Influenza

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. More

I take the influenza vaccine just about every year, and blogged about my reasons for doing so last year. But I was curious about my co-workers: we work in an organization whose mission is “to advance the cause of health and uphold the ideals and heritage of medicine.” Would they be more likely than the average American to take the vaccine? Or would we look roughly like the American population, of whom about 58% pass up the vaccine? I managed to talk to just about everyone here who works directly for the College in a full-time capacity. I told people that they were not obligated to answer my question (one person declined to participate). In response to “Did you get a flu shot this year?” 13 people responded that they had, and 17 people said that they hadn’t. So, here at the College we have about 43% uptake of the vaccine, on par with the national 42%. I was surprised. More

Every year, beginning in early fall, public health messages go out to the American public encouraging influenza immunizations. The reason for this is simple to understand. Influenza causes yearly epidemics during the cold months in each hemisphere – December to March in the northern hemisphere and June to September in the southern hemisphere. To prevent illness and even death from influenza, public health authorities encourage influenza vaccination of all people age 6 months and older. The vaccine – available as an injection or a nasal spray – has been promoted as “the best way to reduce the chances that you will get seasonal flu and lessen the chance that you will spread it to others.” Shortly after the 2009 influenza pandemic, the Center for Infectious Disease Research and Policy (CIDRAP), based at the University of Minnesota, undertook a Comprehensive Influenza Vaccine Initiative (CCIVI). The primary objectives of the CCIVI “were to provide a comprehensive review of all aspects of 2009-2010 pandemic A(H1N1)pdm09 influenza vaccine preparedness and response based on the events of the pandemic vaccine effort and to review the scientific and programmatic basis for the current seasonal influenza vaccine efforts.” This review took about three years, and it was an exhaustive analysis of many aspects of what goes into getting those yearly influenza vaccines from the manufacturer and into the arms or noses of consumers. More

For National Influenza Vaccination Week, we interviewed Dalton Paxman, PhD, FCPP, Regional Health Administrator for the mid-Atlantic region, where he oversees public health initiatives for the Office of the Assistant Secretary for Health (OASH), U.S. Department of Health and Human Services (HHS). NIVW is a national observance that was established to highlight the importance of continuing influenza vaccination, as well as fostering greater use of flu vaccine after the holiday season into January and beyond. Dr. Paxman answer our questions about regional influenza activity and vaccine availability as well as his office's involvement in seasonal flu vaccination. More

The Centers for Disease Control and Prevention (CDC) has published a study in the journal Pediatrics on the effects of influenza in children with neurologic disorders. The study compared clinical outcomes during and after influenza, like hospitalization and death, between children with and without neurologic disorders. For the this study, researchers looked at the medical records of reported pediatric deaths between April 15 and September 30 of 2009, during the H1N1 influenza pandemic. Of the 336 pediatric deaths associated with influenza that were reviewed in the study, 227 (68%) “had at least 1 underlying condition that conferred an increased risk of complications of influenza.” Of those 227, 164 (64%) had a neurologic disorder. More

Even in the heat of summer, influenza is in the news. An outbreak of what is being termed H3N2v influenza has emerged in Indiana and Ohio, affecting as many as 130 people and counting. The infection has been detected in people who had exposure to pigs that were sick with the H3N2v strain. While person-to-person infections have been detected, these seem to be limited and do not go beyond one or two people, according to the Centers for Disease Control and Prevention (CDC). More

As visitors to this site know, the development of new methods to cultivate viruses for vaccine use has been an important part of the history of vaccines. From living, complex organisms such as humans and cows, to chicken eggs, to tissue explants, to mammalian cells in culture, various hosts have been used at different stages of technological development to produce vaccine material. Now, recombinant technology, like cell culture technology before it, is changing the way vaccines are made as plants are being programmed to produce antigens for vaccines. Last week, College of Physicians Director and CEO George M. Wohlreich, MD, and I made a visit to a unique research facility in Newark, Delaware, last week to see first-hand the future of vaccines. Fraunhofer USA’s Center for Molecular Biotechnology built this 14,000 square foot plant-based vaccine research and manufacturing facility, funded partly by grants from the Defense Advanced Research Projects Agency (DARPA). More

It has been a little more than 100 years since the discovery of viruses by Martinus Beijerinck. In that time, more than 5,000 different viruses have been discovered and studied. One of those viruses, influenza, has been a scourge to humanity even before we knew it existed. Influenza has caused local epidemics and worldwide pandemics since well before it was discovered. Between 1918 and 1919, influenza killed between 20 and 40 million people worldwide, more than the World War occurring at the time. At the time of the 1918 pandemic, it was believed that the disease was caused by other agents, like the bacteria Haemophilus influenzae. It wasn’t until the 1930’s that the influenza virus was discovered and grown in chicken eggs. In the 1940s, an influenza vaccine was developed and used widely on soldiers during World War II. More

Recent furor around research on the H5N1 virus strain that has caused influenza in birds and rare cases of severe influenza in people may have died down for the time being after last week’s meeting of a group of experts assembled by the World Health Organization. They recommended that two different groups involved in what has come to be seen as controversial research should publish their findings in full. A halt on the bird flu research in question and publication of those data is still in place, however, and will likely last a few months longer.

To date, this H5N1 virus is not efficiently transmissible among humans – in fact, humans generally have been infected only after close contact with infected poultry. But virologist Ron Fouchier at Erasmus Medical Center in Rotterdam manipulated the virus so that it became easily transmissible between ferrets via airborne droplets. (Ferrets are a useful standin for humans in influenza studies.) A team headed by Yoshihiro Kawaoka at the University of Madison-Wisconsin accomplished similar results: both papers were under review for publication by science journals before the controversy developed. More

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