Archive for August, 2012

The introduction of rotavirus vaccines in Africa

Wednesday, August 22nd, 2012 (last updated)

The roll out of rotavirus vaccines in Africa has begun.

In this five-minute film, immunisation experts, health workers and mothers from Sudan and Tanzania talk about the need for the vaccines and their hope for the future.

Source:
GAVI Alliance

What are vaccine adjuvants?

Tuesday, August 21st, 2012 (last updated)

Adjuvants are substances added to vaccines to help them work better. In fact, the word “adjuvant” comes from the Latin adjuvare, meaning “to help.” Adjuvants are also referred to as immuno-stimulants because they trigger the immune system to become more receptive or sensitive to the presence of a vaccine.

Vaccines work by teaching your immune system to recognize a particular organism and fight it off — without you having to get sick. They are generally made from weakened or killed forms of a pathogen, or sometimes just part of a pathogen called an antigen. On their own, many pure vaccines aren’t quite strong enough to stimulate the immune system to protect you from future infections. So, adjuvants are added to give things a boost.

Aluminium salts (aluminium phosphate and aluminium hydroxide) are the most commonly used adjuvants in vaccines. Called “alum” for short, they have been used for this purpose since the 1930s. Alum causes a small amount of inflammation, triggering the immune system to become a little more “excited” so that it better recognizes the specific pathogen that is being introduced to it.

Researchers are investigating other types of adjuvants that would stimulate the immune system in different ways than alum does. There are various diseases for which vaccines are ineffective, such as AIDS, and scientists hope that new types of adjuvants might help overcome this problem.

Because adjuvants make vaccines so much more effective, many vaccines can be given at a lower dose. Before any vaccine or adjuvant is approved for use, it must go through rigorous studies to determine it is safe for use in humans. Adjuvants degrade and eventually are eliminated from the body.

Source:
National Research Council Canada

Listen, Understand, Engage: a new framework for advocating vaccination

Monday, August 20th, 2012 (last updated)

A quick glance at HealthMap today showed resurgence of whooping cough in the US, Canada and Scotland. Rubella is bouncing back, and measles is hanging on in Europe. These diseases are all preventable by vaccines. And in all these countries the vaccines are available, accessible and affordable to all.

That leaves awareness and/or acceptance of vaccination as the gap.

On May 25 in Geneva at the World Health Assembly ministers of health from 94 countries endorsed the Global Vaccine Action Plan. One of the 6 strategic objectives of this roadmap for global vaccination in the next decade is:

“Individuals and communities understand the value of vaccines and demand immunization as both their right and responsibility”

This objective clearly aims to fill the awareness/acceptance gap. Importantly, the public is also clearly identified as a stakeholder in vaccination. However, with preventable disease outbreaks cropping up everywhere, clearly there is a need for all stakeholders in vaccination – public included – to do a better job securing public acceptance of this life-preserving act.

Mike Watson and Angus Thomson recently published an editorial in Science Translational Medicine in which we propose a broad, integrated framework for vaccination advocacy that moves way beyond the standard ‘broadcast the facts and wonder why they don’t get it’ communications approach employed by most authorities and advocates at present.1

This approach is based on 4 insights we had:

  • the deficit model of science communication doesn’t work
  • because people tend to prefer to trust their sense of ‘truthiness’ (see below)
  • the cognitive and social sciences can tell us how and why that happens
  • then we can use those insights to communicate the evidence in an evidence-based way (hint: stop broadcasting, start engaging)

1. Thomson, M. Watson. (2012) Listen, understand, engage. Sci. Transl. Med. 4, 138ed6 (Download PDF from link on this page to avoid log-in)

Source:
Irrational Scientist & Angus Thomson

Chickenpox cases in the US dropped almost 80% over decade

Monday, August 20th, 2012 (last updated)

Chickenpox cases in the United States dropped almost 80 percent between 2000 and 2010 in 31 states following routine use of the varicella vaccine, the U.S. Centers for Disease Control and Prevention reports.

Updated figures published by the CDC Thursday also show that in the four years after a two-dose vaccine was recommended for children in 2006, cases of chickenpox declined about 70 percent. The biggest drop occurred in children between the ages of 5 and 9.

“This is one of our success stories,” Dr. Charles Shubin, medical director of the Children’s Health Center of Mercy FamilyCare in Baltimore, said when earlier figures were released last year.

The number of states with adequate chickenpox reporting systems jumped from 12 to 31 between 2000 and 2010, allowing the CDC to better monitor the effectiveness of the vaccine, introduced for routine use in the United States in 1996, the agency said.

In those 31 states reporting, incidence of chicken pox dropped from 43 cases per 100,000 population in 2000 to nine cases per 100,000 in 2010, the CDC said.

“State varicella surveillance data reported to CDC are now adequate for monitoring national trends in varicella incidence,” the agency said in this week’s issue of Morbidity and Mortality Weekly Report. But, only with information from all 50 states can health officials paint a complete picture. “Continued strengthening of the surveillance system and participation from all states is needed to monitor fully the impact of the routine second dose of varicella vaccine,” the researchers said.

Symptoms of this common infectious disease include an itchy rash on the face, scalp or trunk, fever and headache. Most cases are mild, lasting five to 10 days, but some people become seriously ill. Adults typically become sicker than children.

In 2010, four chickenpox-related deaths were reported, but none of those were patients known to have had the varicella vaccination, the CDC said.

The CDC recommends that children get two doses of varicella vaccine — the first dose between 12 and 15 months of age, the second between 4 and 6 years of age or at least three months after the first dose.

Teenagers and adults who have not had chickenpox or the chickenpox vaccine should also get two doses, at least four weeks apart.

Initially, just one dose of vaccine was recommended. As two-dose vaccination increases, the CDC expects to see further declines in chickenpox. While some people may still develop the virus after vaccination, those breakthrough cases tend to be mild, the agency said.

Source:
USNews

Advocates say flu vaccine should be mandatory for health workers

Sunday, August 19th, 2012 (last updated)

Despite more than 20 years of recommendations that health workers get flu shots, the most recent data from the Centers for Disease Control and Prevention show more than a third don’t comply.

The voluntary approach to reducing the risk that workers will transmit flu to patients has fallen short.

So consumer and business groups met in Washington Thursday to show their support for a recommendation from the National Business Group on Health that hospitals require all health care workers to be vaccinated annually against the flu.

“We believe that patients have the right to assume that health care personnel, themselves, will take all reasonable measures to reduce and avoid transmission of preventable diseases including the flu,” said Helen Darling, president and CEO of the NBGH. “I think we, as people, assume that after all, they’re our caretakers and we look to them for care and treatment.”

The NBGH is a nonprofit representing more than 300 large employers, including 68 of the Fortune 100. Its statement urged hospitals to “require annual flu vaccination of all employees as a condition of employment unless employees can demonstrate medical contraindications (with physician documentation) or religious objections.”

If that is the case, the NHBG says those employees “should not engage in direct patient care if they have flu-like symptoms.”

But flu vaccinations have been a point of contention among health care workers and labor groups for years. New York health workers pushed back against mandatory vaccination during the pandemic in 2009. A judge sided with nurses who sued to block the requirement.

Even within the government, there are conflicting views. In a letter to the National Vaccine Program Office, Jordan Barab, deputy assistant secretary for the Department of Labor’s Occupational Safety and Health Administration, said his organization supports the goal of the HHS’ Healthy People 2020 initiative to get 90 percent of health care personnel vaccinated. But “we are troubled that some have tried to convert the goal into a mandate,” he wrote.

Source:
NPG

Impact of vaccines

Sunday, August 19th, 2012 (last updated)

Comparison of 20th Century Typical and Current Reported Morbidity due to Vaccine-Preventable Diseases in U.S.

Disease

Pre-Vaccine Era*

2005

% Reduction

Diphtheria

175,885

0

100

Hib/unknown type (<5 yrs.)

20,000**

226

99

Measles

503,282

66

>99

Mumps

152,209

314

>99

Pertussis

147,271

25,616

83

Polio (paralytic)

16,316

1***

100

Rubella

47,745

11

>99

Congenital Rubella Syndrome

823

1

>99

Tetanus

1,314

27

98

* Typically, average during 3 years before vaccine licensure
** Estimated because no national reporting existed in the pre-vaccine era
*** Imported vaccine-associated paralytic polio

Global Number of Reported Cases 1980, 1990, 2000, 2006*

 Disease

 1980

 1990

2000

2006

% change

 Diphtheria

 97,774

 23,864

 11,625

3,978

-95.9%

 Measles

 4,211,431

 1,374,083

 852,937

 373,421

 -91.1%

 Mumps

 –

 –

 544,093

 442,464

 –

 Pertussis

 1,982,384

 476,377

 189,731

 115,924

 -94.2%

 Polio

 52,795

 23,366

 2,971

 2,001

 -96.2%

 Rubella

 –

 –

 671,286

 251,311

 –

 Rubella (congenital)

 –

 –

 181

 191

 –

 Tetanus (neonatal)

 13,005

 25,293

 16,943

 8,376

 -45.6%

 Tetanus (total)

 114,248

64,378

 21,242

 14,529

 -87.3%

 Yellow Fever

 144

4,336

684

356

+147%

*Source:
WHO vaccine-preventable diseases monitoring system, 2007 global summary

Global Percentage of target population vaccinated 2006*

Antigen

1980

1990

2000

2006

% change

 BCG

16

81

80

87

+444%

 DTP1

30

88

85

89

+197%

 DTP3

20

75

73

79

+295%

 HepB3

 1

32

60

 Hib3

14

22

 Measles

16

73

72

80

+400%

 Polio3

22

75

73

80

+264%

 Tetanus2+

 9

55

62

69

+667%

 Yellow Fever

0

4

26

48

*Source:
WHO vaccine-preventable diseases monitoring system, 2007 global summary

Source:
Voices for Vaccines

FDA approves upcoming seasonal flu vaccine

Friday, August 17th, 2012 (last updated)

The U.S. Food and Drug Administration announced the approval this week of the new flu vaccine for the season starting later in 2012.

The FDA annually works with global health experts and other federal agencies on the design of a vaccine that will protect against three viral strains that are mostly likely to cause influenza. The vaccine for the upcoming season has one strain in common with the vaccine from the previous season and two new strains of the virus.

Six companies, including Novartis, Sanofi and GlaxoSmithKline, will take part in manufacturing the vaccine.

Between five and 20 percent of Americans come down with the flu annually, which leads to 200,000 hospitalizations each year, according to the Centers for Disease Control and Prevention. Flu-related deaths vary from year to year and range between 3,000 and 49,000.

The U.S. Centers for Disease Control and Prevention recommends that people over the age of six months receive flu vaccines annually.

“The best way to prevent influenza is by getting vaccinated each year,” Karen Midthun, the director of the FDA’s Center for Biologics Evaluation and Research, said, according to an FDA press release. “It is especially important to get vaccinated this year because two of the three virus strains used in this season’s influenza vaccines differ from the strains included in last year’s vaccines.”

Source:
Vaccine News

Commercial Ebola vaccine ‘unlikely’ say researchers

Thursday, August 16th, 2012 (last updated)

Two companies with leading vaccine candidates have had their funding from the Pentagon suspended in recent weeks.

An expert said it was now “unlikely” a prophylactic vaccine would ever be used to prevent outbreaks of the disease.

Ebola is often described as the most frightening disease on Earth. The virus causes a severe haemorrhagic fever, where victims bleed both internally and externally.

The virus attacks white blood cells and blood vessels, causing a rash, red eyes, severe abdominal pain and vomiting. In recent weeks, an outbreak in western Uganda claimed the lives of at least sixteen people. There is no specific treatment and the virus can kill up to 90 percent of those who become infected.

Efforts to develop a vaccine have been funded in the main by the US Department of Defense and the National Institutes of Health. They have poured millions of dollars into scientific research because of concerns that the virus could be turned into a biological weapon.

As a result of this funding, several vaccine candidates have been developed and have shown themselves effective in animal trials.

Two companies, Sarepta and Tekmira have begun human safety trials of their vaccines. But in recent days, both companies have been told by the Defense Department to temporarily stop work on their vaccines due to funding constraints. It is expected that a decision to either resume testing or completely terminate the contracts will be made by early September.

Scientists say their understanding of the nature of the virus has markedly improved over the past decade. But the chances of turning that knowledge into a vaccine are very dependant on money.

Gene Olinger, a virologist at the US Army Research Institute of Infectious Disease at Fort Detrick in Maryland, told BBC News: “With the current funding, if it doesn’t change, I would say there should be a vaccine in five to seven years.

It could double or triple it if the funding goes away.” There is also a big concern over the lack of a large pharmaceutical company which might be willing to develop and market a vaccine for ebola. Since the disease was first discovered in 1976, slightly more than 2,200 people have been infected. And outbreaks have been almost impossible to predict.

Source:
Mmegi Online

“Decade of Vaccines Collaboration” reception at World Health Assembly 2012

Monday, August 13th, 2012 (last updated)

On 24 May 2012, GAVI held a Decade of Vaccines Collaboration reception to highlight the Global Vaccine Action Plan (GVAP) components being considered for endorsement by the World Health Assembly.

Approximately 200 guests attended the reception and you can see video highlights below. The following day, all 194 member states endorsed the GVAP resolution. They committed to apply the GVAP vision and the strategies to develop the vaccines and immunization components of their national health strategy and plans, to allocate adequate human and financial resources to achieve the immunization goals, and to report back every year to the Regional Committees on progress made.

Source:
GAVI Alliance

Teens who don’t have sex still at risk for HPV

Friday, August 10th, 2012 (last updated)

Even girls who have not had sexual intercourse are at risk for infection with human papillomavirus (HPV), a new study shows.

In the study, which involved teen girls and young women, 11.6 percent of those who had never had sexual intercourse were infected with at least one strain of HPV.

HPV infections are usually transient, but can cause cervical cancer in some people if the infection lingers for long periods.

The findings support the recommendation to administer the HPV vaccine to girls ages 11 and 12, before many become sexually active, the researchers said. Doctors and parents should not delay HPV vaccination because a teen is not sexually active, they said.

“Even before kids have intercourse,they’re being exposed to HPV,” said study researcher Lea Widdice, an assistant professor of pediatrics at Cincinnati Children’s Hospital. “Vaccination at 11 to 12 years old is not too early,” Widdice said.

Eduardo Franco, a cancer epidemiologist at McGill University, in Montreal, said the percentage of girls in the study who tested positive for HPV and had not had sex was higher than he would have expected. But this may be because many of the girls in the group had had some type of sexual exposure, said Franco, who was not involved in the study.

It’s not clear whether the HPV infections seen in this study were found in the vagina or in the cervix, Franco said. HPV infections in the cervix are more risky in terms of their cancer-causing ability, but would be less likely in those who have not had sexual intercourse, Franco said.

Widdice and her colleagues detail their results in the August issue of the journal Archives of Pediatric & Adolescent Medicine.

Source:
NBC News