vaccines
revere | August 2, 2008A new article in the British scientific journal, The Lancet, suggests that seasonal influenza vaccines may not be effective in preventing community acquired pneumonia in people 65 years old and older. This is the group specially targeted by CDC for vaccination each year and, not coincidentally, an age group that includes me. So I have both a scientific and personal interest in the subject. This isn't new news. We've previously discussed the evidence that shows seasonal vaccines are less effective in the elderly a number of times (see here and here) over the last few years, but the proposition…
revere | July 24, 2008The headline said, "Vaccination plan puts health care workers first," but you had to read the article to find out who goes next: the military. This according to the Guidance on allocating and targeting pandemic influenza vaccine released yesterday by the US Department of Health and Human Services (DHHS). The guidance is premised on the assumption that in the early phases of a pandemic, any vaccine will be in short supply and will need to be rationed. The document gives "strong advice" on how DHHS thinks this rationing should take place, although much is left unexplained. Since the allocation…
revere | June 30, 2008We started blogging on public health at the beginning of the 2004 - 2005 flu season, although we didn't concentrate on flu immediately. We intended to use the public health problem of influenza, a disease that contributes to the death of almost 40,000 US citizens a year, as a lens through which to look at public health. The interest in bird flu and pandemic flu followed naturally. The intervening years saw seasonal influenza outbreaks that were milder than previous years, but this resourceful virus made a comeback in the flu season just concluded. CDC has just summarized the 2007 - 2008 flu…
revere | June 23, 2008There is a great deal of activity on the bird flu vaccine front. Several different new techniques to make vaccines are being tested and so are additives to vaccines, called adjuvants, that boost the ability of the preparation to induce the body to make sufficient antibodies to protect us against infection. The smaller the dose needed for protection, the more people can be vaccinated for a given amount of production. Since we are talking about enough productive capacity to vaccinate a significant proportion of the world's population in the event of a catastrophic pandemic, this is obviously a…
revere | June 17, 2008Since we don't do much health services posting around here I sometimes forget how terrific the blog Health Care Renewal is. It's always interesting. Sometimes it brushes against things we are concerned about here and last week there was a post with some good links about GlaxoSmithKline, a Big Pharma company active in influenza antivirals (Relenza) and pandemic vaccines. The companies of Big Pharma represent some of the most profitable on earth, making so much money that normal rates of profit, like what you might get from defense contracting, are considered failure. They justify their obscene…
revere | May 8, 2008We seem to be doing a lot of vaccination stuff here lately. It's an obvious public health topic, one that's in the news and (in some quarters) considered controversial. I'm a strong proponent of vaccination where it makes sense (which is in most of the instances where it is used) but that doesn't mean I think it is problem free. For a public health scientist the problems are not only interesting but of practical import. Yesterday's post about fainting during vaccinations produced an unexpected comment thread from people who have at one time or another fainted during a vaccination or medical…
revere | May 7, 2008Vaccination against most childhood diseases is important for the overall health of the community. I've said that many times here and most recently, along with my Sciblings, bemoaned an increasing trend to refusing vaccination. The health related reasons for refusing to be vaccinated are largely based on false information, but that doesn't mean that when millions of people are being vaccinated something untoward doesn't happen. Usually what happens is innocuous and self-limiting. The person (often an adolescent) faints. We don't know how often that happens, but a recent effort by CDC has tried…
revere | May 3, 2008In other parts of the world measles is a major killer of children and infants. In my own youth measles was a very troublesome childhood disease that was a major cause of morbidity in the US, with 3 to 4 million cases a year. One in 250 died, almost 50,000 a year were hospitalized and 1000 were left with long term disability. Then, in 1963, measles vaccination was introduced. Since 1997 there have been less than 150 cases a year, mostly less than 100.
Except this year:
However, during January 1--April 25, 2008, a total of 64 confirmed measles cases were preliminarily reported to CDC, the most…
hrynyshyn | April 23, 2008Defenders of science and reason everywhere are shocked and appalled that Obama and Clinton have bought into the bogus notion that the science on autism and vaccines is "inconclusive." As plenty of other SciBlings have pointed out, the science is most definitely not inconclusive. (Aetiology Tara's take is straight to the point, but see also Orac and PZ.) There is no link between the two. So now all three presidential contenders have joined the ranks of the irrational fear-mongers. Or have they?
The story that added the two Democrats to the list came from the Washington Post's Fact Checker…
revere | April 15, 2008I haven't posted on the vaccine/autism question for several reasons. It is quite well covered by other science bloggers, it tends to generate more heat than light, and we didn't have anything new to say. I have on several occasions discussed it with two of the world's top experts on the health effects of mercury and one of the world's top autism experts. None of the three felt there was a vaccine-mercury connection to autism. But news that the US government was going to include vaccine critics in shaping national vaccine policy made me change my mind about posting. I won't be addressing the…
revere | April 12, 2008If you want to know the single most important class of public health interventions with respect to infectious diseases in the 20th century it wasn't vaccines but provision of clean water and food supplies. But vaccines may be next. With major waterborne diseases like typhoid and cholera under control, the next big category of infectious diseases was the major childhood ailments: measles, German measles (aka rubella), mumps, chickenpox, polio, diphtheria, whooping cough. Some were just memories by the time I came along (diphtheria, pertussis), one was conquered in my younger years, the others…
revere | March 25, 2008We've covered the Indonesian refusal to cooperate with international influenza surveillance system to a fare thee well (see posts posts here, here, here, here, here, here, here, here, here, here, here, here, here and links therein), so this is just an update with some additional observations how Indonesia's deplorable behavior isn't that different than the US's deplorable behavior in the Middle East. First, Indonesia. When last we checked in Indonesia had sent off half a dozen flu specimens from the period after the end of January 2007 when it started its boycott. The hope was that the…
revere | March 23, 2008My children are no longer young. In fact they are old enough to have children of their own and when my daughter asked me if I thought her then 6 month old should get a flu shot I didn't hesitate: Absolutely, I said. And he did. Two of them, the required number. That was just before the flu season, which he has so far weathered just fine. Sadly that's not true for all children. The two most vulnerable groups for dying from influenza are children under 5 and the elderly (me). I got flu shots, too, although the evidence it will help me is not as good as the evidence my little grandson will be…
revere | March 21, 2008While we are all waiting for the other shoe to drop and a nasty, rip roaring flu pandemic to come rushing down the tracks at us, lots of companies have jumped into the pandemic vaccine sweepstakes. Reuters reports that at least 16 companies are testing flu vaccines and probably even more are involved in some technical aspect of vaccine production. That's good, although whether it will make any significant difference except around the margins remains to be seen. Timing is everything.
Meanwhile, though, work is going forward on many vaccine fronts. The one to hit the PR wires today is a report…
revere | March 16, 2008The headline seemed to say it all: "Funding Issues Stymie Pandemic Preparation." Right, I thought. All the money is going in to procurement, too little into shoring up a failing public health system. Little did I know:
The fear of bioterrorism and avian flu are driving a healthy new interest by biotech firms in developing products in the field of infectious diseases. "Even though we were developing a smallpox vaccine in 2000, there is no doubt that 9/11 was the moment that biodefense suddenly came up the funding ladder in the U.S.," said Clement Lewin, Ph.D., vp of marketing policy and…
revere | March 11, 2008Here's what a flu pandemic might look like:
"In four weeks, we went from a ho-hum flu season to ridiculous overcrowding," said Dr. Maurice Ramirez, an emergency physician who works in several institutions in north Florida. "We have had so many people that we have them, not in beds in the hallway, but in chairs with a number taped to the wall over their heads."
"We've seen a tremendous amount of flu--from an anecdotal standpoint, a much busier season than in recent years," agreed Dr. Peter A. Lipson, a private practice internist in southern Michigan who also sees patients at a walk-in clinic.…
scientificactivist | March 3, 2008Via the ABC News blog Political Punch comes news that senator and Republican presidential candidate John McCain has taken a strong stance on the discredited link between vaccination and autism... a stance contrary to scientific consensus. Here's what Jake Tapper wrote:
At a town hall meeting Friday in Texas, Sen. John McCain, R-Ariz., declared that "there's strong evidence" that thimerosal, a mercury-based preservative that was once in many childhood vaccines, is responsible for the increased diagnoses of autism in the U.S. -- a position in stark contrast with the view of the medical…
revere | March 2, 2008The Indonesian virus sharing impasse is said to be over, and with the dénouement comes some fascinating new information. Many will remember the row started when an Australian vaccine maker took an Indonesian viral isolate and made an experimental vaccine from it (see many posts among those here). At the time it was said the Indonesian Health Minister objected that her country would never be able to afford the vaccine and she therefore stopped making the virus available to WHO. WHO was the source of the seed strain used by the Australian company to make a prototype vaccine.
It turns out,…
revere | February 25, 2008The simultaneous news of widespread flu and the mismatch of two components of this year's seasonal vaccine (see here and here) seem to have synergized. That's not so good in the view of many flu experts, who believe (correctly) that it leads to a misunderstanding of how the vaccine works (or doesn't):
Flu experts and public health officials don't like it when the strains in the flu vaccine aren't an optimal match to the circulating viruses. They know elevated rates of sickness and influenza-related deaths may result.
But they dislike the headlines almost as much, fearing the black-and-white…
revere | February 23, 2008Indonesia is providing bird flu specimens to WHO again. And Indonesian Health Minister Dr Siti Fadilah Supari has just published a book declaring the 50 year plus history of global influenza surveillance is part of a conspiracy by the developed world to control the rest of the world:
"Developed countries become richer because they have the capability to develop the vaccine and control the world," she writes.
Dr Supari also expresses alarm at WHO laboratories sharing bird flu virus data with the United States National Laboratory in Los Alamos, New Mexico, where nuclear weapons are developed.
"…