Archive for June, 2014

Should women who’ve already had HPV be getting the vaccine too?

Friday, June 20th, 2014 (last updated)


About 80 percent of sexually active women will get HPV at least once, making it so common that Girls devoted an entire episode to the subject and even Two Broke Girls (a mainstay of play-it-safe CBS) jokes about it. Nevertheless, when I received my diagnosis, I was floored. I was a 34-year-old mother of two, newly back in the dating game after divorcing my high school sweetheart. Hannah Horvath I was not.

Luckily, cryotherapy, the freezing of abnormal tissue—yes, it’s about as fun as it sounds—cleared my infection. But HPV can lead to cervical cancer, among other health problems, and even after cryotherapy the infection recurs in about 10 to 15 percent of cases. So during one follow-up pap smear, my doctor floored me again—this time by suggesting I get the HPV vaccine. Turns out, though the Gardasil shot is FDA approved only for those aged nine to 26 (the logic being that it benefits primarily those who have not yet been exposed to HPV), a recent study presented in the British Medical Journal found that the vaccine reduced recurrence of HPV-related diseases by 46 percent in women who had been previously infected and treated for the disease. In the study (funded by Gardasil maker Merck), of the 1,350 women given Gardasil or a placebo, more than 25 percent had HPV infections at the study’s start. Among those who eventually required treatment for those infections, the placebo group’s rate of recurrence was nearly double that of the vaccinated group. In short, while the vaccine does not treat ongoing infections—which still require procedures such as cryotherapy—it may prevent subsequent ones.

Given these findings, some doctors feel that women who have a history of abnormal paps or precancerous cells should consider being vaccinated, even if they’re over 26. The study’s lead author, Elmar Joura, MD, associate professor of gynecology at the Medical University of Vienna, notes there is no upper age limit for the vaccine in Europe and that similar studies have found benefits for women up to age 45. And Warner Huh, MD, a professor of gynecologic oncology at the University of Alabama at Birmingham, says that while the vaccine’s efficacy is greatest before a sexual “debut,” as he put it, he supports vaccinating any woman who has a his-tory of HPV-related disease. But in terms of rethinking the age limits for vaccination for all women, Margaret Polaneczky, MD, an associate professor of clinical obstetrics and gynecology at Weill Cornell Medical College, says that while she’s not surprised by the recent findings, she still agrees with the current limit, given the fact that the vaccine does not cover all strains of HPV. “Because most women over age 26 have already had one or more HPV infections, universal vaccination does not decrease cancer rates enough to make it a recommended option in the [over-26] age group,” Polaneczky says. She is, however, quick to reassure women—vaccinated or not—that cervical cancer is almost always preventable. “Pap smears really work.”

The FDA continues to maintain that vaccinating women older than 26 does not decrease cancer rates enough to make it worthwhile (or, perhaps more to the point, cost-effective). That doesn’t mean you shouldn’t discuss the option with your physician. Insurance companies are unlikely to foot the bill for such off-label use, but doctors can still administer it. Some even outright recommend it. I’m glad mine did

Elle Magazine

Trial set for world’s first leprosy vaccine

Thursday, June 19th, 2014 (last updated)

leprosy vaccine

A vaccine for leprosy is being developed by American researchers and is set for toxicology tests towards the end of 2014 and for phase I clinical trials in human volunteers by 2015.

Leprosy is a chronic infection caused by the bacillus mycobacterium leprae. An infected person develops skin lesions and may lose eyesight and the ability to feel pain. While no vaccine has been developed yet to prevent the disease, it can be treated through multi-drug therapy.

According to the World Health Organisation, at least six out of every 10 people infected with leprosy come from south-east Asia. The Philippines and Indonesia are among the 18 countries worldwide that reported more than 1,000 new cases for 2011 alone.

The vaccine development project is led by the Infectious Disease Research Institute (IDRI), a non-profit organisation based in the US focusing on neglected diseases in the developing world, and the American Leprosy Missions (ALM), a Christian group providing financial and technical support to people affected by leprosy. For the clinical testing phase, they have partnered with the Philippine-based Cebu Leprosy and Tuberculosis Research Foundation.

“All the experimental and animal data have been assembled to make the case that this product is worth taking forward to human trials,” ALM communications director Sarah Hesshaus told SciDev.Net about the leprosy vaccine.

For the past 12 years, the ALM, in partnership with IDRI, has invested US$4m into the endeavour to develop the vaccine and a new diagnostic test for leprosy. It has been an uphill battle since “the leprosy bacteria grow very slowly and have been notoriously difficult to grow in laboratories”, Hesshaus says.

Malcolm Duthie, a senior scientist at IDRI and head researcher for the project, further explains that the advancement of vaccines through various clinical trial phases can take significant time as “safety and efficacy are of utmost importance”.

“The current transition of the leprosy vaccine from the preclinical to the clinical testing phase has necessitated a large amount of due diligence and care in manufacturing, which precludes initiation of safety trials in a small number of individuals,” Duthie explains.

Arturo Cunanan Jr, chief of the Culion sanitarium and general hospital in Palawan, Philippines, welcomes the potential breakthrough. “For the first time, the genome of the bacteria that cause leprosy has been identified and mapped.”

The IDRI-ALM study, he says, is a huge improvement over earlier studies, such as the research of Jacinto Convit, a Venezuelan doctor and scientist. Convit combined a bacterium found in armadillos and existing tuberculosis treatment to produce an experimental vaccine against leprosy. But up to now, scientists all over the globe are still trying to perfect a vaccine that can eradicate the disease.

Cunanan says, currently, the most important aspect of leprosy treatment is early diagnosis, when the patient has no disability yet.

“So if scientists can develop a vaccine that can prevent people from developing the disease, that will have a great impact in overcoming the disability and its social stigma,” he notes.

The Guardian

Urging pregnant women to get a pertussis vaccination with each pregnancy

Wednesday, June 18th, 2014 (last updated)

Rady Children’s Hospital

This is how the anti-vaccine campaign sounds

Tuesday, June 17th, 2014 (last updated)

facts about water


Prevention first: vaccination at the heart of public health

Monday, June 16th, 2014 (last updated)

Vaccines Europe calls for EU leadership to develop a comprehensive EU vaccination strategy aimed to support Member States in implementing effective national immunization programmes by:

  1. Implementing a holistic EU approach to prevention
  2. Accelerating citizen access to innovative vaccines
  3. Enhancing EU citizens’ protection against preventable diseases
  4. Supporting a stronger European center for disease prevention and control
  5. Building effective communications strategies and stakeholder engagement.

prevention first Click here

Vaccines Europe

An HIV vaccine: the world’s best long-term hope for ending AIDS

Sunday, June 15th, 2014 (last updated)

The HIV Vaccine Trials Network (HVTN) is the world’s largest publicly funded multi-disciplinary international collaboration facilitating the development of vaccines to prevent HIV/AIDS. The HVTN conducts all phases of clinical trials, from evaluating experimental vaccines for safety and immunogenicity to testing vaccine efficacy.

HIV vaccine trials network

Over the past decade, the HVTN has aimed to improve the process of designing, implementing, and analyzing vaccine trials. Several major achievements include streamlining protocol development while maintaining input from diverse stakeholders, establishing a laboratory program with standardized assays and systems allowing for reliable assessments across trials, setting statistical standards for the field, and actively engaging with site communities. These achievements have allowed the HVTN to conduct over 50 clinical trials and make numerous scientific contributions to the field.

The Network’s Clinical Research Sites are located at leading research institutions in over 30 cities on five continents. Internationally renowned researchers in HIV vaccines and prevention lead these units and contribute to the Network’s scientific agenda. The Network’s headquarters are at the Fred Hutchinson Cancer Research Center in Seattle, Washington.

Here you find more info on HVTN:

HIV Vaccine Trials Network

CDC updates polio vaccination guidelines for travelers to infected countries

Saturday, June 14th, 2014 (last updated)

CDC 2014

The CDC recently issued a health advisory, recommending an inactivated poliovirus booster for adult travelers to countries with active wild poliovirus circulation.

US health officials are trying to align their vaccination recommendations with those of WHO, which declared the international spread of polio to be a public health emergency of international concern on May 5. WHO issued vaccination requirements to residents and long-term visitors to countries with active polio transmission to curtail the spread of the disease. The onus is now on these countries, which are bound by the International Health Regulations, to comply with WHO vaccination requirements.

The US government is not expected to issue any requirements for entry into the United States, according to the CDC.

In the advisory, the CDC urged clinicians to be aware of possible new polio vaccination requirements for patients who intend to travel for more than 4 weeks to countries affected by the disease. These countries include Cameroon, Pakistan and the Syrian Arab Republic, which have exported wild poliovirus (WPV) and must ensure polio boosters 4 to 52 weeks before travel in all departing residents and long-term travelers of more than 4 weeks. An additional seven countries that are infected with WPV but have not exported the disease — Afghanistan, Equatorial Guinea, Ethiopia, Iraq, Israel, Somalia and Nigeria — are encouraged to ensure polio vaccination boosters among residents and long-term travelers.

These vaccination requirements are temporary, and WHO will re-evaluate its position in about 3 months. However, US health officials are unsure how or if these countries will comply.

The CDC recommends that any US citizen who travels to infected countries should have receipt of their booster dose documented in their yellow International Certificate of Vaccination to avoid travel delays.

From January to April 2014 — considered the low season for polio transmission — new cases were still reported in Asia, the Middle East and central Africa. The high-risk transmission season has already begun. If left unchecked, the disease could “multiply considerably,” according to the CDC.

“The consequences of further international spread are particularly acute today given that several countries with complex humanitarian emergencies or other major challenges are bordering the infected countries,” the advisory stated.

CDC guidance on polio vaccination for travel can be found here.

Healio Infectious Disease News

Paul Offit at “The Daily Show”

Friday, June 13th, 2014 (last updated)

Is there a cure to the vaccination denial?

New Scientist

Scientists create cancer vaccine from liver cells

Thursday, June 12th, 2014 (last updated)

liver cells

Tweaking a protein expressed by most liver cancer cells has enabled Georgia Regents University scientists to make a vaccine that is exceedingly effective at preventing the disease in mice.

Alpha-Fetoprotein, or AFP – normally expressed during development and by liver cancer cells as well – has escaped attack in previous vaccine iterations because the body recognizes it as “self,” said Dr. Yukai He, immunologist at the Medical College of Georgia and Georgia Regents University Cancer Center.

Liver cancer is among the fastest-growing and deadliest cancers in the United States with a 17 percent three-year survival rate. Vaccines help direct the immune system to attack invaders by showing it a representative substance, called an antigen, that the body will recognize as foreign, in this case, AFP for liver cancer.

In a process called antigen engineering, He tweaked AFP just enough to get the immune system to recognize it but still keep the AFP expressed by liver cancer cells in the bull’s eye, he and his colleagues report in the journal Hepatology.

AFP is expressed by about 80 percent of most common liver cancer cells but not typically by healthy adults. For cancer to flourish, cells must revert to an immature state, called dedifferentiation, which is why liver cancer cells express a protein during development and why the immune system can recognize AFP as “self.”

He’s modified AFP was delivered in a vehicle with a proven record for getting into cells. The lentivector is the backbone of the human immunodeficiency virus, or HIV, minus most of its genes. It is particularly good at targeting dendritic cells, whose job is to show the immune system antigens then activate T cells to attack.

In a proven model where mice are exposed to chemicals known to induce liver cancer, the vaccine blocked cancer about 90 percent of the time. Mice receiving the vaccine had more T cells generally and more that targeted AFP, which could keep an eye out for re-emerging liver cancer.

Recurring tumor cells is an unfortunately realistic scenario for liver cancer patients, who have a 70 percent recurrence rate in five years, He said. Patients typically have surgery to remove the diseased portion of the liver, but there are currently no effective adjuvant therapies, such as chemotherapy, to reduce recurrence, he said.

Ideally, some version of his vaccine will one day provide that key missing piece and dramatically improve patient survival, He said. Similarly, the approach might also work to prevent the disease in high-risk populations. He has not yet looked at whether the vaccine could be a first-line treatment.

He recently received a $1.6 million grant from the National Cancer Institute that will continue to move the mouse studies toward human application. “Now that we know it works in mice, we have to make sure it works in people,” He said, noting that many promising cancer vaccines have not worked well in humans.

The new studies include taking the blood of healthy individuals and removing monocytes, which are plentiful white blood cells that can become dendritic cells. They’ll coax dendritic cells to develop, give them the vaccine, then give the armed dendritic cells back to mice to see if they will produce AFP-focused T cells.

Next steps also include developing a virus-like particle, which retains the efficiency of lentivector without the safety concerns of the HIV-derived delivery system and can be easily reproduced in a factory. These protein-based delivery systems are utilized by a number of vaccines already used in humans. He and his team also are working on a receptor ligand that would cause AFP to draw even more attention from dendritic cells.

He is betting that a safer delivery vehicle and ligand packaged with his antigen in a so-called “tripartite” vaccine will be a powerful package.

Carcinogen- and hepatitis B-induced liver cancer models are being used for the studies.

While hepatitis vaccines have reduced liver cancer rates in most other countries, unprecedented rates of obesity and diabetes are accelerating rates in this country, He said. Much like chronic hepatitis infections and carcinogens, diabetes and obesity both produce chronic inflammation, a major risk for liver cancer. Both conditions also dramatically increase the workload of the large organ, which has a big role in metabolism, by generating more fat and glucose that needs handling.

The U.S. Food and Drug Administration has approved two vaccines classified as cancer preventers: the hepatitis B virus vaccine and vaccines against human papillomavirus types 16 and 18 that cause most cervical cancer. A variety of cancer treatment vaccines, such as the one He is working on, are under development. The FDA has approved one cancer treatment vaccine for some cases of metastatic prostate cancer, according to the NCI.


On correlation, causation and the “real” cause of autism

Wednesday, June 11th, 2014 (last updated)

Vaccines have been shown time and time again to be a safe, simple and effective way to save lives. So educate yourself and learn the difference between correlation and causationVaccines have been shown time and time again to be a safe, simple and effective way to save lives. So educate yourself and learn the difference between correlation and causation


Here for spreading far and wide is a graphical reminder of the important distinction between correlation and causation.

Redditor Jasonp55 writes that he was practicing Graph Pad when he produced the chart above and discovered the “real” cause of autism: organic food.

His tongue is obviously planted firmly in his cheek here, but the chart is nonetheless a simple and compelling example of how susceptible we can be to logical fallacies, cognitive biases, and extracting what we believe to be meaningful information from insignificant or coincidental data. As Cory Doctorow notes over at Boing Boing, “this a potentially useful chart for discussing this issue with friends who won’t vaccinate themselves and their kids.”