The History of Vaccines Blog

U.S. Cell Line Facility to Produce Pandemic Influenza Vaccine

Influenza virion, CDC/Cynthia Goldsmith A Novartis Vaccines and Diagnostics, Inc., manufacturing facility in North Carolina has geared up to produce pandemic influenza vaccine made from mammalian cell lines, rather than from the traditional hen egg-based methods that have been used for more than 50 years. The plant, open since November 2009, was dedicated in a December 12 ceremony after Novartis submitted a Biological License Application for the vaccine to the U.S. Food and Drug Administration. The cell-based system and production methods are similar to those that have been licensed and used for seasonal influenza vaccine in Europe since 2007. More

Spanish Influenza Pandemic and Vaccines

Courtesy U.S. Naval Historical Center It’s National Influenza Vaccination Week, and we’re taking a look back to 1918, the time of the “Spanish” influenza pandemic. When the illness emerged, several useful vaccines had already been developed: smallpox, typhoid fever, and rabies, for example. Scientists and physicians tried many different approaches to develop influenza vaccines during the pandemic even though the cause of influenza was not clear. We look at several of them below.

No other epidemic has claimed as many lives as the Spanish influenza epidemic in 1918-1919. Worldwide, at least 40 million people died as this virulent illness swept through city after city (some estimates put total deaths closer to 70 million). Newspaper reports described people dying within hours of first feeling ill. The case fatality rate was highest among adults under age 50, who were, for unknown reasons, particularly vulnerable to serious disease resulting from this strain of influenza.

The first reported cases of an unusual influenza appeared in U.S. Army camps in Kansas in early spring 1918. Later that spring, officials reported large numbers of cases from Europe, though this flu did not seem particularly dangerous. However, influenza became more deadly in late summer. Soon waves of infection moved through towns, nations, and continents, overwhelming hospitals and medical personnel. Because of wartime censorship, reports of influenza were not widely distributed, but news from Spain continued to flow. The name Spanish influenza came from the devastating effects of the flu in Spain in autumn 1918. More

Meningococcal Vaccine Use Expanding in Africa

Emergency mass vaccination campaigns are difficult to implement quickly and effectively. Photo credit: Monique Berlier/PATH. Nearly a year ago, the History of Vaccines blog covered the introduction of MenAfriVac (PsA-TT) 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. MenAfriVac, a vaccine against the Group A type of meningococci bacteria that causes 80 to 85% of meningitis cases in the African epidemics, was the result of a collaboration between the World Health Organization (WHO) and PATH. The first vaccine developed specifically for use in Africa, it was introduced last year in Burkina Faso, Mali, and Niger, with almost 20 million people aged 1 to 29 (the age range most at risk) being vaccinated.

In June, the History of Vaccines blog reported that all three countries were reporting record lows in confirmed Group A meningitis cases during an epidemic season. Now the vaccine is being introduced to three more African countries: Cameroon, Chad, and Nigeria. More

Plotkin on CSPAN

Rubella vaccine developer and History of Vaccines advisor Stanley A. Plotkin, MD, appeared on CSPAN's Washington Journal on Thursday, 11/3/2011, to discuss the history of vaccination and the government's role in regulating vaccines. Dr. Plotkin described the long history of vaccination (and early immunization practices) in colonial America and United States, beginning with smallpox variolation. A number of callers then phoned in with questions about vaccine safety, how vaccines are tested, and whether Andrew Wakefield's work attempting to link MMR vaccination to autism has been vindicated. He also countered one caller's claim that new childhood vaccines are not tested as part of the complete immunization schedule by describing concomitant use studies that ensure that safety and immunogenicity are not compromised with the addition of new vaccines. More

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Plotkin on CSPAN's Washington Journal 11/3

Stanley A. Plotkin, 1970s Stanley A. Plotkin, MD, vaccine developer and History of Vaccines advisor, will appear Thursday, 11/3, on C-SPAN's Washington Journal around 9:15 am EDT. Dr. Plotkin will be discussing the history of vaccination and the role of the governement in supporting research and regulating vaccine production. You can watch live on C-SPAN, or live online at This is a call-in program, so please phone in to ask Dr. Plotkin questions about the history of vaccines. The program will be archived at the Washington Journal website, so if you miss the live show, you'll be able to view it later. More

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ACIP Votes to Recommend Routine HPV Vaccination for Boys

The human papillomavirus (HPV) vaccine has been recommended as part of the routine vaccination schedule for girls aged 11-12 since 2006 for the prevention of cervical cancer. In 2009, the FDA licensed the vaccine for use in males aged 9-26 years for the prevention of genital warts caused by two types of HPV, but the vaccine was not yet recommended for boys as part of the routine immunization schedule.

Meeting today at the Centers for Disease Control and Prevention in Atlanta, the Advisory Committee on Immunization Practices voted to recommend routine immunization against HPV for boys at age 11-12. ACIP members, experts selected by the Secretary of the United States Department of Health and Human Services, develop the recommendations that are used in the U.S. Recommended Childhood, Adolescent and Adult Immunization Schedules. More

Paul Offit at the Philadelphia Neurological Society

Paul A. Offit, MD On October 12, the Philadelphia Neurological Society held one of its regular meetings at The College of Physicians of Philadelphia and invited Paul A. Offit, MD, to speak to the membership. Offit, chief of infectious diseases at The Children’s Hospital of Philadelphia (CHOP), vaccine developer, and advisor to The History of Vaccines, greeted the membership with his first slide and title of his talk: “Why are neurologists scared of vaccines?”  Though Offit’s title was tongue-in-cheek, it spoke to a tension he has perceived between neurology and vaccinology. More

Increase in HPV Related Throat Cancers Reported

HPV-16 L1 Virus-Like-Particles. Photo credit: John T. Schiller, Ph.D., Center for Cancer Research. A study published in the October 3, 2011, issue of the Journal of Clinical Oncology reveals a startling rise in the rate of head and neck cancers related to human papillomavirus (HPV). The study looked at specimens from 271 throat cancers (specifically  oropharyngeal squamous cell carcinomas, or OPSCC) collected over 20 years. The researchers found that HPV prevalence in the cancers increased from 16.3% during 1984 to 1989 to 71.7% during 2000 to 2004. They note that “The overall rise in OPSCC incidence during 1984 to 2004 is largely explained by the increasing incidence of HPV-positive cancers, whereas incidence of HPV-negative cancers declined.” The decline in non-HPV related oropharyngeal cancers, which are usually related to tobacco or alcohol use, is likely a result of lower tobacco exposure. The HPV-related cancers, as opposed to the non-HPV-related cancers, were more likely to occur in younger, male, and white individuals. The authors speculate that the increased incidence “perhaps arises from increased oral sex and oral HPV exposure over calendar time.” More

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World Rabies Day: Rabies Vaccines

Semple Rabies Vaccine, The College of Physicians of Philadelphia In honor of World Rabies Day, we’d like to draw attention to two rabies vaccines recently found in the collection of the Mütter Museum of The College of Physicians of Philadelphia. Museum curator Anna Dhody recently alerted us to a box of vaccines and other medical supplies she found in a little-visited storage area in the museum basement. The box belonged to a collection of medical equipment donated by James G. Kitchen II, MD (d. 1998), who was a Pocono Lake, Pennsylvania, physician and fellow of The College of Physicians of Philadelphia. Dr. Kitchen stocked the vaccine in his office supplies to address what was probably a fairly uncommon need in his practice: post-exposure rabies prophylaxis in humans. More

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An Infectious Diseases Doctor Views Contagion

1918 Influenza Scrapbook, The College of Physicians of Philadelphia Going to the movies is a time-honored way of getting away from the vagaries of work and home life and inhabiting a different and exotic place. I don’t know if car mechanics can really enjoy chase movies or cowboys can appreciate Westerns, but as a specialist in Infectious Diseases, I rarely get a chance to see someone plying my trade inside the multiplex. There are spoilers ahead, so read on cautiously if you have not yet seen Contagion and plan to go.

The new Steven Soderbergh movie, Contagion, is a fairly realistic guesstimate of what might happen if a highly contagious, new infectious agent started moving around the world and destroying people willy nilly like a marauding tornado. While there has never been an infection quite like “MEV-1” as depicted in Contagion, the question of how we would respond as a medical community and as a society is a worthy one to address. Whether the answer is right or wrong – well, let’s hope we never find out.

From an Infectious Diseases angle, the infection in Contagion is crafted to be highly transmissible and fatal. This would be like a hybrid of the 1918-1919 pandemic flu, Nipah virus and SARS. The end of the movie shows the mechanism via which MEV-1 began to infect humans, and it is highly reminiscent of Nipah and SARS. Thus has some built-in credibility as it builds on diseases that we already understand. It is also eerily reminiscent of the most recent big flu outbreak (A/California/2009 H1N1) where the virus contained elements that came from birds, pigs and people. The rapidity of spread lends the movie much of its terror, but is not far off the rapidity of spread of influenza. Similarly, the incubation period and time to death is also reminiscent of the 1918-1919 pandemic flu. So the film-makers have done their homework and created a plausible disaster scenario. More

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