimately became the typhoid vaccine now being used in Pakistan.
“I explained to John how complicated it was,” he said. “You couldn’t let people walk around excreting typhoid, so it would have meant monthlong stays in the hospital for them. It wasn’t something we could do. He changed his mind later.”
