Archive for January, 2013

Why flu vaccination matters

Sunday, January 20th, 2013 (last updated)

This powerful six and half-minute video, created by the U.S. Centers for Disease Control and Prevention (CDC) in collaboration with Families Fighting Flu (FFF), features the personal stories of parents who have tragically lost or nearly lost a child to the flu.

Families Fighting Flu

Voices for vaccines: parents speaking up for immunization

Saturday, January 19th, 2013 (last updated)

We are parents. We are grandparents. We are aunts, uncles, godmothers and godfathers, nurses and doctors. We are anyone who wants to protect children. Voices for Vaccines (VFV) provides parents clear, reliable, science-based information about vaccines and vaccine-preventable disease, as well as an opportunity to join the national discussion about the importance of on-time vaccination. We are a parent-driven organization supported by scientists, doctors, and public health officials, whose goal is to give parents a trusted resource to learn more about vaccines and why vaccination is so crucial for their children’s health and well-being—as well as the health and well-being of their communities.

Join “Voices for Vaccines” at:

Voices for vaccines: parents speaking up for immunization

Voices for Vaccines

A preliminary Canadian survey suggests this year’s flu vaccine cuts the risk of infection by about half

Friday, January 18th, 2013 (last updated)

Canadians who got a flu shot this year may have cut in half their risk of getting sick enough from flu to require medical care, new data suggests.

“It seems that this vaccine is cutting your risk of influenza in half, which … is still important protection, especially if you’re a high-risk person,” said Dr. Danuta Skowronski, a flu expert with the British Columbia Centre for Disease Control who oversees the surveillance network from which the data was drawn.

Skowronski said an important message from the data relates to the care of people who are at high risk of the complications of influenza if they become infected.

Doctors caring for such patients shouldn’t assume that because they got vaccinated they won’t contract influenza this winter, she said. For these people, use of antiviral drugs may be warranted if they become ill.

The mid-season flu vaccine effectiveness estimate is drawn from a surveillance network of a couple of hundred family doctors and community physicians in the country’s five most populous provinces: Alberta, British Columbia, Manitoba, Ontario and Quebec.

The network is funded by the Canadian Institutes of Health Research, with support from the involved provinces.

Skowronski and colleagues crunched data submitted by physicians in the network over the weekend.

This type of work studies people who seek care for influenza-like illness, looking to see if they are actually infected with flu and whether they had received a flu shot.

It is similar to a U.S. effort to measure the effectiveness of flu vaccine there which is funded by the U.S. Centers for Disease Control.

The U.S. CDC released interim vaccine effectiveness estimates late last week. In their analysis, this year’s vaccine reduces the risk of requiring medical help for flu by 62 per cent overall, and by 55 per cent for influenza A viruses.

Flu vaccine offers protection against two subtypes of influenza A, H3N2 and H1N1, as well as one type of influenza B virus.

The U.S. figures were based on a sample of patients in which the breakdown of flu infections was 57 per cent for influenza A and 43 per cent for influenza B.

The B component of the vaccine appears to be offering better protection this year than the A, about 70 per cent. And because the U.S. sample had such a large proportion of B cases, that had the effect of raising the overall estimate, Skowronski said.

But the Canadian figures are a closer representation of the proportion of A versus B viruses that are causing illness this winter in this country, she said. So far this flu season H3N2 has been responsible for the lion’s share of Canada’s cases.

In the interim analysis, 90 per cent of the positive cases were infected with influenza A and 10 per cent were infected with influenza B.

The A component of the vaccine appears to reduce one’s risk by between 45 and 50 per cent, Skowronski said. There were too few B cases to calculate a reliable estimate, and the overall estimate for the flu shot was 47 per cent.

Skowronski said an additional analysis will be generated at the end of the flu season.

CBC News Canada

Major step toward an Alzheimer’s vaccine

Thursday, January 17th, 2013 (last updated)

A team of researchers from Université Laval, CHU de Québec, and pharmaceutical firm GlaxoSmithKline (GSK) has discovered a way to stimulate the brain’s natural defense mechanisms in people with Alzheimer’s disease. This major breakthrough, details of which are presented January 15 in an early online edition of the Proceedings of the National Academy of Sciences (PNAS), opens the door to the development of a treatment for Alzheimer’s disease and a vaccine to prevent the illness.

One of the main characteristics of Alzheimer’s disease is the production in the brain of a toxic molecule known as amyloid beta. Microglial cells, the nervous system’s defenders, are unable to eliminate this substance, which forms deposits called senile plaques.

The team led by Dr. Serge Rivest, professor at Université Laval’s Faculty of Medicine and researcher at the CHU de Québec research center, identified a molecule that stimulates the activity of the brain’s immune cells. The molecule, known as MPL (monophosphoryl lipid A), has been used extensively as a vaccine adjuvant by GSK for many years, and its safety is well established.

In mice with Alzheimer’s symptoms, weekly injections of MPL over a twelve-week period eliminated up to 80% of senile plaques. In addition, tests measuring the mice’s ability to learn new tasks showed significant improvement in cognitive function over the same period.

The researchers see two potential uses for MPL. It could be administered by intramuscular injection to people with Alzheimer’s disease to slow the progression of the illness. It could also be incorporated into a vaccine designed to stimulate the production of antibodies against amyloid beta. “The vaccine could be given to people who already have the disease to stimulate their natural immunity,” said Serge Rivest. “It could also be administered as a preventive measure to people with risk factors for Alzheimer’s disease.”

“When our team started working on Alzheimer’s disease a decade ago, our goal was to develop better treatment for Alzheimer’s patients,” explained Professor Rivest. “With the discovery announced today, I think we’re close to our objective.”


Thigh beats arm for childhood vaccine

Wednesday, January 16th, 2013 (last updated)

Thigh beats arm for childhood vaccine

Children are less likely to develop bad reactions to the DTaP vaccine, a routine immunization shot that protects against diphtheria, tetanus and pertussis, or whooping cough, if they get it in their thigh instead of in their arm, a new study shows.

The research looked at more than a million children who were given injections of the vaccine. In many cases it causes some degree of redness or swelling around the injection site, which typically goes away after a day. But in rare instances a child can develop a more pronounced reaction, like severe pain or a swollen limb, that may require medical attention.

In the new study, which was published in the journal Pediatrics, researchers found that children between the ages of 1 and 3 who were given the DTaP vaccine in their thigh instead of in their upper arm were around half as likely to have a local reaction that warranted a visit to a doctor, nurse or emergency room. Previous studies of children who received the vaccine between the ages of 4 and 6 found that they, too, had a lower likelihood of developing a local reaction requiring medical attention if they got the shot in their thigh instead of in their arm.

Why the vaccine would be less harsh on the thigh than the arm is not known for certain. But one possibility is simply that in children at that age, the thigh muscle is much larger than the deltoid, the muscle in the upper arm where shots are typically administered. If any inflammation ensues, it has more room to diffuse in the thigh, said Dr. Lisa A. Jackson, the lead author of the study and a senior investigator at the Group Health Research Institute in Seattle.

“In little kids the upper arm is very tiny,” she said. “You’re injecting the same volume of vaccine in the upper arm as in the thigh, which is a larger area. I think it’s just that it’s a larger muscle mass.”

The benefits, however, may not extend to other immunizations. The study, for example, also looked at shots for influenza and hepatitis A, and in those cases there was no meaningful difference between vaccinating in the arm or thigh for either toddlers or children ages 3 to 6.

In many cases, doctors choose where to administer a shot according to their own preference. But in the case of DTaP, at least, it makes more sense in general to give the shot in the thigh, Dr. Jackson said.

“Unless there’s a compelling reason not to, I would say veer toward giving the DTaP vaccine in the leg,” she said. “There’s less chance of a concerning reaction if you give it in the thigh versus the arm. So that should be the normal practice.”

Dr. Jackson stressed, however, that the absolute risk of a child having a reaction severe enough to warrant medical attention is still quite small, regardless of whether the shot is given in the arm or leg. The study found that it occurred in less than 1 percent of vaccinated children over all.

The New York Times

India celebrates two years of being polio-free

Tuesday, January 15th, 2013 (last updated)

It’s a rare moment of pride for India as it celebrates two years of being polio-free on Sunday. The drive against polio is considered to be one of the most effective public health campaigns launched in India and has started yielding positive results.

Two-year-old Rukhsaar from Howrah in West Bengal remains the last polio case detected in India in 2011. “I regret not getting my child vaccinated. Now, I tell other people not to make the same mistake,” says Rukhsaar’s father Abdul Shah.

In the last few years, India has mobilised 24 lakh volunteers and 1.5 lakh front line workers in an anti-polio effort that costs the government Rs 1,000 crore every year. More than 17 crore children are immunised in each national round of polio vaccination – held six to eight times a year.

But experts warn against complacency – there’s still a risk of the virus travelling to India from across the border. “Pakistan is still not polio-free and there is always a chance of importing polio to India. So, this is no time to grow complacent now,” says WHO India representative Nata Manabde.

While Pakistan, Nigeria and Afghanistan are the only countries which have to still work on anti-polio efforts, India needs just one more year to stay off the list. India, however, tops the world’s list for child mortality and millions of children die from completely preventable conditions, like diarrhoea, and pneumonia. The Pentavalent vaccine, which prevents children five life-threatening diseases, is only available in three states in the country. So, what the Indian government can do now is an immediate boost to its routine immunisation program.

India celebrates two years of being polio-free

IBN Live

Vaccination: A Key Piece of the Puzzle

Monday, January 14th, 2013 (last updated)

Parents work hard to keep their babies healthy and safe. But, even healthy babies need vaccines to protect them from serious diseases. By vaccinating them according to CDC’s recommended schedule, parents can protect their babies from 14 serious diseases before they turn 2 years old.

For more information, visit


New HIV therapeutic vaccine candidate

Sunday, January 13th, 2013 (last updated)

Investigators from the AIDS and Infectious Diseases team of the Hospital Clínic/IDIBAPS- HIVACAT report in “Science Translational Medicine” the safety, tolerability, immunogenicity and virology response results obtained with a new HIV therapeutic vaccine candidate. There is still a lot of work to do, but the new results are the best ones published in the scientific literature until now.


Connecting the Dots: Chicken Pox, Varicella Vaccine and Shingles

Saturday, January 12th, 2013 (last updated)

Question: “How likely is it that my older 2 kids (who got wild pox and weren’t vaccinated) will get shingles later?” 

Answer: First off, let’s start by stating one unarguable fact: shingles sucks. Sorry, there’s no other way to describe it. Burning pain followed by nasty little blisters which are confined to what we call a “dermatome.” A dermatome is an area of the skin that is supplied by a single spinal nerve. In other words, the area of the spine called “T4” (for thoracic nerve #4) provides sensation to the nipple line and “T10” is the level of the belly button. Does that make sense? It may help if I tell you that as a first year medical student I dressed up as “Dermatome Man” by spray painting a sweat suit in stripes of pink, yellow and blue and writing the corresponding dermatome in each area. If that doesn’t help, then it just confirmed for you that I’m a dork. Fine. Moving on.

When a body encounters the varicella virus, either via wild-type chicken pox infection or the vaccine, the virus can basically go for a long snooze in one of these spinal nerves. If it wakes up, it causes shingles, also known as herpes zoster. Complications include zoster of the eyes (causing scarring), infection of the blisters, or infection of other organs of the body including the brain, liver or lungs. As if zoster itself wasn’t miserable enough. What’s even worse is that some people go on to develop a condition called “post herpetic neuralgia.” This is where the blisters have gone away (in about 1-2 weeks) but the burning painful sensation remains, in some cases for years. The pain can be so terrible and debilitating that it has even driven some poor souls to suicide. If that isn’t the definition of “sucks,” I don’t know what is.

So now to the heart of the question. What is the risk that a child will develop shingles at some point in his life? The answer partly depends on how long he lives. As we age, along with our knees and eyesight, our immune systems begin to show signs of wear and tear. This means a greater chance that the varicella zoster can “wake up.” About 50% of people over the age of 85 will have had an episode of shingles. Other people at risk include those with abnormal immune systems, such as children on chemotherapy for cancer.
But there is some good news. Lots of good news, actually. First and foremost is that while scientists are still researching this exact question, it appears that the risk of shingles may be lower for people who have received the varicella vaccine as opposed to having suffered through “wild-type” chicken pox. Of course, that news is only good if your child had the vaccine, isn’t it? Well, don’t lose hope. Because there is more good news. In the form of another vaccine.

Yep, it is now part of our routine immunization recommendations for adults 60 years and older to receive a dose of the zoster vaccine. The zoster vaccine is basically a ramped up version of the varicella vaccine, with at least 14 times the concentration of the live-attenuated virus. That’s enough to wake up the immune system memory and keep that sleeping varicella quiet. While the vaccine isn’t perfect, resulting in about a 50% decrease in the risk of shingles, it is very good at preventing the complications. In a study of over 38,000 adults, there was a significant decrease in duration and severity of the disease and almost a 70% decrease in the risk of post-herpetic neuralgia.

So there you have it. There is an argument that ongoing lifetime exposure to children with “natural” chicken pox will prevent shingles. And that we’ve tinkered with this system by immunizing against varicella in the first place. Which is technically true. Repeated exposure will keep the old immune system more awake and charged up, better prepared to beat down that pesky varicella. But the vaccine does the same thing. And vaccinating against both means a lower risk of severe complications from chicken pox and a much lower risk of severe complications from zoster. Which is worth celebrating, eh?

For more information on the zoster vaccine and shingles, check out these links.

Shot of Prevention

What determines the right age for vaccines?

Friday, January 11th, 2013 (last updated)

Dr. Mark Sawyer, Dr. Paul Offit and Alison Singer respond to the common questions: How do they determine the ages when children should receive each vaccine? Is it okay to delay vaccines?

Vaccinate Your Baby