History of Vaccines Blog
Heidi Larson’s group at the London School of Hygiene & Tropical Medicine just published a review in Vaccine that attempts to construct a descriptive model of parental vaccine hesitancy. They surveyed the literature on hesitancy from both developed and developing countries. They adopt the term vaccine hesitancy in part because it’s less polarizing than the term anti-vaccine. It describes a continuum of attitudes about vaccine but also a continuum of practices around vaccination, or, as they say, those “in the middle of a continuum of total acceptors to complete refusers.” It’s a relatively new concept; in fact, only six of the 1,164 articles included in the review employed the term vaccine hesitancy.
A Drexel University undergraduate has died from an infection caused by Neisseria meningitidis. Stephanie Ross, a 19-year-old sophomore, was found unresponsive by housemates on Monday, March 10. She died later that day at Penn Presbyterian Medical Center in Philadelphia.Caroline Johnson, MD, of the Philadelphia Public Health Department was quoted as saying that Ross “…had an overwhelming bacterial…infection, and she went into shock, and she had symptoms of diffuse hemorrhaging.” Esther Chernak, MD, MPH, who is associate professor at Drexel University School of Public Health and a History of Vaccines advisor, noted that “the course of bloodstream infections with N. meningitidis (meningococcemia) is often rapid and fulminant, which is why this disease is among the most terrifying infections.” Ross’s housemates and other close contacts have been offered prophylactic antibiotics.
March 10, 2014
I’ve been corresponding with a reader who is interested in HA Martin’s On Animal Vaccination, an 1877 publication by the physician who is widely credited with introducing and producing non-humanized smallpox vaccine in the United States. Martin obtained vaccine from the famed Beaugency vaccine line, begun in the 1860s with naturally occurring cowpox in a French cow. The French Académie du Médicine cultivated the vaccine in serial transmission in cows and avoided harvesting any vaccine from humans.
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.
January 23, 2014
Last year I informally surveyed my co-workers here at The College of Physicians of Philadelphia to find out how many, in this organization whose mission is in part to “advance the cause of health,” had taken the influenza vaccine that season. Out of the 30 people I polled, 43% had. Though this was about on par with national flu vaccine uptake, I was still disappointed with the low number. And so this year, with my supervisor's encouragement, I decided to do something. In early October I spoke briefly at an all-staff meeting to talk about benefits, risks, and myths of influenza vaccination. More than that, though, I promised a $10 Trader Joe’s gift card to everyone who’d get vaccinated and show me the proof.
January 9, 2014
The building is abuzz today after the online publication in the New England Journal of Medicine of a paper analyzing a Mütter Museum specimen. Encased in a glass jar, floating in an alcohol solution, is an 8-inch-long segment of small intestine taken from a victim of the 1849 Philadelphia cholera epidemic. Scientists, including the Museum curator Anna Dhody, were able to extract and analyze cholera DNA from the intestine. The study aim was to describe the type of cholera that was responsible for the 1849 epidemic, which was part of the second cholera pandemic. It has been assumed that the classical biotype caused the 19th century pandemics, and that a newer strain, known as the El Tor strain, did not emerge until the 20th century. This hasn’t however, been thoroughly studied.
January 7, 2014
January is National Cervical Health Awarenss Month. My friend Izumi Kajimoto writes today's post. I am writing this on my mother’s 77th birthday – a mark she missed by thirty years. “Preventable cancer” is something you don’t want to hear to describe what killed your mother young. I didn’t waste time bitter that tests were available, but under-publicized, to have caught it in time for her. But I figured I owed it to knowledge and sense to get my first colonoscopy at age 25 (an uncle died of it too: I have it on both sides) and every five years since. Nothing is more exhilarating than having a hose crawling up your butt for an hour – then being told you don’t have cancer. I am one of the few lucky ones who had to quit smoking only once, and it was easy. Keeping the weight down, running a lot, I thought I was doing my bit to prove the preventability of something that wiped out a chunk of my family.
December 20, 2013
Our advisor, Thomas Fekete, MD, FCPP, wrote today’s post. Dr. Fekete, a frequent contributor to this site and an active Fellow here at the College, has many responsibilities at Temple University Hospital and School of Medicine: Section Chief, Infectious Diseases; Professor, Medicine; Associate Professor, Microbiology and Immunology; and Executive Vice Chair for Clinical Affairs, Department of Medicine. Twenty-plus years ago, an improved (protein-conjugated) vaccine for Haemophilus influenzae type b (Hib) was approved and deployed extensively in young children in most developed countries. There was a rapid and sustained drop in serious infections caused by Hib. This reduction of meningitis, pneumonia, blood infections, and so on was dramatic and was accompanied by a major reduction in the formerly common and seemingly innocent carriage of Hib in the throats of children. As a result, even unvaccinated children had protection from Hib via herd immunity.
December 19, 2013
In Mali, the mortality rate for children under five is about 20%, higher than the overall child mortality rate in the World Health Organization Africa Region. It performs worse than much of the region in per capita GDP, government expenditure on health care, maternal mortality rate, and many other measures. Here at the College this week, representatives from Mali Health Organizing Project paid a visit to tell us about their work. Mali Health is a nonprofit group working to reduce child mortality and improve maternal and child health in under-resourced communities in Mali’s capital, Bamako. Since 2006, it has trained and deployed community health workers to work in Bamako’s slums, where they make home visits to evaluate child health, and help facilitate access to healthcare for children and pregnant women.
December 9, 2013
For National Influenza Vaccination Week, I had the pleasure of interviewing 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 is a Fellow here at The College of Physicians of Philadelphia. His biographical information is below. Many thanks to Dr. Paxman and to Mahak Nayyar, MPA, FCPP, Deputy Regional Health Administrator, for her coordination.