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 mortality 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
On Wednesday, January 11, 2012, Peter J. Hotez, MD, PhD, gave the Maurice Hilleman Pediatric Grand Rounds lecture at The Children’s Hospital of Philadelphia/University of Pennsylvania. Hotez is an internationally recognized expert on tropical diseases and vaccine development and holds the following positions: Professor of Pediatrics and Molecular Virology & Microbiology and Chief of the Section of Pediatric Tropical Medicine at Baylor College of Medicine; Endowed Chair of Tropical Pediatrics at Texas Children’s Hospital; and President, Sabin Vaccine Institute. 
Many medications that are essential for the health of children were first developed to treat adults and only later tested on children. Adults tend to have more illnesses than children, which may provide more testing opportunities. Many researchers feel that it is ethically preferable to try new medicines for children only when they already have a record of safety in adults. For vaccinations, the process is often reversed because adults are not prone to acquiring certain infections (e.g., Haemophilus influenzae type b [Hib]) or because vaccinating children is likely to have benefits both in childhood and later in adulthood (e.g., the varicella vaccine protects children from varicella disease, which in turn protects them from varicella zoster, or shingles, as adults). The history of pneumococcal vaccine is different and points out some of the different challenges of preventing disease in adults versus children. A well-tolerated and safe polysaccharide vaccine [PPSV] for adults has been around for three decades. This vaccine was not useful in very young children because they have inadequate production of antibodies to polysaccharide antigens and hence are unprotected when given PPSV. (See this 
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. 
Nearly a year ago, the History of Vaccines blog covered the introduction of 
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 
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. 
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.”