Tag: new vaccines

Why Can’t We Make Better Vaccines?

Some parents who don’t vaccinate and protect their kids claim that they want better and safer vaccines.

Wanting better vaccines doesn't automatically make someone anti-vaccine.

Why does that make them anti-vaccine?

Well, it doesn’t automatically make you anti-anything just because you want things to improve. The “anti-” label comes in when folks start to push misinformation about vaccines, scaring others away from vaccinating and protecting their kids.

We all want safer vaccines...

For example, I want safer cars too, but it doesn’t keep me from driving and riding in the cars we have today.

I’m not anti-car…

Why Can’t We Make Better Vaccines?

But back to the idea of better vaccines, can we make vaccines that are more effective and have fewer side effects?

Folks who read anti-vaccine propaganda are made to think that vaccine manufacturers have no incentive to make better vaccines, even as they push the idea that vaccines are dangerous and don’t work.

As more people are vaccinated and diseases disappear, they forget how bad those diseases are and they think more about the small risks of adverse events.
As more people are vaccinated and diseases disappear, they forget how bad those diseases are and they think more about the small risks of adverse events. Photo by WHO

In reality, most vaccines work very well already and they have few risks or side effects.

“There is a 1 in a MILLION chance of getting a serious reaction to a vaccine.”

Making the Vaccine Decision

Still, researchers and vaccine manufacturers are constantly trying to make new and better vaccines.

Unfortunately, there is only so much they can do with current technology.

“The technological approaches for making new vaccines have been growing rapidly in recent decades owing to significant advances in a broad range of interrelated fields, including next-generation sequencing and antibody repertoire analysis, molecular and structural biology, genetics (reverse vaccinology), protein and polysaccharide chemistry, immunology, virology, bacteriology, fermentation, macromolecular purification, and formulation.”

Ahmed et al on Technologies for Making New Vaccines

Hopefully that is starting to change and we will soon get a few new and better vaccines.

A new pertussis vaccine is in phase 2 trials.
This new pertussis vaccine is in phase 2 trials.

In fact, most vaccine advocates are looking forward to having a new pertussis vaccine, Lyme disease vaccine, and a universal flu vaccine, hopefully sooner rather than later.

We will likely even see a new oral polio vaccine to use in outbreak situations soon, even as we get close to withdrawing all use of OPV as part of the endgame strategy!

Making Better Vaccines

And using new technology, we will hopefully have new vaccines against even more diseases.

These technologies include using:

  • a recombinant virus or bacteria
  • a recombinant virus or bacterial vector
  • protein based vaccines with fusion proteins
  • peptide based vaccines with B-cell epitopes
  • peptide based vaccines with T-cell epitopes
  • nucleic acid based vaccines

Researchers are also developing new adjuvants and delivery systems.

“The number of approaches for making new vaccines should continue to expand in the future such that almost all antigens or epitopes could be presented in a highly immunogenic form in the context of a live or inactivated vaccine or be expressed through a DNA-based vaccine. Further understanding of gene function in viral and bacterial pathogens should enable live vaccines to be more stably and predictably attenuated as vaccines and as live vectors for vaccinating against other pathogens. Adjuvant and delivery system technologies should provide formulations that are more potent than aluminum salts, yet are safe and well tolerated, and enable delivery by routes other than injection. Bioinformatics tools should enable the refinement of vaccine antigens to exclude those that are potentially cross-reactive with antigens found in normal human tissue thus limiting the generation of pathogenic autoimmune responses related to molecular mimicry.”

Ahmed et al on Technologies for Making New Vaccines

When can we expect these new vaccines?

Probably not soon enough, as few of these vaccines are in phase III trials.

Many, including vaccines that protect against 2019-nCoV, malaria, HIV, RSV, herpes, etc., will be very welcome by most of us.

Still, while new and some improved vaccines would be great, it is important to understand that the vaccines we have are safe, with few risks, and very necessary.

More on Making Better Vaccines

Did the National Childhood Vaccine Injury Act of 1986 Cause the Immunization Schedule to Triple?

Why do some parents think that the National Childhood Vaccine Injury Act of 1986 caused the immunization schedule to triple?

The National Childhood Vaccine Injury Act did not cause the immunization schedule to triple.

The usual suspects…

Did the National Childhood Vaccine Injury Act of 1986 Cause the Immunization Schedule to Triple?

It is not just folks holding anti-vax propaganda signs though.

“In 1986, Congress—awash in Pharma money (the pharmaceutical industry is No. 1 for both political contributions and lobbying spending over the past 20 years)—enacted a law granting vaccine makers blanket immunity from liability for injuries caused by vaccines. If vaccines were as safe as many claim, would we need to give pharmaceutical companies immunity for the injuries they cause? The subsequent gold rush by pharmaceutical companies boosted the number of recommended inoculations from 12 shots of five vaccines in 1986 to 54 shots of 13 vaccines today. A billion-dollar sideline grew into the $50 billion vaccine industry behemoth.”

Robert F Kennedy, Jr on The Harlem vaccine forum

It is a common anti-vax talking point that the immunization schedule ballooned in 1986, with passage of the National Childhood Vaccine Injury Act.

It didn’t.

The National Childhood Vaccine Injury Act did not cause the immunization schedule to triple.

In fact, it is very easy to see that most new vaccines weren’t added to the immunization schedule until the late 1990s and after.

  • hepatitis B – 1981
  • Hib – 1985
  • hepatitis B vaccine (improved) – 1986
  • Hib (improved) – 1988
  • Varivax – 1995
  • DTaP – 1996 (replaces DTP)
  • hepatitis A vaccine – 1996
  • RotaShield – 1998 (quickly withdrawn)
  • LYMErix – 1998 (later withdrawn)
  • Prevnar – 2000
  • FluMist – 2004
  • Menactra – 2005 (replaces the Menomune vaccine approved in 1981)
  • Tdap – 2006
  • RotaTeq – 2006
  • Gardasil – 2006
  • Trumenba – 2014

And the immunization schedule did not change very much at all after passage of the National Childhood Vaccine Injury Act.

What about Bobby Kennedy‘s other point? Why did we need the National Childhood Vaccine Injury Act if vaccines are safe?

Protection from frivolous lawsuits.

What we need now is protection from this kind of misinformation that continues to scare parents away from vaccinating and protecting their kids!

More on the Immunization Schedule

Did Gregory Poland Really Say That MMR Vaccines Can’t Prevent Measles Outbreaks?

One of the pillars of the anti-vaccine movement is their belief that vaccines don’t even work.

They even think that they have graphs to prove it! They don’t…

Did Gregory Poland Really Say That MMR Vaccines Can’t Prevent Measles Outbreaks?

To help them try and argue their point, they also seem to like to cherry pick and misuse quotes from real experts.

Anti-vaccine propaganda from Lawrence Solomon.
Is that what Dr. Poland said?

In 2012, Gregory Poland, the Editor-in-Chief of the journal Vaccine, did publish the article, The Re-Emergence of Measles in Developed Countries: Time to Develop the Next-Generation Measles Vaccines?

No where in the article does he say that the measles vaccine can’t prevent measles outbreaks.

He is just saying that since the vaccine isn’t 100% effective and because measles is so contagious, that it can’t prevent all measles outbreaks.

“Thus, measles outbreaks also occur even among highly vaccinated populations because of primary and secondary vaccine failure, which results in gradually larger pools of susceptible persons and outbreaks once measles is introduced.”

Poland et al on The Re-Emergence of Measles in Developed Countries: Time to Develop the Next-Generation Measles Vaccines?

And we likely won’t be able to eradicate measles with our current measles vaccine, “even though measles can be controlled, and even eliminated in some regions for defined periods of time.”

“Thus, while an excellent vaccine, a dilemma remains.”

Poland et al on The Re-Emergence of Measles in Developed Countries: Time to Develop the Next-Generation Measles Vaccines?

The dilemma is that measles is still around and that people who are too young to be vaccinated, too young to be fully vaccinated, and those with immune system problems who can’t be vaccinated sometimes get measles, in addition to folks who are intentionally unvaccinated.

With a better vaccine, fewer people would get caught up in outbreaks that are typically triggered by folks who are intentionally unvaccinated.

Remember, most outbreaks are traced back to someone who is unvaccinated. This is the person Dr. Poland is describing when he says “once measles is introduced,” as the endemic spread of measles has been eliminated in the United States. All cases are reintroduced from outside the country, typically when someone who is intentionally not vaccinated travels overseas and then returns with measles while they are still contagious.

“But he also said that sometimes people who oppose the vaccines will pick out one sentence in the scientific study and extrapolate it to mean things that it does not mean… He said that measles is the most contagious disease that we know, and yet we found that fear and ignorance is more so.”

Senator Carla Nelson on The Anti-vaxxers Might Wish that What was Lost had not been Found

Unfortunately, a better measles vaccine still won’t protect us from anti-vaccine propaganda.

Vaccines are safe, with few risks, and necessary. Get vaccinated and stop the outbreaks. You don’t have to wait for a new measles vaccine…

More on Did Gregory Poland Say That MMR Vaccines Can’t Prevent Measles Outbreaks?

Did the FDA Approve a New HPV Vaccine for Adults?

What do you know about the HPV vaccine?

Hopefully you know that it can prevent cervical cancer and that lots of folks spread misinformation that is intended to confuse and scare you away from getting vaccinated and protected with it and other vaccines.

Did the FDA Approve a New HPV Vaccine for Adults?

News that the approved ages for Gardasil have been expanded will likely add to that confusion for a little while.

The FDA simply approved the expanded use of the existing Gardasil 9 vaccine – not a new vaccine.
The FDA simply approved the expanded use of the existing Gardasil 9 vaccine – not a new vaccine.

The first thing to understand is that the FDA did not approve a new Gardasil vaccine for older adults.

They very simply expanded the age recommendations for who should get the existing Gardasil 9 vaccine, which was approved back in 2014, replacing the original Gardasil vaccine, which was approved in 2006.

“The U.S. Food and Drug Administration today approved a supplemental application for Gardasil 9 (Human Papillomavirus (HPV) 9-valent Vaccine, Recombinant) expanding the approved use of the vaccine to include women and men aged 27 through 45 years.”

Why the new age indication?

“In a study in approximately 3,200 women 27 through 45 years of age, followed for an average of 3.5 years, Gardasil was 88 percent effective in the prevention of a combined endpoint of persistent infection, genital warts, vulvar and vaginal precancerous lesions, cervical precancerous lesions, and cervical cancer related to HPV types covered by the vaccine.”

But isn’t the whole point of giving the HPV vaccine to preteens that you want to get them vaccinated and protected before they are sexually active and exposed to and infected by HPV?

Sure, but if you didn’t, and unless you are sure that you have been exposed to and have been infected by all 9 types of HPV strains that Gardasil 9 protects you against, then the vaccine is still a good idea when you are older.

Except FDA approval doesn’t automatically mean that your insurance company will pay for it.

That usually comes once a vaccine is formally added to the immunization schedule by the ACIP.

“In a 2005 study, 92% of insurance plans reported following Advisory Committee on Immunization Practices recommendations to determine covered vaccines; of those, 60% could extend coverage within 3 months after issuance of recommendations and 13% in 1 month.”

Lindley et al on Financing the Delivery of Vaccines to Children and Adolescents: Challenges to the Current System

And Obamacare still requires insurance plans to provide ACIP-recommended vaccines at no charge.

Will Gardasil 9 be added to the immunization schedule for adults?

The extended age indication for Gardasil 9 will be discussed at the next ACIP meeting.
The extended age indication for Gardasil 9 will be discussed at the next ACIP meeting.

We should know sooner, rather than later. It is on the agenda for the next ACIP meeting on October 25…

More on Gardasil for Older Adults