History of Vaccines Blog
The Pan-American Health Organization of the World Health Organization announced that endemic transmission of rubella in the Americas has ended and that the Americas are rubella-free. The announcement comes after years of surveillance to ensure that any new cases of rubella have resulting from importations from outside the Americas. This task was made more complex by the mild nature of rubella illness in nonpregnant individuals: it is easily mistaken for other illnesses. All suspect cases had to be ruled out, and all true cases of rubella had to be studied carefully to ensure that their origin was from outside the Americas. The last confirmed case of endemic transmission occurred in 2009 in Argentina.
April 23, 2015
Please join us on May 14, 2015, at 6:30 pm, when we'll be hosting a panel discussion on legislation pending in the Pennsylvania state legislature that would end philosophical/moral/personal belief exemptions to school vaccination requirements. In light of Pennsylvania's relatively low rate of measles, mumps, and rubella vaccination coverage (in 2013-2014, 85.3% of Pennsylvania kindergarteners had received both doses of MMR vaccines, as compared with the nation's median of 94.7%) and the 2014-15 measles outbreak related to exposures at Disneyland, this topic is very timely.
April 10, 2015
Sixty years ago, on April 12, 1955, in Ann Arbor, Michigan, the results of the largest clinical trial in history were announced. To the tremendous relief of a hopeful nation, Thomas Francis Jr., MD, revealed that the Salk inactivated poliomyelitis vaccine was “safe, effective, and potent” against paralytic polio. The trial had begun in April 1954 when the first of about 1.3 million first- , second-, and third-graders began their participation as vaccine recipients (about 422,000), placebo recipients (about 201,000), or observed control subjects (about 725,000) (see the official report on the trial for details on the study design). Injections, observations, and data collection continued through the spring, and then the information was handed over to Francis’s team for analysis.
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.
February 23, 2015
Please join us the evening of March 12, 2015, when writer Arthur Allen discusses the lives and work of Rudolf Weigl and Ludwik Fleck, two forgotten scientific heroes. Weigl and Fleck used their knowledge of typhus and vaccines in World War II Poland to save thousands of people and sabotage the Nazis. Allen will also discuss the philosophy of science that Fleck, a Jewish scholar and diagnostician, developed under almost impossibly difficult circumstances in the ghetto and concentration camps. Paul Offit, MD, vaccine developer and author of many books about vaccines, medicine, and social issues, will facilitate a discussion.
I’ve been getting calls from reporters and producers in record numbers in the past weeks as US measles cases have been increasing. I’ve talked to people from Bloomberg Politics, the San Jose Mercury News, CNN, the Baltimore Sun, Men’s Health, Chicago public radio station WBEZ, CBS Interactive, Canadian radio show Day 6, Sirius XM’s Doctor Radio, and a local Philadelphia TV station. The one interaction I’ve had that distressed me was with a local TV station. They asked me to appear on a news magazine segment to talk about measles history and the history of the anti-vaccination movement. A few other segments would air on the same show, one about health insurance enrollment and one about, of all things, sport betting.
January 27, 2015
I've been closely following, as I'm sure most of you have, the recent outbreaks of measles originating from exposures at Disneyland. I wrote about this the other day (and included some information about a lesser-known measles outbreak in a small South Dakota town). Since then, reported cases of measles have climbed. As of the writing of this post, 88 measles cases have been reported and linked directly or indirectly to the initial exposures at Disneyland. It's too soon to know the vaccination history of every person who has developed measles, but usually what we see in measles outbreaks is that the great majority of cases are completely unvaccinated. A smaller number will have had one vaccine (not the recommended two), and an even smaller number will have been fully vaccinated. This is no surprise: the measles vaccine is highly effective at preventing disease, but 2-5% of individuals vaccinated once do not respond to the vaccine. So, some vaccinated individuals will remain unprotected.
January 14, 2015
The CDC just announced its final 2014 measles case numbers. They have reported 644 cases for 2014, the highest number of measles cases in any year since measles was declared eliminated in 2000. The graph below shows measles cases since 2001 up to November 29, 2014. December ended with a bang: between December 15 and December 20, visitors to Disneyland in Anaheim, California, were exposed to measles courtesy of an as-yet-unidentified index case. Related measles cases have been reported in California (22 so far), Utah (2), Washington (1) and Colorado (1). From November 29 to December 31, a total of 31 measles cases were reported across the country.
We've all been following the National Hockey League mumps outbreak in the past few weeks. And by now, those of us who are known for opining on infectious diseases have been asked by our friends why even people who are fully and recently vaccinated are coming down with the disease. (Here's the short version: Two doses of mumps vaccine are 88% (range: 66-95%) effective at preventing disease, so in an outbreak, a certain percentage of fully (2 doses) and partially (1 dose) immunized individuals are vulnerable to becoming ill, as are all the unvaccinated people exposed. For more information see Mumps Vaccine Effectiveness in Highly Immunized Populations and Mumps Outbreaks in Vaccinated Populations: Are Available Mumps Vaccines Effective Enough to Prevent Outbreaks?)
December 11, 2014
For National Influenza Vaccination Week, I had the pleasure of interviewing Dalton G. 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). Dr. Paxman is a Fellow here at The College of Physicians of Philadelphia. Influenza season has begun – has there been much influenza nationally yet? What kind of activity are we seeing in HHS Region 3? Flu activity is beginning to increase in parts of the United States and CDC is getting reports of flu illnesses, flu hospitalizations, and flu deaths. Influenza A (H3N2) viruses are most common so far. H3N2 predominant seasons are associated with more severe illness and mortality, especially in older people and young children, than during H1N1- or B-predominant seasons. If H3N2 viruses continue to predominate, this season could be severe.