History of Vaccines Blog
A recent paper published in Journal of Virology describes sporadic and sustained outbreaks of illness from vaccine-derived polioviruses in Nigeria. This study draws attention to what is often called the polio endgame – the vaccines and immunization activities that will be necessary to eradicate polio, given the ability of vaccine-derived viruses from the live polio vaccines to circulate and cause disease. To understand the complications of eradicating polio, it’s necessary to know that three types of wild poliovirus have been identified. Types 1 and 3 are responsible for all cases of wild polio in the remaining polio-endemic countries of Pakistan and Nigeria. (Very recent polio cases in Kenya and Somalia are due to Type 1 wild poliovirus.) Type 2 wild poliovirus has not been detected since 1999, when it was found in Uttar Pradesh, India. It is presumed to be eliminated.
May 3, 2013
Yesterday I spent some time working with students from nearby Science Learning Academy. We were testing a version of a medical history game in development by Lisa Rosner, PhD, and her colleagues at Richard Stockton College in New Jersey. It’s a bit of a challenge to transport 10th grade urban high school students to 19th century Edinburgh where the game is set. But the students were willing to make the leap, and they spent about an hour in the role of a young doctor who must build a practice, court wealthy patrons, gain entry to a medical society, and protect his patients from disease. The students initially didn’t know much about smallpox (though I did show them this illustration of the course of the disease in a young man in the 1880s). But they soon came to see the threat the disease posed: if they didn’t act quickly to vaccinate the other children in a family after one child became ill with smallpox, all the children died.
April 24, 2013
Day 2 of the National Foundation for Infectious Diseases Annual Conference on Vaccine Research included a focus on maternal immunization. Carol J. Baker, MD, of Baylor College of Medicine, opened the session (much to our pleasure!) with the history of evidence of the effectiveness of maternal immunization for preventing disease in newborns via passive transfer of antibodies via placenta or breastmilk. It’s generally accepted that this passive immunity, for some diseases, benefits the baby for about the first six months of life. We haven’t had a chance to look up her references, but she mentioned evidence from 1879 that showed vaccination with vaccinia prevented smallpox in infants, from 1938 showing that maternal immunization with whole-cell pertussis vaccine protected infants from pertussis complications, from 1961 showing vaccine-induced tetanus immunity transfer from mother to baby in New Guinea, and, finally, from 2011 leading to recommendation of pertussis-containing vaccine and influenza vaccine for pregnant women.
We’re spending National Infant Immunization Week in Baltimore at the National Foundation for Infectious Diseases Annual Conference on Vaccine Research. It’s three full days of sessions focused on research into existing and new vaccines, as well as research on epidemiologic and public health aspects of infectious diseases and vaccines. One of the main threads at the first day of the conference was disease eradication. DA Henderson, MD, opened the conference with a keynote address on the feat of smallpox eradication through vaccination. He highlighted the unique qualities of smallpox that made it an ideal candidate for eradication and compared some of these factors with parallel characteristics of polio. (Dr. Henderson discussed some of these characteristics in our interview with him.) In every category, polio is a more complicated disease
April 13, 2013
Hilary Koprowski, Fellow of The College of Physicians of Philadelphia and a member of the advisory board for The History of Vaccines, died on April 11, 2013. He was 96 years old. Born in Poland in 1915, Koprowski’s long tenure in vaccine research began in 1939 when he received an M.D. degree from the University of Warsaw. After moving to the United States, he developed the first live oral polio vaccine to be used in large-scale trials, administered to the first child in 1950.
On March 13, the Children’s Hospital of Philadelphia Vaccine Education Center sponsored a vaccine update webinar with Paul A. Offit, MD, as the speaker and moderator. Dr. Offit discussed vaccine-related items in the news as well as decisions taken at recent Advisory Committee on Immunization Practices (ACIP) meetings in Atlanta. First on the agenda was a discussion of pertussis vaccine, particularly as it relates to a February 7 letter to the New England Journal of Medicine in which researchers (Queenan, Cassidy, & Evangelista) called attention to new strains of Bordatella pertussis that the group had observed at St. Christopher’s Hospital in Philadelphia. Specifically, these strains were classified as pertactin-negative. Pertactin is a protein that is normally a component of B. pertussis, and it is one several antigenic proteins in acellular pertussis vaccines. The letter questioned whether the acellular vaccine was generating pressure on B. pertussis, thus leading to the emergence of these pertactin-negative strains.
March 11, 2013
Instead of a teething ring, I had a passport. Between a military father and diplomatic step-father, my family moved every year or two or three to exotic places, from Taiwan to the Philippines to Ecuador. Tucked into my passport was another essential travel document, the International Certificates of Vaccination issued by the federal government, a yellow-paper catalog of inoculations with separate pages for smallpox, yellow fever, and cholera. When traveling during the 1950s and 1960s, before computerized databases, immigration officials examined my passport in one hand, the dog-eared vaccination record in the other. Reviewing the vaccination record now, I still derive the same satisfaction that I experienced as a school kid in reading my vaccination history—which we kids called our “shot records”--as a chronology of health accomplishment, a medical report card. A visit to the doctor before taking a trip became so routine that I ceased to fear needle punctures. Rather, I looked forward to having the administering physician sign and return my vaccination record.
February 28, 2013
We at The College of Physicians of Philadelphia were honored to host Anne Schuchat, MD, Acting Director, CDC’s Center for Global Health, on February 26. 2013. Dr. Schuchat was here to accept—symbolically, because as a government employee, she was unable to receive the actual medal—the Jonathan E. Rhoads Medal. The College, the American Philosophical Society, and University of Pennsylvania’s Department of Surgery award this medal annually. Schuchat has worked for the CDC since 1988, when she was an Epidemic Intelligence Service officer. Her biography, which includes a description of her important work on preventing Group B streptococcal disease in newborns, can be found here.
February 27, 2013
Thanks to Joshua Prasad, MPH student at Drexel University School of Public Health, for putting together the information from the White House in an easy-to-read way. Most of you are probably following the news about the potential sequester that may begin on March 1. If US lawmakers can’t come to an agreement to avert the sequester, many federal agencies and programs will need to make across the board budget cuts of 10%. One area in which the cuts may be felt is seasonal influenza response and planning. Representative Henry Waxman summarized CDC Director Tom Friedan’s description of the effects of sequestration on CDC’s influenza immunization activities in the following way:
February 25, 2013
It is with great sadness that we learn of the death of our long-time Fellow and Presidential Advisor, C. Everett Koop, MD, ScD. Dr. Koop was more than a colleague: he was a mentor, advisor, and teacher, but most importantly, our brother and friend. His dedication to our profession and service to this College helped us all better understand what it means to be part of medicine. His compassion for his patients taught us how to be good and caring physicians.