The History of Vaccines Blog

July 18: 90 Years of Tuberculosis Vaccination

National Library of Medicine July 18, 2011, marks an important anniversary in the history of infectious disease and vaccines—on July 18, 1921, the tuberculosis vaccine was first given to a human. The vaccine, developed by French scientists Albert Calmette and Camille Guérin, was an oral preparation of Bacillus Calmette-Guérin, or BCG in shorthand. BCG is a weakened form of a tuberculosis bacterium that causes the disease in cows. Benjamin Weill-Hall (1875-1958), French pediatrician and bacteriologist, fed the vaccine to infants in Paris who were at risk for the disease in this first use of the vaccine.

Albert Calmette (1863-1933) had acquired the Mycobacterium bovis strain of tuberculosis, which had been isolated from the milk of an infected cow, in 1904. In 1908, at the Institut Pasteur in Lille, France, he and veterinarian Jean-Marie Camille Guérin (1872-1961) began attenuating M. bovis by passing it through a growth medium they had developed specifically for this purpose. Their immediate goal was to weaken the bacteria to the point where they could no longer kill a guinea pig. In the end, the researchers hoped to produce an attenuated strain of the bacillus that would safely confer immunity to an uninfected human host. It would be 13 years before they saw the fruits of their efforts. More

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Research May Provide New Possibilities for Universal Influenza Vaccine

Influenza A virus, transmission electron microscopy, 31,710x. Copyright Dennis Kunkel Microscopy, Inc. Each year, researchers select three influenza strains to include in the seasonal flu vaccine. Because there are so many different strains of the influenza virus, and because it mutates so rapidly, this selection is always a guess—a highly educated one based on global surveillance data, but still a guess.

In some years, the selections turn out to be remarkably accurate. During the 2010-2011 flu season, for example, the three strains selected for the seasonal flu vaccine were a very good match to strains circulating in the wild. In other years, however, researchers haven’t been so lucky. And since immunity to one strain of the flu doesn’t necessarily provide protection against other strains, a poor match between the vaccine strains and the circulating ones may mean an ineffective flu vaccine.

Researchers have long hoped to develop a so-called “universal” flu vaccine: one that could provide protection against all, or at least most, of the many strains of influenza capable of making people sick. If such a vaccine could be developed, the need for a new seasonal shot every year could be a thing of the past. More

Pacific Health Summit: June 21-23

HOV at Pacific Health Summit Just a week after a June 13 summit at which public and private donors committed $4.3 billion to continue funding the GAVI Alliance’s efforts to immunize the world’s poorest children, another vaccines summit played out in Seattle. The Pacific Health Summit, a yearly conference examining a different global health issue, convened June 21-23 with the goal of connecting decision makers in science, industry, policy, and public health to improve health by combining the latest in scientific advances with industrial innovation and effective policy. Past topics have included multi-drug resistant tuberculosis, maternal and child health, malnutrition, and pandemic influenza. More

Meningococcal Vaccine Showing Early Promise in Africa

Scanning electron microscope image of Neisseria meningitidis, 3,750x. Copyright Dennis Kunkel Microscopy, Inc. Last December, the History of Vaccines blog covered the introduction of MenAfriVac to the African meningitis belt, an area stretching from Senegal to Ethiopia, where epidemic waves of meningitis occur and can last up to three years. In the largest of these epidemic waves in history, meningitis killed more than 25,000 people from 1996 to 1997.

Polysaccharide vaccines are sometimes used to try to control outbreaks after they have begun: so-called “emergency vaccination” efforts designed to keep meningococcal epidemics from spreading further. However, these types of reactive efforts are very expensive and difficult to manage, and polysaccharide vaccines do not induce long-lasting immunity against meningococcal bacteria. (For more about the different types of vaccines, see our article and Types of Vaccines activity.)

Within these African epidemics, between 80 and 85% of cases are caused by a single group of meningococcal bacteria: group A. In 2000, a group of global health leaders gathered together by the World Health Organization (WHO) determined that a meningitis vaccine could be developed specifically for use in Africa: a low-cost vaccine that would focus solely on the Group A bacteria. The Bill & Melinda Gates Foundation provided a ten-year grant for what would become the Meningitis Vaccine Project (MVP). More

Measles 2011

Distribution & origin of reported measles cases (N = 118), U.S., Jan 1-May 20, 2011, CDC It would be difficult not to notice the many reports of measles occurring in the United States this year. Between January 1 and May 20, 2011, the Centers for Disease Control and Prevention received reports of 118 cases of measles. Most of the cases (89%) were associated with importation of the infection from outside the United States.

We have to look back to 1996, before the elimination of measles in the United States, to find more measles cases in the same number of weeks. That year, the CDC recorded a total of 508 cases. The median number of U.S. measles cases in each of the past 10 years has been 56, so this year’s figures are already markedly higher.

The measles virus is extremely contagious: on average, 90% of those exposed to someone with the measles will get the disease themselves unless they’ve been vaccinated, or have had measles before. Combine that with international travel at unprecedented levels, measles outbreaks occurring all over the world, and pockets of unvaccinated individuals in the United States, and it’s not surprising that we’ve seen so many U.S. cases this year. More

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'No Bones About It' Features HoV Guest Speaker Michael Willrich

Michael Willrich addresses a crowd of about 100 at the College of Physicians. The latest episode of "No Bones About It," The College of Physicians of Philadelphia's popular YouTube series, features historian Michael Willrich. Willrich recently spoke at the College for a well-attended History of Vaccines event and discussed his most recent book, POX: An American History, which chronicles the smallpox outbreaks at the turn of the 20th century. Before the event, he sat down with Robert Hicks, director of the Mütter Museum and the College's Historical Medical Library, and the host of "No Bones About It." In this episode, Hicks and Willrich discuss compulsory vaccination, the intersection between civil liberties and public health, and the beginnings of the American anti-vaccination movements in the late 19th century. More

Just Posted: Interview with Paul Offit, MD

Paul Offit, MD, discussing rotavirus disease in a patient We recently interviewed Paul A. Offit, MD, about his experience developing a rotavirus vaccine. His vaccine, known generically as rotavirus oral vaccine (commercially as RotaTeq), has been part of the recommended childhood immunization schedule since 2006. In the interview, Offit discusses an experience with rotavirus disease as a young physician, working with Stanley Plotkin, MD (developer of the rubella vaccine), the long process of creating the rotavirus vaccine, and the relief and pride involved in receiving encouraging safety results from post-licensure monitoring. He also discusses, more generally, how a researcher goes about developing a new vaccine.

Click the picture to see one of the interview segments in The History of Vaccines Gallery. See the entire set of Offit interview segments by searching for “Offit” in The History of Vaccines search box and clicking the Media tab to access all six video clips.

Dr. Offit is Chief of the Division of Infectious Diseases at The Children’s Hospital of Philadelphia. More

POX: Michael Willrich in Philadelphia May 12

Join us for a fascinating evening of medical, social, and legal history on May 12 at 6:30 pm, when Michael Willrich, PhD, discusses his book POX: An American History (The Penguin Press),  which offers a gripping chronicle of how the nation's continent-wide fight against smallpox in the early 1900s launched one of the most important civil liberties struggles of the twentieth century. Willrich explores the intersection of public health initiatives and private medical decisions as well as the polarizing debate about the morality, ethics, safety, and effectiveness of vaccines. The measures enacted to contain the disease--- quarantines, pesthouses, and "virus squads"--- sparked a wave of popular resistance among Americans who perceived them as a threat to their health and to their rights. More

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National Infant Immunization Week: Spotlight on Measles

U.S. measles cases dropped rapidly after vaccine use became widespread in the 1960s. (Click for full size.) National Infant Immunization Week is April 23-30 this year. This week, the History of Vaccines blog features posts about several diseases that can be prevented by vaccination of infants.

Rubeola, or measles (as it's more commonly known) is an extremely contagious viral disease. It causes a distinctive rash, fever that can reach 104°F or higher, runny nose, and cough, and has many potential complications including ear infection (in about 10% of cases) and pneumonia (about 5% of cases). In about one in a thousand cases, the patient develops encephalitis, a swelling of the brain. About one out of every thousand patients will die.

The rubeola virus spreads easily and rapidly via coughs and sneezes, and remains active and infectious in the air for up to two hours. As a result, a person can become infected just by breathing the air in a room that was occupied by a measles patient as much as two hours earlier. There is no treatment for the disease, although supportive care may be provided, and efforts may be made to lower the patient's fever. More

National Infant Immunization Week: Spotlight on Rotavirus and Pertussis

Transmission electron micrograph of intact rotavirus particles. National Infant Immunization Week is April 23-30 this year. This week, the History of Vaccines blog features posts about several diseases that can be prevented by vaccination of infants.

Although its name is not as well known as those of diseases like chickenpox or measles, rotavirus is the most common cause of severe diarrhea in children and infants worldwide. Before a vaccine was introduced in the United States, the disease caused more than 400,000 doctor's visits and 200,000 emergency room visits each year, causing as many as 60 deaths annually in U.S. children younger than five.

The virus spreads easily among children, and can also be passed from children to those with whom they're in close contact. Rotavirus spreads via the fecal-oral route -- that is, from the waste of an infected person to the mouth of another individual. This can occur via contamination on hands or objects like toys.

Rotavirus can be prevented by vaccination. The first dose of the vaccine series is recommended at two months of age. More