Archive for November, 2013

New WHO malaria vaccines roadmap targets next generation products by 2030

Wednesday, November 20th, 2013 (last updated)

The world should aim to have vaccines which reduce malaria cases by 75%, and are capable of eliminating malaria, licensed by 2030, according to the updated 2013 “Malaria Vaccine Technology Roadmap”, launched today. This new target comes in addition to the original 2006 Roadmap’s goal of having a licensed vaccine against Plasmodium falciparum malaria, the most deadly form of the disease, for children under 5 years of age in sub-Saharan Africa by 2015.

“Safe, effective, affordable vaccines could play a critical role in defeating malaria,” said Dr Robert D. Newman, Director of WHO’s Global Malaria Programme. ”Despite all the recent progress countries have made, and despite important innovations in diagnostics, drugs and vector control, the global burden of malaria remains unacceptably high.”

Current situation

The most recent figures by the WHO indicate that malaria causes an estimated 660 000 deaths each year from 219 million cases of illness. Scale-up of WHO recommended malaria control measures has been associated with a 26% reduction in the global malaria death rate over the last decade. Effective malaria vaccines could be an important complement to existing measures, if they can be successfully developed.

Final results from Phase III trials of the most advanced vaccine candidate, RTS,S/AS01, will be available by 2015. Depending on the final trial results, and depending on the outcome of the regulatory review by the European Medicines Agency, a WHO recommendation for use and subsequent prequalification of this first vaccine could occur in late 2015.

The Malaria Vaccine Technology Roadmap

The new roadmap, launched today at the annual conference of the American Society of Tropical Medicine & Hygiene in Washington DC and also announced in a letter published in “The Lancet”, aims to identify where additional funding and activities will be particularly key in developing second generation malaria vaccines both for protection against malaria disease and for malaria elimination. These include next-generation vaccines that target both Plasmodium falciparum and Plasmodium vivax species of malaria.

“The new vaccines should show at least 75% efficacy against clinical malaria, be suitable for use in in all malaria-endemic areas, and be licensed by 2030,” says Dr Jean-Marie Okwo Bele, Director of WHO’s Department of Immunization, Vaccines and Biologicals. “The roadmap also sets a target for malaria vaccines that reduce transmission of the parasite.”

The 2013 “Malaria Vaccine Technology Roadmap” cites several reasons for the update, among them changing malaria epidemiology associated with the successful scale-up of malaria control measures in the last decade; a renewed focus on malaria elimination and eradication in addition to the ongoing need to sustain malaria control activities; and new technological innovations since 2006 including promising early work on so-called transmission-blocking malaria vaccines.

WHO lists 27 malaria vaccine candidates currently in clinical trials, with most in early stages of testing; RTS,S/AS01 is the only one currently in late-stage development.

The Roadmap’s vision centres on developing safe and effective vaccines against Plasmodium falciparum and Plasmodium vivax that prevent disease and death and prevent transmission to enable malaria eradication, and is built around two strategic goals:

  • Development of malaria vaccines with protective efficacy of at least 75% against clinical malaria suitable for administration to appropriate at-risk groups in malaria-endemic areas.
  • Development of malaria vaccines that reduce transmission of the parasite and thereby substantially reduce the incidence of human malaria infection. This will enable elimination in multiple settings. Vaccines to reduce transmission should be suitable for administration in mass campaigns.

The “Malaria Vaccine Technology Roadmap” is the result of a consultative process led by WHO, which brought together the global community of malaria vaccine researchers and product developers, and is supported by an informally-organized group of malaria vaccine funders. The Malaria Vaccine Funders Group comprises the Bill & Melinda Gates Foundation, the European & Developing Countries Clinical Trials Partnership, the European Vaccine Initiative, the European Commission, the PATH Malaria Vaccine Initiative, the US Agency for International Development, the US National Institute of Allergy and Infectious Diseases, the Wellcome Trust, and WHO.


The effect of childhood vaccine exemptions on disease outbreaks

Tuesday, November 19th, 2013 (last updated)

Vaccination is one of the most cost-effective and successful public health interventions. Each year, vaccines save an estimated 6 million to 9 million lives worldwide, including the lives of 3 million children. In the United States, vaccinations have decreased most vaccine-preventable childhood diseases by more than 95 percent. Vaccines have minimized or eliminated outbreaks of certain diseases that were once lethal to large numbers of people, including measles and polio in the United States and smallpox worldwide. But because the bacteria and viruses that cause diseases still exist, the public health gains achieved through vaccines can only be maintained by ensuring that vaccination rates remain high enough to prevent outbreaks.

Vaccines are effective not only because they protect individuals who have been vaccinated but also because they confer a broader protection for communities by establishing “herd immunity.” When sufficiently high proportion of a population is vaccinated against communicable diseases, the entire population can obtain protection. As the number of vaccinated people in a given population increases, the likelihood that a susceptible person will come into contact with an infected person decreases; it ultimately becomes difficult for a disease to maintain a chain of infection. Although the vaccination rate required to achieve herd immunity varies by vaccine, it typically ranges from 80 percent to 95 percent of a given population.

A significant number of children in the United States, however, do not receive the fully recommended schedule of vaccinations. These children fall into two broad categories: the unvaccinated, who do not receive any immunizations, and the undervaccinated, who do not receive the fully recommended vaccine schedule. Unvaccinated and undervaccinated children are socioeconomically and demographically distinct populations, and separate factors account for why they are not fully vaccinated. Generally, children tend to be unvaccinated due to their parents’ decision to take advantage of vaccine exemptions, whereas many children are undervaccinated because of barriers to access, such as poverty and the cost of vaccines.

While the issues of nonvaccination and undervaccination must be addressed to protect children and their communities from significant health risks, this brief focuses solely on children who are not immunized due to parents’ use of nonmedical vaccine exemptions. We survey the research on state childhood vaccination mandates and exemption categories, focusing on the role that nonmedical exemptions play in reducing immunization coverage in communities throughout the United States. After reviewing the evidence, we suggest possible responses at the state and federal levels.

Center for American Progress Click here

Center for American Progress

4 ways to vaccinate without needles

Monday, November 18th, 2013 (last updated)

From laser beams and ultrasound waves to wireless blood tests, researchers have always been looking for ways to minimize the use of needles — or at least to lessen the pain of the prick.

But the needle-syringe combo is notoriously challenging.

Vials need to be kept cool, sharps must be safely disposed of and never reused, and half-full vials get thrown out to avoid contamination.

Still, there’s got to be a less painful way to give these potentially life-saving shots to children. Here are four budding high-tech, needle-free immunizations compiled by Wired.

1. Stratis, a jet injector from PharmaJet

Intense pressure in a single-use syringe propels a high-velocity stream of liquid. The vaccine goes straight into the muscle or under this skin. No fear of vial contamination; sharps disposal isn’t necessary. This could be available in time for your next flu shot at the local pharmacy.

2. Nanopatch, a little pad of microneedles from Vaxxas

Traditional vaccines don’t always trigger a sufficient immune response. The microscopic projections on this patch deliver meds directly into skin that’s rich in immune cells. Doesn’t need refrigeration. Trials in primates and pigs are underway.

3. Quick-dissolving film that’s taken orally, from Aridis Pharmaceuticals

This film for rotavirus — which causes inflammation of the stomach and intestines — dissolves on your tongue like a Listerine fresh strip. Will remain stable for six months at high temps (up to 113 degrees Fahrenheit). At least 200 can fit in the same space needed for a syringe holding the same dose. In preclinical trials.

4. PuffHaler, powder that’s inhaled, from Aktiv-Dry

Once inhaled, this dry-powder measles vaccine targets the respiratory system (like the virus itself). Bundled in blister packs, it’s transportable and stable for six months without refrigeration. A human trial recently wrapped up in India.

And did you know? Researchers have also looked to porcupine quills and mosquito stingers for less painful jabs.

vaccinate without needles


Protects the one you love

Sunday, November 17th, 2013 (last updated)

It’s important to get immunized against the flu, not just for you… but for the people around you. Seniors, people with chronic conditions like asthma and diabetes, young children and people with compromised immune systems are all at risk for becoming very ill if they get influenza. Protect the ones you love, get a flu shot today.

Island Health

Introduction of rotavirus vaccines

Saturday, November 16th, 2013 (last updated)

WHO recommends that rotavirus vaccines be included in all national immunization programmes. Rotavirus vaccine should be considered a priority particularly in countries with high rotavirus gastroenteritis (RVGE) associated fatality rates, such as in South and South-Eastern Asia, and sub-Saharan Africa.

To maximize the impact of rotavirus vaccine it is important to develop a comprehensive and realistic introduction plan.

This document includes information and guidance to assist policy makers, program managers, and health workers in considering all of the operational preparations that should be included in a rotavirus vaccine introduction plan, once a country has made a decision to introduce the vaccine. It includes the key technical information and up-to-date references needed to successfully incorporate rotavirus vaccine into a national immunization program.

Introduction of rotavirus vaccines Click here


Even healthy kids can die from flu complications

Friday, November 15th, 2013 (last updated)

A new report underscores what health professionals know but parents may not: The flu can be fatal to children, even healthy kids who don’t have other medical conditions.

Researchers with the Centers for Disease Control and Prevention found that 830 kids died from flu-related complications between October 2004 and September 2012, and most of those children had not gotten a flu vaccine. Pneumonia was the most commonly reported complication among the kids who died. Their median age was 7.

The report also shows that 43% of the kids who died from flu complications were otherwise healthy and didn’t have high-risk medical conditions such as asthma, diabetes, certain types of cancer, congenital heart defects or neurological disorders such as cerebral palsy or epilepsy. Children with those types of health problems are at a greater risk of dying from flu complications.

The CDC “recommends that all children 6 months or older get the flu vaccine every year, and this report shows that any child can be at risk for severe complications from influenza,” says the report’s lead author, Karen Wong, a CDC medical officer. These findings reinforce that “prevention is the best strategy, and the best strategy we have is vaccination,” she says.

“The most sobering message is that almost half of these children had no underlying medical condition — these were normal, healthy children,” says William Schaffner, professor of preventive medicine and infectious diseases at the Vanderbilt University School of Medicine. He was not involved in this report but is a member of the CDC’s advisory committee on immunization practices. “That’s a profound fact when you think about it. Everyone in the United States older than 6 months of age should be vaccinated against influenza.”

Schaffner says children younger than 9 who are receiving the vaccine for the first time need two doses. “If they only get one, it’s as though they are not vaccinated that season.”

CDC director Tom Frieden says, “All too often, people dismiss flu as a mild illness, but every year, children, including healthy children, die from flu.”

The CDC says 56.6% of kids, ages 6 months to 17 years, got one or more doses of the flu vaccine during the 2012-13 season.

The pediatric deaths from the influenza complications are reported to a national surveillance system, but the numbers may be underestimated because they include only deaths that were confirmed by a flu test, Wong says. The tally of 830 deaths doesn’t include the 167 pediatric deaths from last year’s flu season.

Even healthy kids can die from flu complications Full paper: click here

USA Today

Two Cervarix doses in young girls is sufficient

Thursday, November 14th, 2013 (last updated)

GlaxoSmithKline announced the results of a Phase III study of its HPV vaccine, Cervarix, which showed that two doses of the vaccine in girls aged 9 to 14 years provide an immunogenicity matching the currently licensed three-dose schedule in 15 to 25 year olds. In the trial, HPV-070, 1,447 patients across five countries were randomized to receive Cervarix. The results showed that the two-dose schedule in girls aged 9 to 14 years old induced immune responses which were comparable to that seen with the 3 dose schedule in 15 to 25 year olds suggesting quality and quantity of the immune response are comparable to the three-dose schedule. The results corroborate the findings of an earlier proof of concept study, HPV-048, which also assessed the immunogenicity of two doses of Cervarix compared to its three-dose schedule and demonstrated that the immunogenicity of two doses of Cervarix in 9 to 14 year old girls is comparable to that seen with three doses in 15 to 25 year olds girls for both the vaccine HPV types 16 & 18 and for non-vaccine types 31 & 45, throughout the four year study period.



Vaccines save lives

Wednesday, November 13th, 2013 (last updated)

According to World Health Organization estimates, vaccination saves the lives of more than 3 million people worldwide each year and prevents millions of others from suffering from diseases and permanent disabilities.

Vaccines save lives


Scientists launch three-year project to develop C. difficile vaccine

Tuesday, November 12th, 2013 (last updated)

A group of leading European scientists presented a new project on Monday aimed at developing an oral vaccine against Clostridium difficile, according to the University of Royal Holloway London.

The three-year project, headed by Royal Holloway, is taking the novel approach of looking to produce an oral vaccine using harmless bacteria to carry antigens to boost immunity against C. difficile. The project is funded by an $8.01 million grant from the European Union.

“We believe that our approach to develop this vaccine will provide significantly greater protection against infection and relapse, than would have been achieved via injections,” Simon Cutting, a professor from Royal Holloway’s School of Biological Sciences, said. “This method is also likely to inform the treatment of many other diseases.”

The scientists presented the project to pharmaceutical companies and practitioners from around the world on Monday at the Raising C. difficile Awareness conference in North Carolina and the Bio-Europe conference in Vienna, Austria.

While C. difficile is harmless in healthy people, the bacterium can be fatal when the natural bacteria of the gut are disrupted by antibiotics. The infection kills approximately 4,000 people annually.

“C. difficile poses a major public health threat and there is an urgent need for protective vaccines,” Cutting said. “I am delighted to be coordinating this program with such a strong team of academic and industrial experts.”

First clinical trials of the proposed vaccine are expected to start in the next 18 months.


Vaccine News Daily

Are doctors inadvertently fueling the anti-vaccine movement?

Monday, November 11th, 2013 (last updated)

A study published in the Journal of Pediatrics analyzed more than 100 vaccine discussions involving 16 healthcare providers and found that how the doctor phrased the vaccine question had an impact on swaying parents who were hesitant about whether to vaccinate their children.

The study found that when doctors told parents it was time to vaccinate (“It’s time for Bobby to have his shots”) rather than presenting it as a question (“What do you want to do about Bobby’s shots?”), parents were much more likely to accept vaccination. As the study by Dr. Douglas Opel, assistant professor of pediatrics at the University of Washington School of Medicine in Seattle, suggests, doctors need to stop presenting vaccination as a question and more assertively advocate for the potentially lifesaving vaccination of young children.

Of course, parents should not be pressured into vaccinating. They should have questions answered and should make decisions based on informed consent. But from a public health perspective, vaccination should not be presented as a choice, implying equally valid options, especially in the context of rampant vaccine misinformation.

Are doctors inadvertently fueling the anti-vaccine movement? Click here

Los Angeles Times