The History of Vaccines Blog

A Physician's Duty: Serving in Pestilence and in War

Plaque at The College of Physicians of Philadelphia Today's blog post is by College Librarian Beth Lander, MLS. “To the memory of Fellows of The College who have fallen whilst in performance of duty during pestilence or war” begins a plaque hanging near our Historical Medical Library. The memorial not only offers a gentle reminder of the sacrifices made by physicians in the care of their patients, but also is a reminder of how closely mortality hovered prior to the age of vaccines. The summer of 1793 was unusually hot and dry. Wells and creeks were low, and the people of Philadelphia were plagued by flies and other pests. By mid-August, people in Philadelphia fell ill with symptoms similar to an outbreak of fever that Benjamin Rush, a founder of The College of Physicians of Philadelphia, had witnessed in 1762: “These patients were generally seized with rigors, which were succeeded with a violent fever and pains in the head and back. The pulse was full, and sometimes irregular. The eyes were inflamed, and had a yellow cast, and vomiting almost always attended. The third, fifth, and seventh days were mostly critical, and the disease generally terminated in one of them, in life or death. An eruption on the third or seventh day over the body, proved salutary. An excessive heat, and burning about the region of the liver, with cold extremities, portended death to be at hand” More

Barre-Sinoussi Speaks on Past, Future of HIV Epidemic

Francoise Barre-Sinoussi; courtesy Darien Sutton/The Wistar Institute In 1982, Françoise Barré-Sinoussi was a young researcher in Luc Montagnier’s lab at the Pasteur Institute, studying the control of retroviruses by their hosts. Late that year, a French virologist made an urgent request to her lab:  would they look for signs of retroviral infection in a group of patients with a troubling new disease? As she says in her 2008 Nobel Prize biographical sketch, “It would have been a relatively routine procedure to detect the presence of a retrovirus” in cells. That statement is excessively modest, because, in fact, the task was not easy and rested on decades of earlier work. One immediate problem was that the unidentified pathogen, obtained from a patient’s lymph node biopsy, threatened to outrun the cells in culture. But once she thought to add more lymphocytes to keep up with the infection cycle, Barré-Sinoussi wrote that “isolation, amplification and characterisation of the virus rapidly ensued, and the first report was published in Science in May 1983.” More

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Children, Conflict, and Polio

National Library of Medicine, 101579926. WWI Red Cross Nurse The sight of a red cross or crescent on a white background is supposed to signal medical aid, neutrality, and safety. In conflicts around the world, however, hostile actors are flouting decades of protocol and the Geneva convention itself: they are killing and kidnapping Red Cross, Red Crescent, and other emergency aid workers. Al Qaeda-associated militants kidnapped an International Committee of the Red Cross/Crescent (ICRC) team in Mali in February this year (military forces freed them about a week later). ICRC polio vaccination workers and staff were killed in Afghanistan in April 2014. Polio vaccinators and their guards have been killed in Pakistan and Nigeria as well. More

NFID Vaccine Research Conference: Challenges in Immunization Policy

Bordetella pertussis, CDC A Monday afternoon session at the National Foundation for Infectious Diseases Annual Conference on Vaccine Research was entitled “Current Challenges in Immunization Policy.” The topics ranged from vaccine hesitancy, effectiveness of acellular pertussis vaccine, and the burden of adverse events from rotavirus vaccination. Saad B. Omer, MBBS, MPH, PhD, of the Emory Vaccine Center, is widely published on vaccine refusal and its consequences in relation to disease. Most of the work he presented Monday explored the relationship between vaccine hesitancy and pertussis incidence.  More

Sixtieth Anniversary for Polio Pioneers

Card from the 1954 Salk vaccine trial, courtesy Marsha Drake Sixty years ago tomorrow the largest clinical trial in history began. On April 26, 1954, thousands of U.S. schoolchildren rolled up their sleeves to take Jonas Salk’s inactivated poliovirus vaccine. Newspapers reported that Randall Kerr of McClean, Virginia, was the first child in the trial to get the vaccine. (Thousands of others in earlier stages of research had received the vaccine, including Salk’s wife and children.) The 1954 trial was blinded, meaning that the children didn’t know whether they received the vaccine or a saline placebo injection. Regardless, most viewed themselves if not exactly as test subjects (which they certainly were) but as Polio Pioneers, as they and their parents were encouraged to think of them. More

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Children and Conflict: Fundraiser May 8

Disease and conflict are unfortunate companions. We’ve seen this recently in the Syrian Arab Republic, where polio has surfaced after violence uprooted millions of people. Other outcomes of conflict for children in Syria and elsewhere are hunger, displacement, interruption of education, and other harms. Please join us May 8 at The College of Physicians of Philadelphia to commemorate World Red Cross and Red Crescent Day. Christiaan Morrsink, PhD, director of the United Nations Association of Greater Philadelphia, will give an overview of conflicts around the world and their effect on children. Pavan Ganapathiraju, MPH, will discuss how the war is interrupting polio eradication efforts in Syria. World fusion artist Farah Siraj will perform, and Clara Barton, U.S. Civil War nurse and founder of the Red Cross, will appear.

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UN Meeting on Partnerships in the Vaccine Cold Chain

Discussants on the cold chain panel, 4/8/2014 Leaders and innovators in global health met yesterday at the United Nations to provide guidance about partnerships as the UN considers the next iteration of the Millennium Development Goals. This particular meeting was a side event, sponsored by the Institute for Strategic Threat Analysis and Response, to the UN Economic and Social Council’s two-day meetings on the role of partnerships. Many of the MDGs have been achieved as their 2015 target date approaches. Those successes, and failures, now must inform the setting of new goals, or, as the UN calls them, the Post-2015 Development Agenda. More

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New Review on Vaccine Hesitancy

BCG vaccination in Czechoslovakia, 1950s Heidi Larson’s group at the London School of Hygiene & Tropical Medicine just published a review in Vaccine that attempts to construct a descriptive model of parental vaccine hesitancy. They surveyed the literature on hesitancy from both developed and developing countries. They adopt the term vaccine hesitancy in part because it’s less polarizing than the term anti-vaccine. It describes a continuum of attitudes about vaccine but also a continuum of practices around vaccination, or, as they say, those “in the middle of a continuum of total acceptors to complete refusers.” It’s a relatively new concept; in fact, only six of the 1,164 articles included in the review employed the term vaccine hesitancy. More

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Death of Drexel Student Due to Neisseria meningitidis Serogroup B

A Drexel University undergraduate has died from an infection caused by Neisseria meningitidis. Stephanie Ross, a 19-year-old sophomore, was found unresponsive by housemates on Monday, March 10. She died later that day at Penn Presbyterian Medical Center in Philadelphia.Caroline Johnson, MD, of the Philadelphia Public Health Department was quoted as saying that Ross “…had an overwhelming bacterial…infection, and she went into shock, and she had symptoms of diffuse hemorrhaging.” Esther Chernak, MD, MPH, who is associate professor at Drexel University School of Public Health and a History of Vaccines advisor, noted that “the course of bloodstream infections with N. meningitidis (meningococcemia) is often rapid and fulminant, which is why this disease is among the most terrifying infections.” Ross’s housemates and other close contacts have been offered prophylactic antibiotics. More

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A Taxonomy of Vaccination Scars

Denarp Decanteleu JEB. The Historical Medical Library of The College of Physicians of Philadelphia. I’ve been corresponding with a reader who is interested in HA Martin’s On Animal Vaccination, an 1877 publication by the physician who is widely credited with introducing and producing non-humanized smallpox vaccine in the United States. Martin obtained vaccine from the famed Beaugency vaccine line, begun in the 1860s with naturally occurring cowpox in a French cow. The French Académie du Médicine cultivated the vaccine in serial transmission in cows and avoided harvesting any vaccine from humans. More