History of Vaccines Blog
How far should state power extend into medical decisions that parents make on behalf of their children? What is a parent’s responsibility to children in the community who have particular susceptibility to harm from infectious diseases? These questions framed the discussion we had last week here at The College of Physicians of Philadelphia on pending legislation in Pennsylvania to eliminate personal belief exemptions to school vaccination requirements. Both the bill’s sponsor, Pennsylvania State Senator Daylin Leach (17th District) and Paul A. Offit, MD, argued that personal belief exemptions allow parents to shirk responsibility for keeping their communities safe and healthy. The Honorable James G. Colins, President Judge Emeritus, Commonwealth Court of Pennsylvania, introduced and moderated the event.
In late 2014, the US Food and Drug Administration approved a 9-valent human papillomavirus vaccine. In early 2015, the Advisory Committee on Immunization Practices made the recommendation that it be offered as one of the available HPV vaccines this country. The vaccine, made by Merck, is known commercially as Gardasil 9 and generically as Human Papillomavirus 9-valent Vaccine, Recombinant (9vHPV). This change in the vaccine will make HPV vaccination more broadly effective; 9vHPV protects against HPV strains that cause 90% of cervical cancers – as compared with the quadrivalent vaccine, whose two oncogenic strains account for approximately 68% of cervical cancers in the United States. Moreover, the new vaccine may provide protection to subgroups of women who are more vulnerable to HPV types not in the bivalent and quadrivalent vaccines.
April 30, 2015
The Pan-American Health Organization of the World Health Organization announced that endemic transmission of rubella in the Americas has ended and that the Americas are rubella-free. The announcement comes after years of surveillance to ensure that any new cases of rubella have resulting from importations from outside the Americas. This task was made more complex by the mild nature of rubella illness in nonpregnant individuals: it is easily mistaken for other illnesses. All suspect cases had to be ruled out, and all true cases of rubella had to be studied carefully to ensure that their origin was from outside the Americas. The last confirmed case of endemic transmission occurred in 2009 in Argentina.
April 23, 2015
Please join us on May 14, 2015, at 6:30 pm, when we'll be hosting a panel discussion on legislation pending in the Pennsylvania state legislature that would end philosophical/moral/personal belief exemptions to school vaccination requirements. In light of Pennsylvania's relatively low rate of measles, mumps, and rubella vaccination coverage (in 2013-2014, 85.3% of Pennsylvania kindergarteners had received both doses of MMR vaccines, as compared with the nation's median of 94.7%) and the 2014-15 measles outbreak related to exposures at Disneyland, this topic is very timely.
April 10, 2015
Sixty years ago, on April 12, 1955, in Ann Arbor, Michigan, the results of the largest clinical trial in history were announced. To the tremendous relief of a hopeful nation, Thomas Francis Jr., MD, revealed that the Salk inactivated poliomyelitis vaccine was “safe, effective, and potent” against paralytic polio. The trial had begun in April 1954 when the first of about 1.3 million first- , second-, and third-graders began their participation as vaccine recipients (about 422,000), placebo recipients (about 201,000), or observed control subjects (about 725,000) (see the official report on the trial for details on the study design). Injections, observations, and data collection continued through the spring, and then the information was handed over to Francis’s team for analysis.
March 19, 2015
Six cases of disease from serogroup B meningococcal bacteria have occurred at the University of Oregon; the latest case was confirmed just today. One student has died. The university has offered the newly licensed serogroup B meningococcal vaccines (Bexsero and Trumenba) to students; so far, about 9,000 students have received one dose of the vaccine. (Bexsero is a two-dose series and Trumenba is a three-dose series.) Students were offered the vaccine at clinics on campus, and standing orders at local pharmacies allow those at risk to get the vaccine. In most cases, student’s health insurance plans are covering the cost of the vaccine.
February 23, 2015
Please join us the evening of March 12, 2015, when writer Arthur Allen discusses the lives and work of Rudolf Weigl and Ludwik Fleck, two forgotten scientific heroes. Weigl and Fleck used their knowledge of typhus and vaccines in World War II Poland to save thousands of people and sabotage the Nazis. Allen will also discuss the philosophy of science that Fleck, a Jewish scholar and diagnostician, developed under almost impossibly difficult circumstances in the ghetto and concentration camps. Paul Offit, MD, vaccine developer and author of many books about vaccines, medicine, and social issues, will facilitate a discussion.
I’ve been getting calls from reporters and producers in record numbers in the past weeks as US measles cases have been increasing. I’ve talked to people from Bloomberg Politics, the San Jose Mercury News, CNN, the Baltimore Sun, Men’s Health, Chicago public radio station WBEZ, CBS Interactive, Canadian radio show Day 6, Sirius XM’s Doctor Radio, and a local Philadelphia TV station. The one interaction I’ve had that distressed me was with a local TV station. They asked me to appear on a news magazine segment to talk about measles history and the history of the anti-vaccination movement. A few other segments would air on the same show, one about health insurance enrollment and one about, of all things, sport betting.
January 27, 2015
I've been closely following, as I'm sure most of you have, the recent outbreaks of measles originating from exposures at Disneyland. I wrote about this the other day (and included some information about a lesser-known measles outbreak in a small South Dakota town). Since then, reported cases of measles have climbed. As of the writing of this post, 88 measles cases have been reported and linked directly or indirectly to the initial exposures at Disneyland. It's too soon to know the vaccination history of every person who has developed measles, but usually what we see in measles outbreaks is that the great majority of cases are completely unvaccinated. A smaller number will have had one vaccine (not the recommended two), and an even smaller number will have been fully vaccinated. This is no surprise: the measles vaccine is highly effective at preventing disease, but 2-5% of individuals vaccinated once do not respond to the vaccine. So, some vaccinated individuals will remain unprotected.
January 14, 2015
The CDC just announced its final 2014 measles case numbers. They have reported 644 cases for 2014, the highest number of measles cases in any year since measles was declared eliminated in 2000. The graph below shows measles cases since 2001 up to November 29, 2014. December ended with a bang: between December 15 and December 20, visitors to Disneyland in Anaheim, California, were exposed to measles courtesy of an as-yet-unidentified index case. Related measles cases have been reported in California (22 so far), Utah (2), Washington (1) and Colorado (1). From November 29 to December 31, a total of 31 measles cases were reported across the country.