Tag: Louis Pasteur

Why Did France Take the Rotavirus Vaccine off Their Schedule?

Have you heard that France took the rotavirus vaccine off their immunization schedule?

Why?

It was supposedly because two babies died of intussusception after being vaccinated.

Rotavirus Vaccines and Intussusception

Intussusception? Wasn’t that just a risk from RotaShield, the original rotavirus vaccine?

While the risk was higher with RotaShield, the current rotavirus vaccines do have a small risk of intussusception.

france-immunization-schedule
The French immunization schedule is published in the Bulletin épidémiologique hebdomadaire and has never included the rotavirus vaccine.

So did France take the rotavirus vaccine off of their schedule?

Technically, France hadn’t yet added the rotavirus vaccine to their schedule, but it had been available since 2006 and they did formally recommend infants get vaccinated beginning in November 2013.

That recommendation was suspended in April 2015, after they recorded 47 cases of intussusception over an 8 year period. This included 14 cases that required surgery and tragically, two deaths, including one child who died at home without getting any medical care. The other developed intussusception after the third dose of vaccine, which is not usually linked to any increased risk.

It is important to note that at least 80 other countries, including the United States, Finland, Germany, Norway, and the UK, haven’t stopped using the rotavirus vaccine.

Why not?

Because the risks of a natural rotavirus infection are much greater than the risk of intussusception. In other words, the benefits of the vaccine exceed its risks.

In France alone, for example, it is estimated that rotavirus vaccines could prevent 30,000 emergency room visits, 14,000 hospitalizations, and 8 to 17 deaths each year, all in children under the age of three years.

And even without the rotavirus vaccine, there are about 200 to 250 spontaneous intussusceptions each year in France. Fortunately, infants with intussusception can almost always be successfully treated, often without surgery.

Why Did France Take the Rotavirus Vaccine off Their Schedule?

It actually makes no sense that France stopped recommending that infants get vaccinated with one of the rotavirus vaccines.

The decision was widely condemned and there are calls to reassess the decision and put the rotavirus vaccine back on the schedule in France.

“After the surprising decision of the CTV-HCSP of April 2015 to suspend its own recommendation for widespread vaccination against Rotavirus (following a false and misleading pharmacovigilance report) against the international recommendations, we advise you to read the meta-analysis on efficacy (in comparative studies) and the effectiveness (field efficacy) of these vaccines.”

InfoVac Bulletin Novembre 11/2016

The benefits of the rotavirus vaccines far outweigh its risks.

“The estimated benefits of vaccination in our study greatly exceed the estimated risks and our results should contribute to provide further evidence for discussions around rotavirus vaccination in France.”

Larmrani et al A benefit–risk analysis of rotavirus vaccination, France, 2015

Why did France take the rotavirus vaccines off their schedule?

News of the Newark kids going to Paris to get Pasteur's rabies vaccine made the front page of the New York Times.
In 1885, four boys from New Jersey went all of the way to France to get Pasteur’s new rabies vaccine, which wasn’t yet available in the US.

That’s a good question.

Another good question? How many infants have died of rotavirus infections since they did? And when will they put the vaccine back on the schedule? Fortunately, the rotavirus vaccines are still available in France, they weren’t banned as some folks say.

Of course, this isn’t the first time that France impulsively suspended a vaccine.

In 1998, France suspended the routine vaccination of teens against hepatitis B because of the possible association of the vaccine with multiple sclerosis. This was done amid “pressure from anti-vaccine groups and reports in the French media have raised concerns about a link between HBV immunisation and new cases or relapses of MS and other demyelinating diseases,” even though “scientific data available do not support a causal association between HBV immunisation and central nervous system diseases, including MS.”

“In 1998, official concerns were first voiced over a possible association between hepatitis B virus (HBV) vaccination and multiple sclerosis (MS). Despite a number of studies that have demonstrated no such association, ten years on the French population’s confidence in the vaccine remains shaken and immunization rates of infants have stagnated beneath 30%. With a chronic carriage of the virus estimated at 0.68%, it seems unlikely that France will be able to control the circulation of the virus. ”

Marta Balinska on Hepatitis B vaccination and French Society ten years after the suspension of the vaccination campaign: how should we raise infant immunization coverage rates?

Do you know where all of this has left France now?

With high rates of vaccine-preventable disease (15,000 cases of measles in 2011, with 16 cases of encephalitis and 6 deaths) and a move towards vaccine mandates. As of January 2018, all infants and toddlers in France must receive DTaP, Hib, HepB, pneumococcal, MMR, and meningococcal C vaccines.

What to Know About France Taking the Rotavirus Vaccine off Their Schedule

In no longer recommending the rotavirus vaccines, officials in France actually put infants at greater risk for sickness and death.

More on France Taking the Rotavirus Vaccine off Their Schedule

 

Who is Joseph Meister

Most people know the big names in the history of vaccines.

They know that Edward Jenner developed the first smallpox vaccine (1798) and that both Jonas Salk (1955) and Albert Sabin (1960s) developed polio vaccines.

Many other important names are forgotten though.

Ever heard of James Phipps? He was the 8-year-old boy who was the first to become inoculated with cowpox by Jenner to see if it would protect him from smallpox.

Who is Joseph Meister

Edward Jenner didn’t go out of his way to experiment on Joseph Meister, but he has a similar story.

A plaque honors Joseph Meister and Louis Pasteur in the Alsace region of France.
A plaque honors Joseph Meister and Louis Pasteur in the Alsace region of France.

In 1885, Louis Pasteur had been working on an attenuated (weakened) rabies vaccine in his lab in Paris, but had still not tested it on any human patients yet.

One hot July morning in 1885, feverish little Joseph Meister was dragged by his frantic mother through the streets of Paris in search of an unknown scientist who, according to rumors, could prevent rabies. For nine-year-old Joseph had been bitten in 14 places by a huge, mad dog and in a desperate attempt to cheat death, his mother had fled from their home town in Alsace to Paris. Early in the afternoon Mme Meister met a young physician in a hospital. “You mean Pasteur,” he said. “I’ll take you there.”

Time magazine 1939

Supervised by two doctors, Dr. Alfred Vulpian and Dr. Jacques-Joseph Grancher, Joseph Meister received the first of 14 doses of Pasteur’s rabies vaccine on July 6, 1885, two days after he was bitten.

Joseph Meister survived and became the first person to be successfully vaccinated against rabies.

“As the death of this child appeared inevitable, I decided, not without deep and severe unease, as one can well imagine, to try on Joseph Meister the procedure which had consistently worked in dogs.”

Louis Pasteur

So at about the same time as anti-vaccine folks were marching in Leicester, Joseph Meister’s mother traveled over 400km to see a doctor she didn’t know, to get her son an experimental vaccine that had never even been used on a person before.

News of the Newark kids going to Paris to get Pasteur's rabies vaccine made the front page of the New York Times.
News of the Newark kids going to Paris to get Pasteur’s rabies vaccine made it into the New York Times.

Her son was lucky that she did.

It saved his life.

A few months later, a teenager named Jean-Baptiste Jupille was bitten by a rabid dog as he saved six other children that were being attacked. He became the second person to receive Pasteur’s rabies vaccine and he too lived.

Soon, Pasteur was a hero and many people were seeking his rabies vaccine from all over the world.

In December 1885, six boys from Newark, New Jersey were bitten by a rabid dog and there were calls to send them to Paris to be treated by Pasteur. Donations were collected and four of the boys ended up going on the steamship Canada to Paris.

While that trip to Paris generated some controversy, as some later doubted that the dog had rabies, there is no doubt that Pasteur’s rabies vaccine saved a lot of lives.

Few people survived having rabies in the pre-vaccine era.
Few people survived having rabies in the pre-vaccine era.

Why were folks in Newark, and apparently everywhere else, so afraid of rabies?

It had only been a few months earlier, about the time that Joseph Meister was being successfully vaccinated in Paris, that newspapers were reporting about “the terrible death” of a 5-year-old in Newark “after suffering the most intense agony.”

He had rabies.

Even if news of that case wasn’t fresh on their minds, it is easy to see that rabies wasn’t something you survived.

It should come as no surprise that there were soon rabies treatment clinics in major cities all over the world using Pasteur’s vaccine.

What to Know About Joseph Meister

At about the same time as anti-vaccine folks were marching in Leicester, Joseph Meister’s mother traveled over 400km to see a doctor she didn’t know, to get her son an experimental vaccine that had never been used on a person before – to save him from rabies.

More About Joseph Meister

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