Author: Vincent Iannelli, MD

Cancer Vaccines Can Prevent and Treat Many Cancers

The CDC recommends HPV vaccination for 11 and 12 year olds.
The CDC recommends HPV vaccination for 11 and 12 year olds.

When you think about a cancer vaccine, what do you imagine?

Hopefully it isn’t the anti-vaccine myth that the polio vaccine causes cancer – it doesn’t.

Is it a vaccine that prevents all cancer, a so-called universal cancer vaccine? Or vaccines that target specific types of cancer?

Or do you get thoughts of a cancer vaccine that targets and kills cancer cells, treating patients once they already have cancer?

Sound too futuristic?

While a universal cancer vaccine is likely for than a few years away, many people are surprised that some of the vaccines in the current childhood and adolescent immunization schedule can actually prevent cancer.

Another vaccine is approved to treat cancer.

And that’s good news, as cancer is now the leading cause of death in the United States.

Current Cancer Vaccines

When cancer is caused by an infection, it makes sense that you can prevent the cancer by preventing the infection in the first place. That is the rationale for the current preventive cancer vaccines for the human papillomavirus (HPV) and hepatitis B:

  • Gardasil – an HPV vaccine that can be given to preteen boys and girls to protect against most genital warts and anal cancer. Gardasil also protects women against most cervical cancers.
  • Hepatitis B – the hepatitis B vaccine prevents hepatitis B infections, which when they become chronic, can develop into liver cancer.

For these vaccines to be effective, they have to be given before you are exposed to the virus. That is why it is critical for preteens to get the HPV vaccine before they become sexually active teens and young adults.

Since babies can get hepatitis B if their mother is infected and they are more likely to develop chronic hepatitis B infections, it is also important that all infants be vaccinated with the hepatitis B vaccine. Vaccination programs that instead try to target just those newborns of mothers already known to be infected with hepatitis B are much less successful than universal vaccination programs.

In addition to a preventive cancer vaccine, another type of cancer vaccine is the therapeutic or cancer treatment vaccine. This type of cancer vaccine actually helps your body fight the cancer.

So far, only one cancer treatment vaccine has been approved by the FDA.

Provenge is approved for some men with metastatic prostate cancer, increasing their survival by about 4 months. Provenge works by stimulating T lymphocytes, a part of our immune system, to kill prostate cancer cells.

Cancer Vaccines in Development

Although there are just four approved cancer vaccines in use today, there are many more in development, including:

  • DCVax(R)-L – in phase III trials to treat certain patients with glioblastoma multiforme, a type of brain tumor.
  • NeuVax – in multiple phase II trails, including one for certain patients with breast cancer to help prevent breast cancer recurrence.
  • Rindopepimut – in phase III trial to treat certain patients with glioblastoma.
  • Tecemotide – in phase III clinical trials for certain patients with non-small cell lung cancer.

Even more cancer vaccines are in phase I and phase II trials, such as WDVAX, which is in phase I clinical trials to treat certain patients with melanoma.

Although perhaps not as far along and still in early exploratory or pre-clinical research stages, there are other preventive cancer vaccines being developed too. These new vaccines would provide protection against hepatitis C (liver cancer), Epstein-Barr virus (Burkitt lymphoma, non-Hodgkin lymphoma, and Hodgkin lymphoma, etc.), Helicobacter pylori (stomach cancer), schistosomes (bladder cancer), and liver flukes (liver cancer).

What To Know About Cancer Vaccines

In addition to the hepatitis B and HPV vaccines that can prevent cancer, multiple vaccines are being developed to actually treat cancer.

For More Information On Cancer Vaccines

 

Hedda Get Bedda Doll and Other Measles Stories

Hedda Get Bedda originally came with a hospital bed.
The Hedda Get Bedda doll originally came with a hospital bed.

In the early 1960s, the American Character Doll Company produced a series of Whimsie dolls, including:

  • Annie the Astronut
  • Fanny the Flapper
  • Hilda the Hillbilly
  • Lena the Cleaner (baseball)
  • Samson the Strongman
  • Simon the Degree
  • Wheeler the Dealer (casino dealer)
  • Zero the Hero

Hardly politically correct for our times, the stereotyped dolls do provide a look at the history of their time.

One other doll, Hedda Get Bedda, is especially helpful in that sense.

Made in 1961, this Whimsie doll could change her face, letting you know how she was feeling when you turned the knob on her head. She could go from having a sleeping face, to a sick face (perhaps having chicken pox or measles), to a happy face (once you made her better).

Does the fact that she also came with a hospital bed mean anything?

Just like some anti-vaccine folks like to think that the simple fact that they made a doll that had measles or chicken pox could possibly mean that they looked at them as mild diseases, you could just as easily say that including the hospital bed means ‘they’ understand they were life-threatening diseases that could put land you in the hospital.

We are talking about the pre-vaccine era after all, and in 1961, and when the Hedda Get Bedda doll came out, there were about 503,282 cases of measles in the United States and 432 measles deaths.

Like the Brady Bunch measles episode, the Hedda Get Bedda doll is sometimes used to push the myth that vaccine-preventable diseases aren’t that serious, helping folks justify their decisions to intentionally skip or delay vaccines and leaving their kids unprotected.

“…for those trained in pediatrics in the 1970s, Hib (Haemophilus influenzae type b) was a horror.”

Walter Orenstein, MD

For example, if you believed that measles, chicken pox, or Hib were mild diseases, then you might feel better about not getting your child the MMR, chicken pox, or Hib vaccines.

Sure, many people get measles and do get better without any complications. On their way to getting better though, even they have high, hard to control fever for 5 to 7 days, with coughing and extreme irritability.

But while most get better, we shouldn’t forget that some people don’t survive measles without complications. Natural immunity sometimes comes with a price, from vision problems and permanent hearing loss to brain damage.

And tragically, some people don’t get to survive measles.

Get Educated. Get Vaccinated.

For More Information and Measles Stories

Mumps Outbreaks

Pre-Vaccine Era Mumps Outbreaks

In the pre-vaccine era, mumps was a common childhood infection that could cause orchitis, meningitis, pancreatitis, deafness, and even death.

There were about 212,000 cases a year in the early 1960s, before the first mumps vaccine was licensed in 1968.

Post-Vaccine Era Mumps Outbreaks

Tips to prevent getting sick with the mumps.
A large Ohio mumps outbreak prompted an education campaign to help protect everyone from getting sick.

As with other vaccine-preventable diseases, there was a big drop in cases of mumps once the mumps vaccine was introduced.

In 1968, there were just over 152,000 cases and 25 deaths  and just ten years later, in 1978, that was down to 16,817 cases and 3 deaths.

Once the recommendation for the second dose of MMR came in 1990, it looked like mumps was on it’s way out.

We went from 5,292 cases and one death that year, to just 906 cases and no deaths in 1995. When measles hit its low point of 37 cases in 2004, there were just 258 cases of mumps.

That wasn’t the end for mumps though, as we had some up and down years, including big outbreaks in:

  • 2006 – 6,584 cases among Midwest college students and one death
  • 2008 – only 454 cases, but one death
  • 2009 – 1,991 cases and two deaths
  • 2010 – 2,612 cases mostly among Orthodox Jewish communities and two deaths
  • 2011 – 370 cases
  • 2012 – 229 cases
  • 2013 – 584 cases
  • 2014 – 1,223 cases involving a large outbreak in Ohio and in the NHL
  • 2015 – 1,057 cases mostly among university students in Iowa and Illinois

Could this all be because of waning immunity?

2016 Mumps Outbreaks

So far in 2016, the CDC reports that there have been:

  • at least 4,619 cases of mumps
  • cases have been reported in all states except Delaware, Louisiana, Vermont, and Wyoming
  • seven states, AK, IA, IN, IL, MA, NY, and OK with more than 100 cases in 2016

The most recent, ongoing outbreaks are in:

  • Arkansas (at least 2,159 cases) – which may be fueled by a large community of Marshall Islanders living in close quarters, with low levels of vaccinations among adults in the community
  • Oklahoma (at least 324 cases)
  • Washington (93 cases)
  • Long Beach, New York (45 cases), and at State University of New York (SUNY) at New Paltz in New York (13 cases)
  • Harvard University (4 cases)
  • University of Missouri (31 cases)
  • Tufts University (9 cases)
  • Texas – with most of the cases in North Texas, including a large outbreak in Johnson County (72 cases) and two other outbreaks linked to four different cheerleading competitions.

At SUNY New Paltz, most of the cases were among the swim team. In addition, 20 unvaccinated students were sent home from school under quarantine until December 3.

In Arkansas, 42 workplaces, 39 schools in six school districts, six colleges and two private schools in Benton, Carroll, Conway, Faulkner, Madison, Pulaski, and Washington counties are seeing most of the cases. A quarantine is in effect, with unvaccinated children being kept out of school for 26 days from the date of exposure or for the duration of the outbreak, whichever is longer.

Many of these outbreaks occur despite many of the cases having had two doses of the MMR vaccine. A third dose is sometimes recommended during these outbreaks.

That doesn’t mean that the MMR vaccine doesn’t work. After all, just compare today’s rates of mumps, even if they are a little higher than we would like, to pre-vaccine levels…

Getting two doses of the MMR vaccine is still the best way to avoid mumps.

There is no general recommendations to get extra shots though.

Keep in mind that the MMR vaccine isn’t just for kids. Adults who didn’t have mumps when they were kids (or who were born before 1957, when most kids got mumps), should make sure they are vaccinated (at least one dose) and protected too.

For More Information on Mumps Outbreaks:

References on Mumps Outbreaks:
CDC. Reported Cases and Deaths from Vaccine Preventable Diseases, United States, 1950-2013.

Updated on December 24, 2016

US Presidents and Vaccines

You would think that getting kids vaccinated and protected against vaccine-preventable diseases would be a non-partisan issue, but it unfortunately isn’t always the case.

donald-trump

Even before Donald Trump brought up false claims that vaccines cause autism, we have seen what can happen when funding for vaccines dropped. Federal support for vaccines dropped while Reagan was in office and we quickly saw outbreaks of vaccine-preventable diseases, including many deaths.

Fortunately, most American Presidents have strongly supported vaccines.

There is no longer any reason why American children should suffer from polio, diphtheria, whooping cough, or tetanus. … I am asking the American people to join in a nationwide vaccination program to stamp out these four diseases.

JFK in 1962

  • George Washington – had smallpox and later mandated that every soldier in the Continental Army had to be inoculated against smallpox
  • John Adams – was innoculated against smallpox (before Jenner‘s vaccine was available), as were his wife and children
  • Thomas Jefferson – conducted his own smallpox vaccine trials
  • James Madison – signed the Vaccine Act of 1813 – An Act to encourage Vaccination.
  • James K Polk – died of cholera, a now vaccine-preventable disease, three months after his term ended
  • Zachary Taylor – died of cholera while still in office
  • Abraham Lincoln – developed smallpox while he was in office
  • Franklin D Roosevelt – had polio and founded the National Foundation for Infantile Paralysis, which was later renamed the March of Dimes, and helped fund Jonas Salk‘s research on the first polio vaccine
  • Harry S Truman – had diphtheria as a child, which may have left him with vision problems, and was vaccinated against smallpox
  • Dwight D Eisenhower – signed the Polio Vaccination Assistance Act in 1955, which gave $30 million in federal grants to states to cover the costs of planning and conducting polio vaccination programs, including purchasing polio vaccine
  • John F Kennedy – signed the Vaccination Assistance Act in 1962 (Section 317 of the Public Health Service Act), which started as a three year program to help get kids vaccinated against polio, diphtheria, tetanus, and pertussis, but it has been continuously reauthorized ever since
  • Lyndon B Johnson – established a legacy of US leadership in global immunization by funding the CDC Smallpox Eradication program in 1965 (smallpox wasn’t eradicated until 1980)
  • Richard Nixon – observed that scientists who helped develop the polio vaccine with Jonas Salk “deserve far greater respect and support by the people whom they serve than they now receive.”
  • Gerald Ford – instituted a swine flu vaccination program for an outbreak that never appeared
  • Jimmy Carter – his National Childhood Immunization Initiative in 1977 reached its goal of immunizing 90% of children
  • Ronald Reagan – signed the National Childhood Vaccine Injury Act (NCVIA) of 1986, which created VAERS and the NVICP, while federal support for vaccine programs reached a low point in his years in office, as rates of children living in poverty and without health insurance increased
  • George HW Bush – his immunization action plan in 1991 once again raised immunization rates following three years of measles outbreaks
  • Bill Clinton – his Childhood Immunization Initiative in 1993 which included signing the Vaccines for Children (VFC) Act, provided free vaccines to many children
  • George W Bush – announced a major smallpox vaccination program in 2002, but very few healthcare workers actually volunteered to get vaccinated
  • Barack Obama – declared the 2009 H1N1 swine flu outbreak a national emergency, Obamacare requires health insurance plans to pay for vaccines without co-pays, made the Ebola outbreak a national security priority, and helped keep funding for Zika vaccine research going

What can we expect our next President to do about vaccines and vaccination rates?

For More Information on US Presidents and Vaccines:

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Founding Fathers on Vaccines

The Founding Fathers presenting a draft of the Declaration of Independence.
The Founding Fathers presenting a draft of the Declaration of Independence. By John Trumbull – US Capitol

What did the Founding Fathers think about vaccines?

While some folks like to claim that the Founding Fathers would have been against vaccines, most experts think that claim is nonsense.

What we know is that the seven key Founding Fathers, which include:

  • John Adams – was innoculated against smallpox (before Jenner‘s vaccine was available), as were his wife and children
  • Benjamin Franklin – was vaccinated and regretted not vaccinating his own son, who died of smallpox
  • Alexander Hamilton – supported George Washington’s plan to inoculate the Continental Army against smallpox
  • John Jay – having a brother and sister that were both blinded by natural smallpox infections, you would expect that he would be in favor of vaccinations and he did indeed inoculate his own children Maria, Nancy and Sally Jay against smallpox
  • Thomas Jefferson – conducted his own smallpox vaccine trials
  • James Madison – signed the Vaccine Act of 1813 – An Act to encourage Vaccination.
  • George Washington – had smallpox and later mandated that every soldier in the Continental Army had to be inoculated against smallpox

Without speculating on what they would have thought of today’s immunization schedules and anti-vaccine movements, it is safe to say that they supported the use of the vaccines that were available to them at the time to protect themselves and their families.

For More Information on the Founding Fathers and Vaccines:

Vaccines and Seizures

A newborn baby getting an EEG.
A newborn baby getting an EEG.

Can vaccines cause seizures?

Unfortunately, they sometimes can.

Vaccines and Febrile Seizures

The CDC reports that “There is a small increased risk for febrile seizures after MMR and MMRV vaccines.”

We also know that:

  • there is a small increased risk for febrile seizures when the influenza vaccine is given at the same time as either the Prevnar13 vaccine or the DTaP vaccine, although “the risk of febrile seizure with any combination of these vaccines is small and CDC’s Advisory Committee on Immunization Practices (ACIP) does not recommend getting any of these vaccines on separate days.”
  • there is a small increased risk for febrile seizures if the combined MMR and chicken pox vaccine (ProQuad) is given to infants between the ages of 12 to 23 months vs their getting the shots separately.

But remember that febrile seizures, while scary for parents and other caregivers, are rarely dangerous.

It is also important to note that while febrile seizures are common, they are not commonly triggered by vaccines. A 2016 report in Pediatrics, “Vaccines and Febrile Seizures: Quantifying the Risk,” states that “The risk is 1 febrile seizure per pediatric practice every 5 to 10 years.”

Not surprisingly though, vaccines can likely prevent many febrile seizures, as chicken pox, flu, Hib, measles, mumps, rubella, pneumococcal infections and other vaccine-preventable diseases often cause fever and can trigger febrile seizures themselves.

Also, a study recently found that children who got sick with pertussis could be at increased risk for developing epilepsy, or recurrent seizures. That’s just another good reason to get vaccinated and protected against vaccine-preventable diseases.

Vaccines and Other Types of Seizures

While vaccines can sometimes trigger febrile seizures, they do not typically cause other types of seizures.

It was once thought that seizures were a common side effect of the DPT vaccine, but many studies have found that to not be true and seizures following DPT was even removed as a table injury from the NVICP. In fact, many of these children were instead found to have Dravet syndrome, which put them at increased risk for febrile seizures.

Long-term non-febrile seizures are still listed as side effects for the DTaP and MMR vaccine, but they “are so rare it is hard to tell if they are caused by the vaccine.”

A 2010 study in Pediatrics, “Lack of Association Between Acellular Pertussis Vaccine and Seizures in Early Childhood,” did not find any “increased risk for seizures after
DTaP vaccination among children who were aged 6 weeks to 23 months.”

Do report any reaction to VAERS if you think it was caused by a vaccine though.

Seizures After Getting Vaccines

If vaccines don’t usually cause seizures, then how do you explain a healthy infant developing seizures a few days, weeks, or months after getting his vaccines?

We’re always looking for reasons why something happened. The example I use is from my wife, who is a pediatrician. She was about to vaccinate a four-month-old baby, and while she was drawing the vaccine from the syringe, the baby had a seizure — and went onto have a permanent seizure disorder. Now, my wife hadn’t given the vaccine yet. But if she had given that vaccine five minutes earlier, there would have been no amount of statistical data in the world that would have convinced that mother that the vaccine hadn’t caused the baby’s seizure. You can do studies that show no increased risk with vaccines and seizure disorders, but that mother might still say “well, that’s true for the population but it’s not true for my child.”

Temporal associations are powerful, and they’re hard to defeat with statistics or studies.

Paul Offit, MD interview for The Thinking Persons Guide to Autism

There are many seizure disorders that begin in infancy.

Some even start in the newborn period, before a baby is a month old.

They are not triggered by vaccines though.

They include:

  • Infantile Spasms (first described in 1841) – typically begin when infants are about 4 months old, just when they get their second set of vaccines, which weren’t available when Dr. West described his own son’s repeated spasms
  • Benign Familial Neonatal Seizures – often genetic, seizures may begin on a baby’s third day of life
  • Benign Neonatal Convulsions – begin on the fifth day of life – the “fifth day fits,” and the seizures stop in about a month

If your child got her first hepatitis B vaccine when she was five days old and began having seizures, would you accept a diagnosis of Benign Neonatal Convulsions or would you blame the shot?

Would you remember the saying about correlation and causation?

For More Information on Vaccines and Seizures:

Vaccine Excise Tax

The Vaccine Injury Compensation Trust Fund was set up by the National Childhood Vaccine Injury Act of 1986 as a source of funds to compensate people found to be injured by certain vaccines by the Vaccine Court.

Vaccine Excise Tax

Money for the Vaccine Injury Compensation Trust Fund comes from a $0.75 excise tax on each vaccine that kids routinely get as recommended by the CDC.

Who pays this vaccine tax?

Is it the drug companies or folks getting the vaccines?

The U.S. Department of the Treasury collects the tax from the vaccine manufacturers.

But like other manufacturing costs, they likely just add it to the price of the vaccine. They are still paying it though.

Vaccine Injury Compensation Trust Fund

How much does the IRS collect?

Between 2009 and 2013, it has averaged about $200 million a year.

The Vaccine Injury Compensation Trust Fund has a balance of over $3 billion, as in addition to the excise tax, it gains interest on investments. That balance has grown because the Fund’s income has outpaced its payments (about $3.5 billion) over the years.

For More Information on the Vaccine Excise Tax