Virol & Micro: Piedra
Baylor College of Medicine
Houston, TX, US


Advanced Training from State University Of New York At Buffalo
Advanced Training from State University Of New York Buffalo Affiliate Hospitals
Advanced Training from Medical University Of South Carolina Hospital
M.D. from University Of South Florida College Of Medicine
B.S. from University Of Florida

Professional Interests

  • Reduction of respiratory virus illness burden in infants

Professional Statement

Reduction of respiratory virus illness burden in infants, children, and the community through successful vaccination program

Dr. Piedra major area of research is to reduce respiratory virus illness burden in infants, children, and the community through successful vaccination programs. His research has focused on influenza virus, respiratory syncytial virus, adenovirus viruses and the recently described human metapneumovirus. Dr. Piedra and his colleagues (at the influenza research center) have been investigating candidate and license influenza vaccines for the prevention of disease and control of epidemic influenza. He has been involved in phase I, II, III and IV clinical trials in the development of the live attenuated influenza vaccine (LAIV) for use in children. The LAIV is a novel attenuated reassortant live virus vaccine that is delivered by nasal spray and induces excellent mucosal immunity. LAIV was approved by the Food and Drug Administration for use in the United States in June 2003. It is the only new influenza vaccine that has been licensed since the development of the inactivated influenza vaccine over 40 years ago. We have demonstrated that LAIV is safe in infants and children, have demonstrated its efficacy against similar and drifted influenza variants, have shown that one dose is sufficient to provide protection and that protection last for at least two influenza seasons.

Dr. Piedra is the principal investigator of an R01 grant entitled “Control of Epidemic Influenza” (NIAID 2 R01: AI-041050-07, Feb. 1, 2004 - Jan. 31, 2008). The goal of this community trial is to protect the community (herd protection) against influenza by vaccinating school-aged children. School-age children have the highest influenza infection rates and play a major role in the transmission of influenza to other susceptible contacts in school, at home, and in the community. Our vaccination strategy of universal immunization of school children was recommended favorably by the CDC's Advisory Committee on Immunization Practices on February 2008 which complementary the current strategy of vaccinating at risk groups because of chronic medical conditions or age (adults >50 yrs and children <5 yrs). Universal immunization of school age-children may also serve as a vaccination strategy for pandemic preparedness plan.

Respiratory syncytial virus is the major cause of lower respiratory tract illness in infants and young children. Dr. Piedra and his colleagues have been investigating the epidemiology, pathophysiology, correlates of immunity, antiviral drugs, candidate subunit RSV vaccines and vaccination strategies for the prevention of RSV among different age groups. Currently, a major area of research is maternal immunization; a strategy to protect young infants against severe disease during the first several months of life by vaccinating pregnant women. This research is supported by NIAID through the Vaccine and Treatment Evaluation Unit contract (N01 AI25465; WA Keitel (PI); June 1, 2003 to May 31, 2007).

Partnerships with Industry are being developed for access to candidate vaccines. To date we have demonstrated that subunit RSV vaccines are safe and immunogenic in child-bearing women, that maternal serum neutralizing antibodies are efficiently transferred to infants, identified the minimum protective threshold serum neutralizing antibody titer against RSV-associated hospitalization, and have conducted the only RSV vaccine study in pregnant women. In addition to maternal immunization, colleagues and I have described the epidemiology of RSV in children with cystic fibrosis (CF), have demonstrated the detrimental impact of RSV in CF children, and have evaluated subunit RSV vaccines in CF children.