History of VA in 100 Objects
Telling VA's story - two objects at a time
If you wanted to create an album of your family’s history but were limited to 100 items, what would you put in and what would you leave out? These were the questions that the VA History staff asked in compiling the History of VA in 100 Objects virtual exhibit. The exhibit explores the history of the nation’s efforts to honor and reward Veterans for their service by spotlighting objects that tell key parts of the VA story. The objects span the centuries, from the earliest laws governing disability claims for Revolutionary War soldiers to the latest medical gear to protect VA workers and Veterans from the COVID-19 pandemic. The exhibit is being published serially throughout 2022 and 2023, with new entries appearing Thursdays at the rate of one or two per week. Entries from previous weeks are available for viewing on the GALLERY PAGE. We hope you will join us as we embark on this year-long journey through VA’s past, object by object.
Object 33: The Million Veteran Program
By Claudia Gutierrez, Public Relations Specialist, Million Veteran Program, and Jeffrey Seiken, Historian, Veterans Benefits Administration
In May 2009, twelve VA doctors and scientists gathered in a small conference room in Rockville, Maryland, to brainstorm about the design of VA’s first-ever large-scale genetic research program. They wanted to collect medical information from Veterans along with blood samples to extract DNA, with the goal of creating a genomic biobank or database for researchers to explore how genes affect health and disease.
The team was encouraged by the results of recent focus groups and surveys with Veterans about their attitudes and concerns around the new field of genetic research. An overwhelming 82 percent said they would support a database for genetic research at VA, with 71 percent expressing a willingness to participate in such a program themselves. Still, that left open the question of how many Veterans the program should seek to enroll. The database needed to be large for research studies to yield statistically significant results on a wide range of health conditions. Timothy O’Leary, the Director of VA’s Biomedical Laboratory Research and Development Service, challenged the group to think big. They started with 100K and continued throwing out even larger numbers before settling on one million Veteran participants. Over dinner, they also came up with a name: the Million Veteran Program.
For VA to undertake a research program of this magnitude was more than ambitious; it was also unprecedented. At the time, the largest research initiative VA ever conducted was a colonoscopy study with 10,000 participants. To date, most genetic research studies involved a few thousand people at best.
Yet, several factors made VA ideally suited to execute a program on this scale. The agency oversees the largest health care system in the United States. With nine million Veterans enrolled in VA health care, VA has access to an enormous patient population, many of whom want to give back and help their fellow Veterans. For the past 30 years or more, VA has also employed a sophisticated electronic health record system to track Veteran treatment and medical information.VA also has a well-developed research infrastructure and supports research efforts at more than 100 VA medical centers and other facilities nationwide.
It took almost two years from the first planning session to the official launch of MVP. Drafting the research protocol for the program proved complicated, as enrollees would be agreeing to share genetic and health data not just for one specific research project but for any number of approved studies in the future. This, too, had never been done before at VA. The MVP team cleared this important hurdle when VA’s Central Institutional Review Board approved the protocol in 2010.
Enrollment in MVP began in early 2011 at nine different sites. Recruitment efforts ramped up from there. Over the next five years, MVP opened 52 main enrollment sites plus more than 65 satellite locations across 37 states. The program also launched an enormous and still ongoing mail campaign to solicit participation, sending out letters and questionnaires to millions of Veterans. By March 2014, a quarter million Veterans had joined the program. MVP reached the half-million mark on August 1, 2016. The COVID-19 pandemic slowed its march to one million participants, but the program is closing in on that milestone, with nearly 900,000 Veterans enrolled as of June 2022.
Even in the program’s early stages, VA investigators took advantage of the genetic and health data collected from participants to initiate studies on a range of pressing health problems afflicting Veterans. The first studies using the MVP database focused on such conditions as heart and kidney disease, post-traumatic stress disorder, Gulf War Illness, and substance use. Since 2015, as more research projects have gotten underway, the scope of inquiry broadened to include diabetes, prostate and breast cancer, and anxiety and depression, to name just a few of the many health conditions MVP researchers are studying.
The program has also been enlisted in the fight against COVID-19. One VA study, the results of which were published in April 2022, established a link between genetic variants associated with severe COVID-19 and other medical conditions that place individuals at high risk if they contract the virus. Another study found that Black Veterans who carry a genetic variation linked to kidney disease were more than twice as likely to die from COVID-19, which triggered severe kidney infection in many of these patients. This discovery was made possible thanks to the diversity of Veterans in MVP, which has more people of African descent than any other research program in the world.
Other MVP studies promise to yield equally important insights into how genes interact with lifestyle issues and environmental factors to impact health. Over time, the knowledge gained through these studies will lead to groundbreaking improvements in the diagnosis, treatment, and prevention of illness and disease for Veterans and all people.
Have an idea for an object? Let us know!
We have worked hard to capture VA’s complex and varied history in the exhibit, but our list of 100 objects is not set in stone. We invite readers to submit their own suggestions of objects to include in the exhibit. Send your ideas to VAHistoryOffice@va.gov. If we like your suggestion, we will write it up and give you full credit when the entry on your object appears on the website.
CLICK BELOW for the 100 Objects gallery pages to see all previous entries in the exhibit.