An American Recovery and Reinvestment Act grant of 10-million dollars funded by the National Institute on Drug Abuse was awarded to Nabi Biopharmaceuticals for the first pivotal phase II trial of NicVAX, a vaccine that may help people quit smoking and prevent relapse. NicVAX was given fast-track designation by the United States Food and Drug Administration and has passed initial regularly hurdles. Patients participating in the trial will receive six shots each month. Some earlier results indicated that smokers who were given the vaccine had a higher chance of quitting and were able to stay quit longer than those who were given a placebo. Director of the National Institutes of Health, Dr. Francis Collins, says, "Nicotine addiction causes nearly a half million deaths annually in the United States alone. Finding effective treatments that can help people stay off cigarettes has been a real challenge." According to the NIH, cigarette smoking costs the United States more than $193 billion in lost productivity and health care costs each year. The vaccine works by giving the immune system a boost. It generates antibodies that bind to nicotine, making it a larger molecule that cannot get into the brain as easily, reducing the reward. The most addictive drugs tend to give a rapid reward and pass the blood-brain barrier quickly, so by reducing this effect the patient feels less compelled to continue smoking. The vaccine seems to be effective for six to 12 months after vaccination. It is also hoped the vaccine could be used in smoking prevention.