ECDC communicable disease threats report

July 28th, 2014 (last updated)

The ECDC communicable disease threats report is a weekly bulletin intended for epidemiologists and health professionals in the area of communicable disease prevention and control. Summarising information gathered by ECDC through its epidemic intelligence activities regarding communicable disease threats of concern to the European Union, it also provides updates on the global situation and changes in the epidemiology of communicable diseases with potential to affect Europe, including diseases that are the focus of eradication efforts.

ECDC communicable disease threats report Click here


Communicating Science to the Public

July 27th, 2014 (last updated)

Media attention and consequent public concerns about vaccine safety followed publication of a small case-series of children who developed autism after receipt of the measles-mumps-rubella (MMR) vaccine. Many well-controlled studies performed subsequently found no evidence that MMR vaccine causes autism. However, despite these studies, some parents remain concerned that the MMR vaccine is not safe. Professor Paul Offit discusses the origins of the hypothesis that the MMR vaccine causes autism, studies performed to test the hypothesis, how these studies have been communicated to the public, and some suggested strategies for how this communication can be improved

Paul Offit

Why vaccine costs are soaring?

July 26th, 2014 (last updated)

Vaccination prices have gone from single digits to sometimes triple digits in the last two decades, creating dilemmas for doctors and their patients as well as straining public health budgets. Some doctors have stopped offering immunizations because they say they cannot afford to buy these potentially lifesaving preventive treatments that insurers often reimburse poorly, sometimes even at a loss.

Childhood immunizations are so vital to public health that the Affordable Care Act mandates their coverage at no out-of-pocket cost and they are generally required for school entry.

The New York Times

The flu vaccine is safe for pregnant women

July 25th, 2014 (last updated)

Pregnant women are one of the high-priority groups for the annual flu vaccine which protects them and their baby. Previous research has shown that the vaccine is safe and reduces the risk of babies being born prematurely or with low birth-weights.

Vaccines Today & The Scottish Governmant

With disease’s resurgence, officials urge whooping cough boosters

July 24th, 2014 (last updated)

whooping cough

With the disease’s resurgence in recent years and an only somewhat effective vaccine, public health officials are pushing preventive measures meant to keep pertussis, more commonly known as whooping cough, at bay. That includes urging adolescents, pregnant women, adults, and those in contact with newborns, such as grandparents and caregivers, to get a booster shot.

Pertussis is characterized by fits of coughing, followed by a “whoop” sound from the attempt to inhale. A booster shot is an additional dose of the vaccine that “boosts” the immune system response as immunity to the disease wanes over time.

Massachusetts health officials said some people have been slow to follow the recommendations, but have encouragingly seen more people across all age groups receive the shots this year. Ninety percent of adolescents received the shot this year — a significant increase from 2005, when it was first licensed for middle-school age children — but it’s difficult to make sure that children who do not visit a pediatrician every year get the shot, said Dr. Lawrence Madoff, director of the Division of Epidemiology and Immunization at the Massachusetts Department of Public Health.

And few adults get the booster vaccine — only 36 percent in the state have ever received it. Experts say adults may not be aware they need it.

“The public at large and even physicians in general are inappropriately secure that early immunization has taken care of the problem and this is a disease of the past,” said Dr. Jeffrey Gelfand, an infectious disease physician at Massachusetts General Hospital and professor at Harvard Medical School. “The public still needs additional education. The public needs to be aware that we’re more susceptible than perhaps even 10 years ago.”

Cases of whooping cough in the United States were sparse for decades after a combined diptheria, tetanus, and pertussis vaccine was introduced in the 1940s. The shot was a whole-cell vaccine, meaning it used an entire inactivated Bordetella pertussis bacteria, the organism that causes the infection, so the patient could mount a robust immune response.

But after patients continually reported adverse side effects, such as swelling in the arm, fever, and even rare neurological problems, the vaccine was redesigned in the 1990s to only use fragments of the bacteria.

It used to be enough for infants and young children to get their school-mandated five doses of the old vaccine, which was expected to protect them for the rest of their lives. But the new vaccine, known as DTaP (the adult version is Tdap), while safer, is less effective. Massachusetts experienced a pertussis outbreak in 2012, with 653 cases and at least one death, and the country saw nearly 50,000 cases that year, the most since 1955. The rates have since decreased, with 346 cases in the state in 2013 and about 50 so far this year, according to DPH.

Immunity to pertussis wanes over time for those who receive the new vaccine. The DTaP shot is about 98 percent effective in its first year, but declines to about 70 percent effectiveness after five years, said Dr. Thomas A. Clark, director of the CDC’s Meningitis and Vaccine Preventable Diseases Branch.

“People think of a vaccine as: you get it and you’re sort of protected, or you don’t get it and you’re not protected,” Clark said. “It’s more a matter of degree. A vaccine can be 95 percent effective, but you can still be susceptible.”

A study from the American Academy of Pediatrics last year found that teenagers who received the new vaccine had a six times higher risk of contracting whooping cough than those who received the whole-cell vaccine. More than 85 percent of reported pertussis cases are in people who are vaccinated, Clark said.

Researchers are at least 10 years away from developing a new — and, they hope, more effective — vaccine, Clark said, so for the time being, there will be more cases. While some states that experienced outbreaks have since mitigated the spread of pertussis, including Massachusetts, health officials continue to see cycles of outbreaks. California declared a pertussis epidemic last month.

As more parents are choosing not to vaccinate their children, the lower number of immunized individuals, coupled with the vaccine’s waning immunity, has expedited transmission of pertussis and other diseases.

The Boston Globe

New vaccine fights mosquito-borne viruses

July 23rd, 2014 (last updated)

Clinical stage biotechnology company, Arbovax Inc., created a vaccine for Chikungunya, the company announced last month.

It was developed by Dr. Dennis Brown and Dr. Raquel Hernandez of North Carolina State University.

The mosquito-borne virus had an outbreak in the Caribbean last December, spreading to several other islands. Recently, the virus touched down in the United States.

“To date, there have been over 130,000 cases, so it was only a question of time before it came to the U.S. and we have effective means to combat it,” Abrovax CEO Malcolm Thomas said in a statement.

According to the Centers for Disease Control and Prevention, there were 80 confirmed cases of Chikungunya in 13 states, Puerto Rico and the U.S. Virgin Islands as of June 17. Of those cases, 57 were people who recently visited the Caribbean. The virus originated in Africa in the 1950s, with the name Chikungunya meaning “bent out of shape.”

One of the most common signs of the virus is multiple joint pains along with fever.

Chikungunya is not usually fatal but can cause severe pain to the infected.

In animal tests, the vaccine has proven to fight the virus and other mosquito-borne viral diseases such as dengue fever, West Nile, Japanese encephalitis and yellow fever, according to Arbovax researchers.

mosquito borne viruses


Needle Tips

July 22nd, 2014 (last updated)

Needle Tips is a publication written for health professionals who provide immunization services to children, teens, or adults. Every issue includes the Ask the Experts feature by CDC experts who answer challenging and timely questions about vaccines and their administration; the Vaccine Highlights section which contains vaccine news from ACIP and CDC; and ready-to-print materials from IAC to photocopy and hand out to staff and patients. The technical content of Needle Tips is reviewed for accuracy by CDC. Subscribe to Needle Tips – it’s free!

needle tips Click here

Immunization Action Coalition

Seasonal influenza and vaccine herd effect

July 21st, 2014 (last updated)

The seasonal influenza vaccine programs in many regions aimed to protect most vulnerable population, but current trivalent influenza vaccine does not provide sufficient effectiveness among people under high risk for severe outcome of the influenza. The vaccine herd effect (VHE) is the extra protection of non-immune high risk persons, with increase of immunity among vaccinated healthier persons which prevents circulation of influenza in the community. Accumulating evidences are supporting the immunization of extended population with regard to the VHE.

Seasonal influenza and vaccine herd effect Click here

Clinical and Experimental Vaccine Research

HPV Vaccination in India: Critical Appraisal

July 20th, 2014 (last updated)

Cervical cancer is the third most common cancer in women worldwide. The role of human papilloma virus (HPV) in the genesis of cervical carcinoma is well documented. The HPV 16 and 18 are found to be most commonly associated with invasive cervical carcinoma. The advent of cervical carcinoma vaccine has advanced the hopes that eradication of cervical carcinoma might be possible in future. The scenario of prevention of cervical carcinoma is completely different in developed and developing countries. The implementation of the vaccination as a routine in India is still controversial. Here we have tried to critically analyse these issues in Indian context. However it is clear that cervical cancer vaccine is not an immediate panacea and cannot replace the cervical cancer screening which is mandatory in Indian context.

HPV vaccination Click here

ISRN Obstetrics and Gynecology

Extra dose of inactivated polio vaccine boosts immunity in children and could speed up global eradication efforts

July 19th, 2014 (last updated)

Giving children under 5 years old an extra dose of inactivated polio vaccine (IPV) helps to boost their immunity to the poliovirus and should be added to vaccination programmes in polio-endemic countries and those facing a high risk of imported cases, suggests new research published in The Lancet.

Lead author Dr Jacob John from Christian Medical College, India explains, “Adding a supplementary IPV dose to children already vaccinated with oral poliovirus vaccine (OPV) may hasten polio eradication by boosting herd immunity in endemic regions, act as a booster to prevent international spread by travellers, and minimise the risk of polio outbreaks due to imported wildtype or vaccine-derived polioviruses.”

Mass vaccination with OPV has successfully eliminated wild poliovirus from most of the world, although it remains endemic in Afghanistan, Nigeria, and Pakistan, and imported cases have led to large outbreaks in Africa, Asia, and Europe.

Although OPV is highly effective, easy to administer, and relatively inexpensive, its ability to generate a strong intestinal immunity to infection wanes as early as a year after vaccination. Thus, vaccinated children and adults can still be infected and shed wild poliovirus, contributing to the spread of the disease.

In an attempt to increase protection in children whose immunity might have waned, scientists from India and the UK examined the effect of an additional dose of IPV on both systemic and intestinal immunity in children from Vellore, India (aged 1 to 4 years) who had received at least five doses of OPV as part of routine immunisation at least 6 months previously. Children were randomly assigned to receive a dose of IPV (225 children) or no vaccine (225) at enrolment. The researchers used shedding of the virus (testing stool specimens) after a challenge dose of bivalent OPV containing serotypes 1 and 3 poliovirus to measure the immune response.

The additional IPV dose substantially boosted levels of protective antibodies in the blood and intestinal immunity against poliovirus compared with no vaccine. One week after challenge with OPV, 43 (19%) and 57 (26%) children given no vaccine shed serotype 1 or 3 poliovirus compared with 27 (12%) and 17 (8%) of those receiving IPV. Among children in the no vaccine group, the first dose of bivalent OPV did not reduce poliovirus shedding following a second challenge dose of this vaccine.

According to Professor Grassly, senior author of the study from Imperial College London, UK, “The substantial benefit of using IPV rather than further doses of OPV to boost intestinal immunity in children within the typical age range for mass vaccination supports its use as part of the global eradication programme.”

Writing in a linked Comment, Professor Kimberly Thompson from the University of Central Florida College of Medicine, USA discusses the results in the context of national immunisation strategies saying that, “Giving an extra dose of IPV or OPV to already OPV-vaccinated children with waned immunity will provide some incremental individual benefit…[however] the effects on overall population immunity and cost-effectiveness of an extra dose remain uncertain…Some results from models that explore the potential addition of an IPV dose at the same time as the last OPV routine immunisation dose suggest that the benefit on overall population immunity and thus on poliovirus transmission might be small.”

end polio now

Science Daily