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History of Vaccines Blog
Human papillomavirus vaccination series completion will now require only two doses of vaccine for adolescents younger than 15 years. The Advisory Committee on Immunization Practices approved this recommendation at their biannual meeting in Atlanta yesterday. The new schedule for <15 year olds calls for the second dose to be given between 6 and 12 months after the first dose. Adolescents receiving the first dose of HPV vaccine at age 15 or older will continue to be recommended three doses of vaccine, given at 0, 1-2, and 6 months.
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.
January 29, 2014
After eight cases of group B meningococcal disease at Princeton University and four cases at University of California, Santa Barbara, health authorities are taking an unusual pathway to using a vaccine that is not licensed in the United States. More than 5,000 Princeton students and staff members with certain medical conditions have received one dose of a meningococcal serogroup B vaccine approved for use in the outbreak by the FDA under an Expanded Access to Investigational New Drug protocol. (I have written about IND approval in the context of vaccines for emergent diseases and biological attacks.) Students will receive the second of the two needed doses in February.
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.
October 26, 2012
As of October 24, 2012, the U.S. Advisory Committee for Immunization Practices (ACIP) recommends to vaccinate all pregnant women against pertussis (whooping cough) with the Tdap vaccine regardless of whether they have had Tdap in the past. If that is not feasible, the vaccine should be given upon discharge from the hospital or birthing center. Giving the vaccine during pregnancy allows for the mother's immune system to make antibodies, that then get transferred to the newborn body through the umbilical cord. This can protect the infant during the time before he or she receives the first set of scheduled vaccines at two months of age. The vaccine was previously recommended to be given to pregnant women who never had the Tdap vaccine, but it has now been determined that a single dose of Tdap vaccine is not enough to protect for additional pregnancies.
November 21, 2011
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.
June 21, 2011
Last December, the History of Vaccines blog covered the introduction of MenAfriVac 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.
Polysaccharide vaccines are sometimes used to try to control outbreaks after they have begun: so-called “emergency vaccination” efforts designed to keep meningococcal epidemics from spreading further. However, these types of reactive efforts are very expensive and difficult to manage, and polysaccharide vaccines do not induce long-lasting immunity against meningococcal bacteria. (For more about the different types of vaccines, see our article and Types of Vaccines activity.)
Within these African epidemics, between 80 and 85% of cases are caused by a single group of meningococcal bacteria: group A. In 2000, a group of global health leaders gathered together by the World Health Organization (WHO) determined that a meningitis vaccine could be developed specifically for use in Africa: a low-cost vaccine that would focus solely on the Group A bacteria. The Bill & Melinda Gates Foundation provided a ten-year grant for what would become the Meningitis Vaccine Project (MVP).
December 6, 2010
In the United States, meningitis is thought of as an extremely rare disease. It usually appears in the news when a college student has fallen ill, amid reminders by public health officials that a meningococcal vaccine can protect against diseases caused by Neisseria meningitidis bacteria, including meningitis. In 2008 (the most recent year for which data are available) only about 1,100 total cases of meningococcal disease were reported in the United States, and meningitis cases were only a fraction of that number.
In other parts of the world, however, meningitis takes a much larger toll. In Sub-Saharan Africa, an area that spans from Senegal to Ethiopia is called the “meningitis belt” because of the epidemic waves that occur there, some lasting as long as three years. The largest epidemic wave in history led to more than 25,000 meningitis deaths from 1996 to 1997. In 2009 alone, more than 88,000 cases were reported. Now, a new vaccine developed specifically for use in Africa offers hope that future epidemics may be prevented.