I have seen shareholders vote down option grants as well as...

I have seen shareholders vote down option grants as well as directors re-appointments for that matter.

I few comments.
Yes VLA was able to rise capital from a few institutions, but at a very low price, and we all suffer from the dilution.
The pivotal trial, was started long before the current CEO was hired. So he has nothing to do with that.
Yes there has been progress, and the Viruses seem to be doing what is expected in the case of Bladder cancer. It will be very interesting to see the results of the combo trial with Yervoy.

The point is simple, and you obviously don't agree, but the main function of the CEO is to generate interest in the technology, yes from Pharma, but MOST importantly from investors too!
My point is a simple one, the market Cap of VLA is less than it should be given the results. And therefore the CEO options at a strike price equal to the current share price is rewarding him for his failure in getting the share price higher.
If the Share price was $1.50, and the board decided to give him 5M options at a strike price of $1.50, I would support it.

The share price is barely higher than it was almost 3 years ago in the days before he was hired. This is dramatic underperformance vs the milestones achieved.

This is the definition of FAILURE for a CEO. The inability to increase shareholder value, in spite of great results. How else can you analyze this? The share price is the report card for the CEO.