The History of Vaccines Blog

Dateline: Edinburgh, 1802

Pox and the City. Courtesy Lisa Rosner We were pleased to see Lisa Rosner, PhD, in the Historical Medical Library here at The College of Physicians of Philadelphia the other day. Rosner, who is professor of history at Stockton College as well as an advisor to History of Vaccines, is the recipient of an NEH grant in the digital humanities to develop a role-playing game about early smallpox vaccination in Scotland. She was in the library finding great materials for the game, and we’re looking forward to playing it and promoting it when it’s completed. Keep an eye on her blog to read about the progress her team is making on the game. You can also follow her on Twitter to enjoy her musings on the history of medicine and her book The Anatomy Murders. The post below is reproduced from her blog with her permission.

Imagine a world in which there are no antibiotics, no routine medical checkups, no blood tests, and no sterile surgery. Imagine a world in which people are surrounded by deadly microbes, with no way to hold them in check. And now imagine that there exists one, and only one, proven vaccine: the vaccine for smallpox. The trouble is, that vaccine is very new and largely untested.

Now imagine that you live in Edinburgh in 1802. A young doctor in the city, Alexander Robertson, is trying to set up a vaccination dispensary, to protect people from the deadly smallpox virus while establish a paying medical practice. More

Rukhsar's Story: A Little Girl with the Last Case of Polio in India?

Rukhsar Khatoon was diagnosed with the last confirmed case of polio in India on 1/13/11, pictured here with her mother We are looking for Rukhsar Khatoon, the young girl with the last reported case of wild poliovirus in India, when we set out for Shahpara village, near Kolkata in the Indian State of West Bengal. It had already been a long day of monitoring a polio immunization campaign and as we walk on, we see groups of vaccinators, lugging “vaccine carriers” and notebooks, headed back to the health center where they started the day’s activities.

Rukhsar, the focus of our search, was just 18 months old when she was paralyzed by polio in January 2011. Although her two siblings received polio vaccinations, Rukhsar was often sick with diarrhea and despite encouragement from local health workers her parents had thought it was safer for her to avoid the vaccine.

We find Rukhsar’s father on the broad, cobbled path that runs through the heart of the village and he leads us to his home. He, like most others in Shahpara, is an embroidery worker who spends long hours creating intricate designs with colorful thread and beads, the famous zardozi work that adorns beautiful clothing worn throughout the country. More

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Hotez at CHOP on Neglected Tropical Diseases

Ascaris lumbricoides, CDC/James Gathany 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. More

Approval of Conjugate Pneumococcal Vaccine for Adults

Streptococcus pneumoniae, CDC, Janice Carr 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 video of vaccine developer John Robbins, MD, discussing why this is so.) However once the success of protein-conjugated polysaccharide vaccines was appreciated, a number of them were developed for young children. There are three successful conjugate vaccines for children: Hib, meningococcal, and pneumococcal. Hib vaccine is not needed for adults because of the negligible risk of this infection in adults. Conjugate meningococcal vaccine is standard for children and can also be used for adults who are at unusually high risk of meningococcal disease because of medical condition or travel to a part of world where meningococcal disease occurs in epidemics. Now, as of December 2011, a 13-valent pneumococcal conjugate vaccine [PCV-13] has been approved for use in adults. More

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 http://www.c-span.org/Series/Washington-Journal/. 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