Vaccine Blog Posts

URI cancer researcher now aiming sights on Lyme disease

02/02/2011

KINGSTON, R.I. – As part of her research into breast cancer, University of Rhode Island scientist Roberta King has for years been studying the role of an enzyme in regulating estrogen activity.

King is specifically interested a type of enzyme, called sulfotransferases, which contribute to balancing and regulating numerous biologically active compounds such as estrogen and dopamine.

Now the associate professor of biomedical sciences in the College of Pharmacy is targeting dopamine sulfotransferase and its potential role in the transmission of the bacteria that causes Lyme disease. In a partnership with Thomas Mather, professor of entomology and director of the URI Center for Vector-Borne Diseases, King and her research team are looking at how tick dopamine sulfotransferase affects tick salivation and ultimately the feeding process that leads to Lyme disease and other tick-borne diseases.

“In the lab, we have shown that the tick sulfotransferase controls dopamine activity. Because others have shown that dopamine controls tick salivation, we expect that manipulating the sulfotransferase may turn off salivation, which in turn would prevent ticks from feeding,” King said. “If we can prevent ticks from feeding, then we can stop them from transmitting diseases.”

[snip]

“Tom’s team, which has included Sivakamasundari Pichu, a former post-doctoral fellow, and Dr. Jose Ribeiro from the National Institutes of Health in Rockville, Md., identified tick genes that looked like sulfotransferase and that the gene expression level changed from before a tick fed to after a tick fed,” King said. “He keyed in on that action because it should be important biologically. Organisms don’t waste energy changing things unless they benefit from the change. We wanted to discover the purpose of the gene and to see if the protein it produced could be targeted for a vaccine or drug.”

[snip]

She said deer ticks need to blood feed for longer than 24 hours to transmit disease.

“We don’t have to stop the initial bite, as much as we need to shorten the feeding process,” King said. “With these long-feeding ticks (they typically feed for 3 or more days), if we shorten the attachment time by interrupting salivation, then we may have an effective way to stop transmission of Lyme disease. We found that tick sulfotransferase turns off dopamine, which should turn off salivation, and in turn prevent feeding. The tick then would drop off the person and/or die.”

Since King and her team have found that tick sulfotransferase is potentially a key to regulating salivation in lab tests with tick tissue, they are now proceeding with tests on live ticks in Mather’s lab.

King said they were initially looking at two options for attacking Lyme disease--a vaccine, which would target the sulfotransferase in the tick saliva, or a drug, which would be absorbed into the tick. Mather’s research focus is on anti-tick vaccine development, “but it also may be possible to target the tick sulfotransferase using a topical drug,” King said.

[snip]

ScienceInsider

Why the 'Prius Driving, Composting' Set Fears Vaccines

by Greg Miller

31 January 2011

Journalist Seth Mnookin's new book, The Panic Virus: A True Story of Medicine, Science, and Fear, explores the public health scare over vaccines and autism. The 1998 paper in The Lancet by British physician Andrew Wakefield that sparked the panic has long since been debunked and retracted, and Wakefield himself has been barred from practicing medicine and accused of fraud. But that hasn't stopped thousands of people from refusing to vaccinate their children out of fear that they could become autistic.

Mnookin warns of grave consequences. Recent outbreaks of measles, whooping cough, and other preventable infections have sickened thousands of children and killed more than a dozen in the United States. Vaccine rates are falling below the level needed to prevent an outbreak in a growing number of communities, including ones with wealthy, educated populations.

Read the interview here.

Clinical Infectious Diseases, Volume 52 suppl 3 February 1, 2011

The Need for a New Lyme Disease Vaccine (Free full text)

Plotkin SA. Correcting a public health fiasco: The need for a new vaccine against Lyme disease. Clin Infect Dis. 2011 Feb;52 Suppl 3:s271-5.

Livey I, O'Rourke M, Traweger A, Savidis-Dacho H, Crowe BA, Barrett PN, Yang X, Dunn JJ, Luft BJ. A new approach to a lyme disease vaccine. Clin Infect Dis. 2011 Feb;52 Suppl 3:s266-70.

Steere AC, Drouin EE, Glickstein LJ. Relationship between immunity to Borrelia burgdorferi outer-surface protein A (OspA) and Lyme arthritis. Clin Infect Dis. 2011 Feb;52 Suppl 3:s259-65.

Poland GA. Vaccines against Lyme disease: What happened and what lessons can we learn? Clin Infect Dis. 2011 Feb;52 Suppl 3:s253-8.

Angela K, Shen AK, Mead PS, Beard CB. The lyme disease vaccine--a public health perspective. Clin Infect Dis. 2011 Feb;52 Suppl 3:s247-52.

The Age-Old Struggle against the Antivaccinationists

Gregory A. Poland, M.D., and Robert M. Jacobson, M.D.

Excerpts from the N Engl J Med 2011; 364:97-99.

Since the introduction of the first vaccine, there has been opposition to vaccination. In the 19th century, despite clear evidence of benefit, routine inoculation with cowpox to protect people against smallpox was hindered by a burgeoning antivaccination movement. The result was ongoing smallpox outbreaks and needless deaths. In 1910, Sir William Osler publicly expressed his frustration with the irrationality of the antivaccinationists by offering to take 10 vaccinated and 10 unvaccinated people with him into the next severe smallpox epidemic, to care for the latter when they inevitably succumbed to the disease, and ultimately to arrange for the funerals of those among them who would die (see the Medical Notes section of the Dec. 22, 1910, issue of theJournal). A century later, smallpox has been eradicated through vaccination, but we are still contending with antivaccinationists.

Little has changed since that time, although now the antivaccinationists' media of choice are typically television and the Internet, including its social media outlets, which are used to sway public opinion and distract attention from scientific evidence.

The H1N1 influenza pandemic of 2009 and 2010 revealed a strong public fear of vaccination, stoked by antivaccinationists. In the United States, 70 million doses of vaccine were wasted, although there was no evidence of harm from vaccination. Meanwhile, even though more than a dozen studies have demonstrated an absence of harm from MMR vaccination, Wakefield and his supporters continue to steer the public away from the vaccine.

the reality that none of the antivaccinationists' claims of widespread injury from vaccines have withstood the tests of time and science. We believe that antivaccinationists have done significant harm to the public health. Ultimately, society must recognize that science is not a democracy in which the side with the most votes or the loudest voices gets to decide what is right.

Read the entire commentary here.

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Vaccine. 2010 Dec 8.

Reliable surveillance of tick-borne encephalitis in European countries is necessary to improve the quality of vaccine recommendations.

Stefanoff P, et al.

National Institute of Public Health-National Institute of Hygiene, Warsaw, Poland.

Tick-borne encephalitis (TBE) is an acute disease of the central nervous system caused by viruses from the Flaviviridae family. Infection most commonly occurs following exposure to ticks infected with one of the 3 viruses belonging to the TBE complex. Food borne transmission of TBE has also been increasingly reported following consumption of unpasteurised milk or dairy products.

The infection usually progresses biphasically. The first (viremic) phase often is asymptomatic or causes influenza like symptoms. Only about one third of cases progresses to the second phase which may present as meningitis, encephalitis, meningoencephalitis, meningoencephalomyelitis or cause other clinical syndromes. Post encephalitic sequelae (e.g. sustained paresis, ataxia, headache, hearing impairment) are reported in 35–58% of symptomatic patients. Diagnosis of TBE is based on detection of specific IgM and IgG antibodies in serum or cerebrospinal fluid using the enzyme-linked immunosorbent assays (ELISA), however cross-reactivity with other flaviviruses has been observed. Neutralization testing allows confirmation of specific anti-TBE antibodies presence.

There is no specific treatment for TBE. Although personal protective measures (such as covering limbs, wearing insect repellants and removing ticks), as well as avoidance of unpasteurised milk coming from endemic areas is usually encouraged, the only efficient measure of disease prevention is active immunization.

In Europe two highly effective and safe vaccines are used for prevention of TBE infections and their chronic sequelae. The two vaccines available are whole-virus inactivated products: FSME-IMMUN(Baxter AG, Vienna, Austria) and ENCEPUR (Novartis AG, Basel,Switzerland). Typically three doses are needed for primary immunization at 0, 1, 6–12 months, and booster doses every 3–5 years.

Despite availability of safe and effective vaccines, TBE is an increasing public health problem in Central and Northern Europe. During the previous decade, on average 3000 clinical cases have been reported annually from European countries.

The optimal vaccination strategy is difficult to establish as TBE is azoonotic disease, with highly focal natural distribution. Mass immunization would not affect the local circulation of the virus in enzootic cycles. Theoretically, the best approach would be a combination of health promotion, vaccination of high risk groups, and, potentially, vector control measures. To define the best strategy for TBE control, however, good quality data are needed on TBE virus (TBEV) occurrence, as well as information on population-level and individual risk factors.

The aim of the present study was to summarize vaccine recommendations in European Union (EU) and European Economic Area(EEA) countries, in context of surveillance of human cases, and monitoring TBE endemic areas.

New Meningitis Vaccine Brings Hope of Taming a Ravaging Illness in Africa.

By CELIA W. DUGGER, NYT

JOHANNESBURG — For over a century, epidemics of bacterial meningitis have swept across Africa, arriving with the dry harmattan winds to kill with terrifying speed. But on Monday, a drive starts to inoculate tens of millions of West Africans with a new vaccine in what scientists hope will be the beginning of the end of ravaging meningitis epidemics.

[snip]

Hundreds of millions of dollars are still needed to accomplish that goal, public health officials say. But the meningitis vaccine itself is a milestone in developing inexpensive vaccines against neglected diseases that afflict poor countries, experts say.

More than a million cases of meningitis have been reported in Africa over the past two decades, and the vaccine works against the group A meningitis strain that causes more than 8 out of 10 cases on the continent. Moreover, it costs less than 50 cents a dose. In the United States, Novartis and Sanofi Pasteur market a single dose of meningitis vaccines against multiple strains of the disease for $80 to $100.

[snip]

The meningitis vaccine relies on a technology that was devised by researchers at the Food and Drug Administration and donated by the United Statesgovernment at the cost of only token royalties. It is being manufactured by the Serum Institute of India, a major vaccine producer, and it was developed independently of the major American and European pharmaceutical companies.

http://www.seruminstitute.com/

[snip]

The development of the vaccine was led by a team from PATH, a nonprofit group in Seattle, and the World Health Organization. They coordinated contributions from nonprofit, public and for-profit parties. In June, after five years of clinical trials in West Africa and India, the World Health Organization approved the vaccine for use on a large scale.

[snip]

Until the development of the new vaccine, public health officials had to rely on a far less effective polysaccharide vaccine that protected people only for two to three years and did not prevent transmission of the bacteria. As a result, it was used only to rein in an outbreak after it had occurred. Often, by the time supplies arrived, many people had already died.

In contrast, the new conjugate vaccine, which links the sugar in the vaccine with a protein, produces a more powerful immunity that experts hope will last 10 to 20 years. It also prevents transmission, helping protect people who have not been vaccinated and producing what is known as herd immunity. The plan is to vaccinate 300 million people across 25 nations, protecting about half a billion people from the disease, W.H.O. officials said.

Read the entire article here.

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Science 22 October 2010

Rinderpest, Deadly for Cattle, Joins Smallpox as a Vanquished Disease

Dennis Normile

Rinderpest, an infectious disease that has decimated cattle and devastated their keepers for millennia, is gone. The United Nations Food and Agriculture Organization (FAO) announced on 14 October in Rome that a 16-year eradication effort has succeeded and fieldwork has ended. "This is the first time that an animaldisease is being eradicated in the world and the second disease in human history aftersmallpox," FAO Director-General Jacques Diouf said in his World Food Day address inRome the next day.

[snip]

Although nearly forgotten in much of the West, as recently as the early 1900s, outbreaks of rinderpest—from the German for "cattle plague"—regularly ravaged cattle herds across Eurasia, often claiming one-third of the calves in any herd. The virus, a relative of those that cause canine distemper and human measles, spreads through exhaled droplets and feces of sick animals, causing fever, diarrhea, dehydration, and death in a matter of days. It primarily affects young animals; those that survive an infection are immune for life.

[snip]

In 1990, Jeffrey Mariner, then at Tufts University School of Veterinary Medicine, haddeveloped an improved vaccine that did not require refrigeration up to the point of use. This allowed vets and technicians to backpack vaccine into remote areas. One of the reservoirs was in the heart of war-torn eastern Africa, where vet services had broken down and international agencies dared not send personnel. GREP relied on local pastoralists to track the disease and on trained community animal-health workers to administer the vaccine to quell outbreaks.

[snip]

One of the final steps of the rinderpest eradication program is tracing virus samples held in labs around the world and then sequestering them in a small number of secure international depositories, says Roeder. The GREP secretariat will continue to watch for the disease, he says, noting that he personally monitors disease outbreak Web sites and international news for any hint of a rinderpest revival. Rinderpest might be gone, but it's not forgotten.

Welcome to the 19^th century.

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Below, an interesting review of the state of research on candidate vaccines against Lyme Borreliosis and the Ixodes tick vector.

Lyme borreliosis vaccination: the facts, the challenge and the future.

Schuijt TJ, Hovius JW, van der Poll T, van Dam AP, Fikrig E.

Trends Parasitol. 2010 Jun 29.

The OspA vaccine successfully completed Phase I, II and III trials and the OspA vaccine was approved by the Federal Drug Administration in the United States in 1998. Vaccinated individuals showed approximately 80% protection against B. burgdorferi infection after receiving three vaccine doses with OspA using aluminum as an adjuvant. One draw back of the OspA vaccine was that protective immunity correlated with high titers of OspA antibodies after immunization and it was shown that ~5% of the vaccine recipients developed insufficient antibody responses against OspA. This was associated with decreased cell surface expression of Toll-like receptor (TLR)-1. Thus, high antibody titers did not persist long after vaccination and additional boosters would be necessary to maintain protective titers causing the vaccine to be withdrawn from the market four years after its release.

‘Tick immunity’ refers to the phenomenon in which ticks are unable to feed successfully after several tick infesta- tions and was first described by William Trager in 1939.

Tick immunity not only affects tick feeding but can also interfere with transmission of pathogens, such as Babesia, Francisella and Borrelia. In addition, humans were found to develop immediate and delayed cutaneous hypersensitivity reactions after repeated tick bites and were less likely to develop Lyme Borreliosis.

These observations further underscore that tick proteins could be used as vaccinogens to prevent Borrelia transmission

Tick proteins that interact with Borrelia are potential targets. The Ixodes salivary protein Salp15 specifically binds to the OspC of Borrelia and thereby protects the spirochetes against borreliacidal antibodies. As we postulated before, by using Salp15 as a vaccine candidate, specific antibodies could not only neutralize the immuno-suppressive effects of Salp15 but could also bind Borrelia surface-coated Salp15, enhancing clearance by host phagocytic immune cells.

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Whooping Cough Sweeping Across California

July 4, 2010

Health officials across California are urging parents of children to get them vaccinated against whooping cough as hundreds of cases are being reported in the state.

So far this year more than 950 cases of whooping cough have been reported in infants across the state and up to three deaths have been reported.

In various Bay Area counties in the state the vaccine is being offered free of charge in an attempt to boost the numbers of parents who choose to take their children to be vaccinated.

Compared to this time last year in the state, four times the number of whooping cough cases have been reported and if this trend keeps up, the state could reach record levels.

Whooping cough is spread via the air and even adults who spend a lot of time around young children are also being urged to get vaccinated.

Microbe magazineExcerpted from "Measles Target Missed?"By Bernard DixonAs rinderpest approaches global extinction, the goal of eliminating measles in Europe this year seems unattainable; why? and what could now be done to hasten its demiseThe reason for this disappointment is the suboptimal level of vaccination seen in a small number of European countries. And nowhere is the problem more vividly demonstrated than in minority groups such as those following the teaching of the Austrian "mystic" Rudolf Steiner. Among the tenets of his "anthroposophy" are the avoidance of chemicals in agriculture and the rejection of immunization. Steiner believed that febrile illnesses such as measles and scarlet fever were related to a child's spiritual development. Adherents assert that the use of vaccines (especially measles vaccine) deprives infants of the opportunity to benefit from the experience of having those diseases.

Anthroposophy is by no means the only source of anti-vaccination sentiment, either historically or today. Even members of the medical profession have played key roles in fostering public hostility to immunization in general or to specific vaccines. The UK is only just beginning to recover from the furor triggered by a suggestion of links between MMR (measles, mumps, rubella) vaccine and intestinal inflammation and autism occasioned by a notoriously poor paper in The Lancet...by Andrew Wakefield and others at the Royal Free Hospital, London. Following publication of the paper, parents began to reject immunization, and recent measles outbreaks have been attributed to the resulting low level of protection among young children.

Reading Dixon's article about the impact of flakey philosophy and medical quackery on increased morbidity and mortality from vaccine-preventable infections, I was reminded of Lewis Thomas' experiences as a young medical student in Boston during the 1930s.

He wrote, "The third three-month period was spent across the street in a huge annex called the South Department, where all the contagious diseases were cared for—several hundred patients, mostly children, with diphtheria, whooping cough, scarlet fever, chickenpox, measles, and poliomyelitis." (Lewis Thomas,The Youngest Science: Notes of a Medicine-Watcher, pg. 38.) It must have been a distressing sight. It would be an unimaginable sight today thanks to five vaccines and one antibiotic.

So much for philosophy and quackery.

MMR doctor 'broke research rules'

By Nick Triggle

BBC News

Published: 2010/01/28

The doctor who first suggested a link between MMR vaccinations and autism acted unethically, the official medical regulator has found.

Dr Andrew Wakefield's 1998 Lancet study caused vaccination rates to plummet, resulting in a rise in measles - but the findings were later discredited.

The General Medical Council ruled he had acted "dishonestly and irresponsibly" in doing his research.

Afterwards, Dr Wakefield said the claims were "unfounded and unjust".

The GMC case did not investigate whether Dr Wakefield's findings were right or wrong, instead it was focused on the methods of research.

During the two-and-a-half years of hearings - one of the longest in the regulator's history - he was accused of a series of charges.

The verdict, read out by panel chairman Dr Surendra Kumar, criticised Dr Wakefield for the invasive tests, such as spinal taps, that were carried out on children and which were found to be against their best clinical interests.

The panel said Dr Wakefield, who was working at London's Royal Free Hospital as a gastroenterologist at the time, did not have the ethical approval or relevant qualifications for such tests. The GMC also took exception with the way he gathered blood samples. Dr Wakefield paid children £5 for the samples at his son's birthday party. Dr Kumar said he had acted with "callous disregard for the distress and pain the children might suffer". He also said Dr Wakefield should have disclosed the fact that he had been paid to advise solicitors acting for parents who believed their children had been harmed by the MMR.

[snip]

The panel chairman was heckled by supporters of the doctors during his delivery of the verdicts. One woman shouted: "These doctors have not failed our children. You are outrageous." Another person in the public gallery said it was a "kangaroo court".

[Sounds like the Lyme disease movement, no member or doctor of which can ever be found to have been wrong about anything.]

[snip]

After the hearing, Dr Wakefield, who now lives and works in the US, said: "I am extremely disappointed by the outcome. "The allegations against me and my colleagues are unfounded and unjust and I invite anyone to examine the contents of these proceedings and come to their own conclusions."

[snip]

And in a related--not to mention ironic--story, the NYT today published this notice about Bill Gates efforts to bring more vaccines to more people.

January 30, 2010

Gates Foundation to Double Spending on Vaccines

By DONALD G. McNEIL Jr.

Endorsing vaccines as the world’s most cost-effective public health measure, Bill and Melinda Gates said Friday that their foundation would more than double its spending on them over the next decade, to at least $10 billion.

The change could save the lives of as many as eight million children by 2020, Mr. Gates calculated. He said he hoped his gift would inspire other charities and donor nations to do the same.

“Vaccines are a real success story,” Mr. Gates said in an interview before the announcement, which he made at the World Economic Forum in Davos, Switzerland. “The cost is tiny, and yet it saves more lives than any other component of a health care system.”

[snip]

Vaccines already get more financing from the Gates Foundation than any other cause, and Mr. Gates said no money would be shifted away from other projects, like improved crops, assistance to small businesses and, on the domestic front, schools and libraries. Instead, he and Warren Buffett will increase their annual gifts to the foundation, and about 30 percent of all spending, up from 20 percent, will be for vaccines.

In calculating that eight million lives could be saved, Mr. Gates cited a computer model developed for the foundation by public health specialists at Johns Hopkins University.

Whether such an optimistic prediction comes true depends on several factors that are still uncertain.

For starters, Mr. Gates wants to make sure that 90 percent of the world’s children get shots for routine childhood diseases like measles, diphtheria, whooping cough and polio. Right now, almost 80 percent do. But with 134 million children born each year, it is a constant struggle to keep up, and efforts can be interrupted by factors like war, natural disasters, bad roads and corrupt officials.

[snip]

From The Scientist: Why vaccines are pharma's Next Big Thing.

Here's what's in the pipeline:

And a note about vaccine injury compensation:

In addition to long market lives and choice prices, the vaccine industry is buoyed by a unique piece of legislation deflecting a major expense. In the 1980s, the high costs of liability insurance and lawsuits led to the demise of many companies' vaccine programs. Because vaccines inject otherwise healthy children with a medication, risk tolerance is traditionally very low, and manufacturers often found themselves in court. The trend became so pronounced that Congress stepped in, fearing for the vaccine supply, and established the Vaccine Injury Compensation Program in 1988. Since its inception, consumers are charged a $0.75 tax for each dose of a vaccine purchased in the United States; the money is collected into a trust fund that provides no-fault compensation to approved vaccine injury claims. Today, the program covers adverse reactions to every vaccine recommended by the CDC from infancy to adulthood (besides the zoster vaccine for shingles), including seasonal influenza. The fund, which collects no money from companies, has paid out approximately $1.8 billion in awards to petitioners since 1989.

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From the New York Times on New Year's Day, part of an article about the H1N1 vaccine and efforts to counter active misinformation and online nonsense.

One real triumph, several experts said, was how little damage misinformation did. In 1976, many people refused shots after three elderly Pittsburgh residents died shortly after getting theirs; it took the C.D.C. five days to explain that it was just a coincidence.

This time, many rumors arose but were quickly debunked: That thousands had died in Mexico. That the virus had circulated in the Midwest for a decade, undetected. That it had escaped from a laboratory. That seasonal flu shots made catching swine flu more likely. That flu shots did not work or caused autism. That the administration would make them mandatory. That Tamiflu resistance was widespread in Northern California. That a flu shot had disabled a Washington Redskins cheerleader, or that she was cured by chelation therapy by a doctor associated with the antivaccine movement. That mutant killer flu strains were circulating in Argentina or Ukraine or North Carolina.

Remaining to be seen is what effect the pandemic has had on Americans’ feelings about vaccines.

Dr. Frieden said he thought a victory over the antivaccine movement had been scored. Nearly 60 million people have been vaccinated, including many pregnant women and children, with no surge in side effects.

John P. Moore, an AIDS researcher at Weill Cornell Medical College, was less sure. Dr. Moore, who spent years fighting AIDS denialism, has called skepticism about flu vaccine “an unholy alliance of the left and right” because it joined the liberal natural-medicine proponents with anti-big-government conservatives.

“It’s hard to say if it hurt or helped,” Dr. Moore said, pointing out that polls still show a large minority of Americans rejecting the vaccine. “As with AIDS, people have to die before others understand the consequences of ignoring science-based medicine.”

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I thought this was worthing posting in its entirety.

The Worst Ideas of the Decade

Vaccine scares

by Clive Thompson

Why didn't the United States have enough vaccine to fight swine flu this fall? It's partly because federal health officials didn't mix adjuvants into the drug. Adjuvants are substances that boost the immune system's response to a vaccine, so that less vaccine is needed per dose. Using them could have allowed us to create up to four times more H1N1 vaccine doses than we have. Most of Europe used adjuvants; so did Canada. Why didn't the feds?

They were too worried about spooking anti-vaccine activists, many of whom claim adjuvants contribute to autism. This almost certainly isn't true: Adjuvants have been widely used for years, with no reputable study suggesting a link between them and autism. But federal officials feared people would avoid the H1N1 vaccine if it included adjuvants. As Anne Schuchat of the Centers for Disease Control and Prevention said in congressional testimony last month, "The public's confidence in our vaccine system and in vaccines in this country [is] very, very fragile."

The movement blaming vaccines for causing autism emerged in the early 2000s, and it was one of the most catastrophically horrible ideas of the decade. Not just because it's misguided: Sure, study after study has found no solid link between autism and many alleged vaccine-based culprits, ranging from adjuvants to thimoserol, a mercury-based preservative. The bigger problem is how uniquely powerful the anti-vaccine contingent has become - and how it has begun to deform both public policy and everyday behavior.

Immunization used to be regarded as one of modern society's greatest achievements; before smallpox vaccines, the disease routinely accounted for 10 percent of all deaths in Europe. But amazingly, we're now moving back to the dark ages. The number of children showing up at school in California without routine shots has doubled since 1997, according to an analysis by the Los Angeles Times. If enough people stop vaccinating their children, we will lose "herd immunity" - the ability of a society to collectively resist a disease. (You typically need something like 85 percent of a population immunized to keep the nastiest communicable diseases from circulating.)

It's impossible to tell how many swine-flu deaths were caused by the deficit of vaccine, but the numbers are serious: According to the CDC, about 10,000 people had died from the disease by the middle of last month, 1,090 of them children.

The subtler but more insidious effect of the vaccine-autism movement is philosophical. The anti-vaccine folks have whipped up anti-science sentiment by painting scientists as corrupt elitists on the take from Big Pharma, cackling sadistically as they force us to get shots. This paranoia flows equally from woo-woo Hollywood liberals and the anti-government right; few other subjects can unite Jenny McCarthy and Jim Carrey with Glenn Beck and Rush Limbaugh.

Of course, the only hope we have of treating autism and, God willing, preventing it comes from careful, rigorous science - the same process that created vaccines, eradicated polio and smallpox, and saved millions of lives. For the anti-vaccine crowd, that's an irony that ought to prick.

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Insciences.Org

Published on 18 November 2009

New Haven, Conn. — A protein found in the saliva of ticks helps protect mice from developing Lyme disease, Yale researchers have discovered. The findings, published in the November 19 issue of Cell Host & Microbe, may spur development of a new vaccine against infection from Lyme disease, which is spread through tick bites.

Traditionally, vaccines have directly targeted specific pathogens. This is the first time that antibodies against a protein in the saliva of a pathogen’s transmitting agent (in this case, the tick) has been shown to confer immunity when administered protectively as a vaccine.

The Lyme bacterium known as Borrelia burgdorferi is transmitted by ticks. When it moves through the tick, it is coated with a tick salivary protein known as Salp15. The Yale team injected Salp15 into healthy mice and found that it significantly protected them from getting Lyme disease. When combined with outer surface proteins of B. burgdorferi, the protection was even greater.

[snip]

Several years ago there was a Lyme vaccine on the market that utilized just the outer surface proteins of the bacteria. It was taken off the market in 2002, and to date no other antigen has been tested in phase III clinical trials.

The authors believe this new strategy of targeting the saliva - the “vector molecule” that a microbe requires to infect a host - may be applicable not just to Lyme disease but to other insect-borne pathogens that also cause human illness. “We believe that it is likely that many arthropod-borne infection agents of medical importance use vector proteins as they move to the mammalian host,” Fikrig explained. “If so, then this paradigm, described with the Lyme disease agent, is likely to be applicable to these illnesses. Currently, we are working to determine if this strategy is likely to be important for West Nile virus infection, dengue fever, and malaria, among other diseases.”

This isn’t a new idea—others have been working on a tick-based vaccine for a number of years—but it is a promising approach to the problem of protecting against multiple infectious agents carried by a single vector. You can develop half a dozen separate vaccines or develop one single vaccine against the vector itself. There is already one working model of such a vaccine: the Boophilus tickvaccine used to protect cattle in Cuba, Brazil and Australia.

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This is part of a fluff piece from the Department of Homeland Insecurity. I’m ignoring the self-serving “don’t blame us” tone of the Homeland propaganda to highlight some actual facts about the problems of manufacturing viral vaccines…. especially when you’re relying on antiquated techniques.

Vaccine Shortage Result of Old Production Tech, Slow Growing Virus

Nov 17, 2009

by Anthony L. Kimery

Had the H1N1 influenza pandemic instead been the feared H5N1 pandemic, the on-going shortages of H1N1 vaccine would mean the world would, well, be screwed. Current shortages have left untold thousands without access to the vaccination. Many hospitals and clinics have run out, forcing them to turn people away - some who'd been waiting in long lines to get vaccinated. Though news organizations, pundits, and critics have implied that blame for the shortage rests with federal and state public health authorities, the critics have largely misplaced their venting.

[Right. They should be blaming federal authorities for believing the pie-in-the-sky production estimates from the too few vaccine manufacturers still around.]

Governments and the handful of vaccine manufacturers for the entire world have been doing the best they can using 1950s vaccine production technology at break-neck production speed. Compounding this problem was the unpredictable slow growth of the H1N1 virus in eggs, in which viruses are grown for producing vaccines in current manufacturing processes. This could not have been foreseen. [Except that slow-growing influenza viruses have been encountered in the past.]

Indeed. Manufacturers have had a hard time getting the H1N1 virus to grow in eggs quickly enough. Switzerland-based Novartis, for example, initially was able to grow only 23 percent of the virus it normally is able to grow for a typical seasonal flu vaccine.

….at best, the world’s vaccine makers are hard pressed to produce just a billion doses of pandemic vaccine for the whole world, a grim reality US and world emergency public health planners have had to accept. It also on average takes a minimum of six months to develop a workable vaccine and perform safety testing once the specific pandemic strain is isolated.

It was only after the realization about five years ago that the highly virulentH5N1 avian flu might become transmissible between humans and erupt into a devastating planetary pandemic that investments slowly began to be made in state-of-the-art vaccine production technologies.

In its pandemic preparedness-funding package three years ago, the government earmarked less than $2 billion for exploring new vaccine manufacturing methods, assisting manufacturers in retrofitting their half-a-century-old vaccine production processes with 21st-century technology and expanding existing production lines.

HHS awarded two contracts totaling $132.5 million to Sanofi Pasteur, Lyon, France, and MedImmune Inc., Gaithersburg, Md., over five years to retrofit their existing egg-based domestic vaccine manufacturing facilities on a cost-sharing basis to expand influenza vaccine manufacturing capacity that could be used in the event of a pandemic.

In June, 2007 Novartis Vaccines & Diagnostics began construction of the firstcell culture-derived flu vaccine plant in the United States. HHS awarded a $220.51 million grant to the company a year earlier to aid in the construction. The facility is expected to produce up to 150 million doses of monovalent vaccine supplemented with the company’s adjuvant technology in the event of a pandemic outbreak. The plant is expected to be ready to start making vaccine in 2011.

But even then, it’s unclear just how soon a cell-based flu vaccine would win Food and Drug Administration approval.

WHO estimates that building and licensing a new vaccine production line can take up to five years.

In May 2006, DynPort Vaccine Company LLC, Frederick, Md., and Baxter International Inc., Deerfield, Ill., received a potential $242.5 million contract from HHS to develop Baxter’s cell-cultured seasonal and pandemic influenza vaccines.

GlaxoSmithKline, Brentford, UK, received a $274.75 million assistance grant; MedImmune, $169.6 million; DynPort Vaccine, $40.97 million; and Solvay Pharmaceuticals Inc., Marietta, Ga., $298.59 million.

“We must be prepared to face the first wave of the next pandemic without vaccine and potentially without sufficient quantities of influenza antiviral medications,” a CDC statement warned.

Meanwhile, other vaccine manufacturing companies have abandoned plans for such plants in the US and instead are rennovating their egg-based production plants.

Not just a few experts have warned that the only way to expand global vaccine manufacturing capacity is if governments step up to the plate to help pay for expanding their production lines.

"If we really want to have surge capacity for pandemic vaccine, we have to invest in it like we do our oil reserves, or military reserve capacity," Dr. Michael Osterholm has pointed out.

The ultimate goal is to make a universal flu vaccine that targets a component of flu viruses that doesn't change each season.

October 8, 2009

NIAID Announces Vaccine Adjuvant Discovery Contracts

The National Institute of Allergy and Infectious Diseases (NIAID)....Health, has awarded six new research contracts to discover and characterize novel adjuvants, substances that can be added to vaccines to enhance the protective immune response they induce. Currently, the only vaccine adjuvant approved for use in the United States is an aluminum mixture known as alum.

NIAID has awarded a total of approximately $60 million over five years for these contracts. The awardees will identify novel compounds with the potential to be vaccine adjuvants. All compounds will be tested in animal models and human cells to determine how well they stimulate the immune response. The investigators also will examine and describe the cellular reactions the compounds induce. The institutions receiving contracts for 2009 are:

• James R. Baker, Jr., M.D., University of Michigan, Ann Arbor
• Dennis A. Carson, M.D., Moores Cancer Center, University of California San Diego, La Jolla
• Sunil A. David, M.D., Ph.D., University of Kansas, Lawrence
• Michael J. Gale, Jr., Ph.D., University of Washington School of Medicine, Seattle
• David A. Johnson, Ph.D., Corixa Corporation (now part of GlaxoSmithKline Biologicals), Hamilton, Mont.
• Peter Palese, Ph.D., Mount Sinai School of Medicine, New York City

For a brief review of how adjuvants work, including Charles Janeway’s “pattern recognition” theory and Polly Matzinger’s “danger” theory, see this immunology blog summary.

So there’s a shortage of flu vaccines according to the NYT. Well, that’s no surprise. There’s a shortage of vaccine manufacturers. According to the WHO, there are just three companies in the US that make the seasonal flu vaccine (Medimmune-Avirion, Sanofi Pasteur, Wyeth Lederle). In September, HHS “announced the FDA's approval of [swine flu] vaccine made by four of the expected five manufacturers: CSL Ltd. of Australia, Switzerland's Novartis Vaccines, Sanofi Pasteur of France – which produces flu shots at its Swiftwater, Pa., factory – and Maryland-based MedImmune LLC, which makes the only nasal-spray flu vaccine.”

As the chart shows, there are not many vaccine makers left in the U.S. Two decades ago there were 25, but costs, litigation and the anti-vaccine movement have encouraged most to switch to Vigara and Rogaine knockoffs. And who can blame them.

Well, the economy, the war(s) and the pandemic seemed to have push this megalomaniac right off the front page again. So what better way to ride right back into print than to piggyback on someone else's crisis. Blum is fishing around for overpriced vaccine. Most of it is free. Half the country doesn't want it. Good luck finding any profiteers.

Still, Dick Blum must be in the news....even if he has to make up the news. What next? The alleged Tampon shortage? Over-priced bagels in East Coast grocery chains? I'm just wondering if he'll wait until spring to start alleging vaccine injuries.

Blumenthal Investigating Possible Vaccine Price Gouging

By JOSH KOVNER

The Hartford Courant

November 3, 2009

Doctors, nursing agencies and other health care providers have reported to state regulators that the price of seasonal flu vaccine has shot up to as much $100 a dose in some cases, triggering an investigation by Attorney General Richard Blumenthal into possible price gouging.

Blumenthal said Monday that the vaccine was selling for as low as $7 a dose less than a year ago. In recent days his office has written to 13 national vaccine manufacturers and distributors who do business in Connecticut, and requested information on current and previous per-dose prices.

A spokeswoman for one of the firms, MedImmune Vaccines of Gaithersburg, Md., said the company's prices for seasonal flu vaccine "have not changed at any time during this season."

[snip]

The letters also ask the 13 companies to explain any significant price increases, whether the firms are honoring price quotes given to customers before a recent shortage of seasonal flu vaccine, and whether the companies have repurchased and then resold the vaccine at substantially higher prices.

Blumenthal said some health care providers also are reporting that they have received only a portion of the seasonal vaccine they have ordered. He said some manufacturers have told him that they have reduced production of seasonal flu vaccine to concentrate on meeting the growing demand for H1N1 vaccine.

[snip]

Blumenthal said he would go to court to seek fines and restitution if he can show that vaccine makers are "skewing" the market toward large drugstore chains and other retailers that can afford to pay more for the doses than health clinics can.

[snip]

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IDSA Symposia

Thursday, Oct 29, 2009, 2:45 PM - 4:45 PM

Objectives:

The program concerns the prevention of Lyme disease by immunization. Participants should be familiar with the disease. At the completion of the session participants will be able to discuss the epidemiology of the disease, why the first vaccine against Lyme disease failed, and the reasons for and against the development of new vaccines.

Moderators

STANLEY A. PLOTKIN, MD, FIDSA

University of Pennsylvania, Doylestown, PA.

GARY P. WORMSER, MD, FIDSA;

New York Medical College, Valhalla, NY.

Lessons Learned from the OspA Vaccine in Humans

GREGORY A. POLAND, MD, FIDSA;

Mayo Clinic and Foundation, Rochester, MN.

Relationship Between OspA and Lyme Arthritis

ALLEN C. STEERE, MD

Director of Clinical Research in Rheumatology, Massachusetts General Hospital, Harvard Medical Sc, Boston, MA.

A Public Health View on a Lyme Disease Vaccine

CHARLES B. BEARD, Ph.D.;

Centers for Disease Control and Prevention, Fort Collins, CO.

New Approaches to a Lyme Disease Vaccine

IAN LIVEY, PhD;

Baxter Innovations GmbH, Orth an der Donau, Austria.

A New Lyme Disease Vaccine is a Priority

STANLEY A. PLOTKIN, MD, FIDSA;

University of Pennsylvania and Sanofi Pasteur, Doylestown, PA.

This was a surprise topic at Thursday’s meeting. Seldom is history discussed at a conference devoted to “breaking news.”

Still, it was useful to hear again the reasons for the lack of a vaccine: overall efficacy, costs and the inconvenience of three shots, limited geographic need, exclusion of an important age group (5-15-year-olds), and garbled communications between doctors, manufacturers and patients.

It was also useful for fellows and medical students to hear about safety issues; in particular, the number of adverse events associated with vaccination (usually the first shot) was only slightly higher than the placebo group, and that there is still no convincing scientific evidence for an autoimmune mechanism in transient post-vaccination arthralgia.

The schizophrenic role of the Lyme Movement also was discussed. First they wanted a vaccine, then they didn’t. Yet, they continue to insist Lyme infections are a modern day plague worst than the 14^th century Black Death or the 1918 pandemic, but they have no interest in a preventive measure such as a vaccine.

What was most surprising to hear was the interest the speakers voiced in having a new vaccine for Lyme. (As someone joked during the discussion, we often fail to learn from history.) There are no effective prevention methods (e.g., repellants, tick checks) so a vaccine would be the most promising prevention measure. Baxter/Austria has been doing some basic research on OspC and OspA constructs but don’t expect to see those in a vaccine in the near—or far—future. Those desperate for a vaccine are going to have to continue persuading local veterinarians to give them the canine vaccine. (You’d be surprised how many people have done just that.)

The apparent enthusiasm for a new vaccine still must face the fact that: 1) Lyme is a nonfatal, non-communicable, antibiotic-responsive infection that is geographically- and seasonally-limited and therefore lacks the public urgency of a polio or measles vaccine, and 2) an offshoot of the anti-vaccination movement (i.e., Lyme activist) will be against any public health measure that might diminish their ability to generate hysteria and public confusion. No doubt they are lying in wait with their lies and anecdotes about adverse events and profiteering. Probably a lawyer or two also are waiting to extort a little more money from any manufacturer foolish enough to waste time and money on another vaccination effort.

While some investigators can see a need for a new preventive vaccine, it’s not likely to happen. That, of course, leaves open the question of how to prevent new and recurring cases of Lyme disease. Public health officials don’t seem to have any answers, and Lyme activists don’t even want the question asked.

NOTE: All the symposium presentations will eventually be published in some form.

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