History of Vaccines Blog
A few weeks ago, I attended a talk by the CDC's Anne Schuchat, MD, on US HPV vaccination that she subtitled “How Not to Introduce a Vaccine.” In spite of the promise of HPV vaccines to reduce the burden of cervical and other cancers in this country, uptake of the complete three-dose series has lagged far behind the other vaccines on the adolescent immunization platform. On Friday, I heard a more optimistic talk about HPV vaccination in African countries by Helen Rees, MD, MA, Executive Director, Wits Reproductive Health and HIV Initiative, University of Witswatersrand. Dr. Rees is a member of the WHO immunization policy committee and has a background in pediatrics, HIV care, and obstetrics and gynecology. She spoke as a guest of the Johns Hopkins Vaccine Initiative as part of their annual Vaccine Day events. Globally, 90% of HPV-related cancers are cervical cancers, and sub-Saharan Africa is, as Rees said, the epicenter for cervical cancer. The high prevalence of HIV infection, which is a risk factor for oncogenic HPV infection, and the lack of access to HPV screening contribute to the high HPV disease burden. And apart from HPV-related cancers, Rees also noted that genital warts are not a trivial condition in an HIV-prevalent setting: they can be debilitating in those with compromised immune systems. The quadrivalent HPV vaccine offers protection from the two most common types of oncogenic HPVs and two types that cause genital warts; the bivalent vaccine covers only the two most common types of oncogenic HPVs.
How is the immune system similar to your marathon time? As we age, our immune response decreases at the same slope that our marathon race times increase. Presenters laid out this and some of the other problems of immunizing adults in the Symposium on Adult Immunizations, an early session at the Infectious Diseases Society 2014 conference at the Philadelphia Convention Center. Kenneth Schmader, MD, noted that though adults age differently – some adults at age 75 may be running marathons while others may be frail – all are subject to immune system senescence, and all are vulnerable to rapid functional declines that may result from an acute stressor, whether it’s a fall or a debilitating case pneumococcal pneumonia.
September 24, 2014
On Monday, September 22, in Philadelphia, Matthias J. Schnell, PhD, of the Jefferson Vaccine Center, announced that one of his lab's Ebola virus vaccine candidates was moving into human trials. Funding from the National Institute of Allergy and Infectious Diseases and the Department of Defense will allow production of a clinical lot of the vaccine for a Phase 1 trial that could be completed as early as mid-2015 (see Anthony Fauci's testimony to the House Foreign Affairs Committee). Schnell addressed a gathering of diplomats, scientists, and large audience of students and healthcare professionals at Thomas Jefferson University to discuss the Ebola epidemic in West Africa. Ambassadors of Sierra Leone, Ivory Coast, and Guinea spoke about the difficulties of epidemic response in their countries, which are especially complex given the legacies of years of civil unrest there.
September 18, 2014
The news of infant deaths on September 16 in northern Syria from measles vaccination is heartbreaking. Shortly after vaccination, the children became limp and unresponsive: those most severely affected died before reaching hospital. Seventy-five children were affected, and fifteen died. The World Health Organization is investigating the incident. The first reports couldn't identify the problem and speculated that the vaccine had spoiled or that it had been tampered with. The latest reports state that atracurium, a neuromuscular blocking agent used in procedures like intubation, was used as a diluent for measles vaccine, rather than the standard water-based diluent.
September 10, 2014
Tonight be sure to watch or record "Vaccines: Calling the Shots," the latest installment of NOVA on PBS. This documentary looks at parental attitudes toward vaccination and their influences on disease spread. Check your local listings -- here in the Philadelphia area it's scheduled for 10 pm, but in other areas it's scheduled at 9 pm Eastern. Additionally, there's the matter of the President's televised address at 9 pm Eastern, which is likely to push the broadcast later. We here at The College of Physicians of Philadelphia were lucky enough to host award-winning filmmaker Sonya Pemberton (who wrote/produced/directed the film)--and her crew in 2012, when they were filming segments of the documentary. A version aired in 2013 as 90-minute film titled "Jabbed: Love, Fear, and Vaccines."
September 2, 2014
I was a sprouting ten-year-old girl in Westchester County, right outside of New York City, and all was well. I’d hop on my bike and help my older brother deliver newspapers up and down the streets of my town. I’d swim in Long Island Sound, a short bike-ride from our house. And I had a new baby sister! I was in fifth grade. One day while walking home from school for lunch, kicking a stone down the road, my legs began to hurt. After a peanut butter and jelly sandwich and glass of cold milk, I said, “Mom, I can’t go back to school today.” My neck got stiff, my fever rose alarmingly, and what started as small pains turned into large ones. The doctor came and soon I was rushed to the hospital in an ambulance, diagnosed with polio.
August 4, 2014
Today's blog post is by Robert D. Hicks, PhD, Director, Mütter Museum/Historical Medical Library, William Maul Measey Chair for the History of Medicine, The College of Physicians of Philadelphia. The World Health Organization has been debating the future of smallpox. The debate concerns what to do with existing stocks of infectious smallpox virus given its eradication from the planet decades ago, one of the most significant public health achievements ever. Assuming a method could be devised to dispose of these smallpox stocks safely to avoid their being used as a terrorist weapon, can we be assured that all of it has been destroyed? Is destruction a good thing, since future technologies may be able to elicit from virus samples answers to fundamental questions about epidemic diseases, their origins, evolution, and treatment? What if possibly infectious samples of smallpox still exist . . . in museums and libraries?
July 31, 2014
Many thanks to my great high school interns Arkiea and Mercedes for writing this review and summary of World War Z. When I first heard about World War Z I thought “ugh, another zombie movie.” It was a movie that I did not want to see because honestly I hate zombie movies. Almost all zombie movies have the same plot where it's people awakening from their grave to become a brain-eating zombie. Not that I’m against that, it’s just I did not want to sit through another movie that’s two hours long for eleven dollars just so I can predict the outcome. So, I decided to avoid World War Z at all costs, meaning that I stayed home on a Saturday night while my dad and sister went to the movies. Three hours later my sister returns home and she tries to persuade me to see the movie but because of my stubbornness and utter dislike for zombies, I tell her no. After months of listening to my sister rant about the movie, I finally decide it would be in our best interests if I saw the movie.
July 14, 2014
Today's blog post is by College Librarian Beth Lander, MLS. “To the memory of Fellows of The College who have fallen whilst in performance of duty during pestilence or war” begins a plaque hanging near our Historical Medical Library. The memorial not only offers a gentle reminder of the sacrifices made by physicians in the care of their patients, but also is a reminder of how closely mortality hovered prior to the age of vaccines. The summer of 1793 was unusually hot and dry. Wells and creeks were low, and the people of Philadelphia were plagued by flies and other pests. By mid-August, people in Philadelphia fell ill with symptoms similar to an outbreak of fever that Benjamin Rush, a founder of The College of Physicians of Philadelphia, had witnessed in 1762: “These patients were generally seized with rigors, which were succeeded with a violent fever and pains in the head and back. The pulse was full, and sometimes irregular. The eyes were inflamed, and had a yellow cast, and vomiting almost always attended. The third, fifth, and seventh days were mostly critical, and the disease generally terminated in one of them, in life or death. An eruption on the third or seventh day over the body, proved salutary. An excessive heat, and burning about the region of the liver, with cold extremities, portended death to be at hand”
June 5, 2014
In 1982, Françoise Barré-Sinoussi was a young researcher in Luc Montagnier’s lab at the Pasteur Institute, studying the control of retroviruses by their hosts. Late that year, a French virologist made an urgent request to her lab: would they look for signs of retroviral infection in a group of patients with a troubling new disease? As she says in her 2008 Nobel Prize biographical sketch, “It would have been a relatively routine procedure to detect the presence of a retrovirus” in cells. That statement is excessively modest, because, in fact, the task was not easy and rested on decades of earlier work. One immediate problem was that the unidentified pathogen, obtained from a patient’s lymph node biopsy, threatened to outrun the cells in culture. But once she thought to add more lymphocytes to keep up with the infection cycle, Barré-Sinoussi wrote that “isolation, amplification and characterisation of the virus rapidly ensued, and the first report was published in Science in May 1983.”