Tag: vaccine pipeline

Too Many Too Soon Revisited

You know how anti-vaccine folks like to say that kids get too many vaccines at too early an age these days?

Four generations of vaccines or vaccine misinformation?
Four generations of vaccines or vaccine misinformation?

It’s not like the ‘good old days,’ when instead of more vaccines, they just got more diseases.

But looking at the immunization schedules from the 1950s and 1960s, you should know that folks back then got a lot more vaccine doses than you have been led to believe.

Too Many Too Soon Revisited

And you know what else? Those vaccines include the “crude brew” of DPT and smallpox, which contained far more antigens per vaccine than today’s vaccines.

The 1951 immunization schedule published by the AAP.
The 1951 immunization schedule published by the AAP.

By six months, these kids got the smallpox vaccine (200 antigens) and three doses of DPT (3,002 antigens), for a total of 9,206 antigens.

And today?

They could get up to about 174 antigens, including

  • DTaP: 7 antigens * 3 doses = 21 antigens
  • IPV: 15 antigens * 3 doses = 45 antigens
  • Hib: 2 antigens * 3 doses = 6 antigens
  • Prevnar13: 14 antigens * 3 doses = 42 antigens
  • hepatitis B: 1 antigen * 3 doses = 3 antigens
  • rotavirus: 15 antigens * 3 doses = 45 antigens
  • Flu: 12 antigens * 1 dose = 12 antigens

That’s 9,032 fewer antigens or less than 2% of what they once got, even though they are protected against many more diseases!

Not worried about antigens anymore?

Just remember that in the 1950s, in addition to all of these extra antigens, except for smallpox, these vaccines were made with thimerosal and aluminum.

Not that those ingredients were dangerous then, or today. It’s just more recently that folks decided that they were scary.

But it is just important to keep in mind that it is misleading to say that kids only got 2 vaccines then, and now get 69, 72, or 74.

In fact, it’s not just misleading, it’s lying.

If you use the same anti-vaccine math, in the 1950s, they actually got at least 22 doses by age 9 or 10! And they got even more once the polio vaccine was introduced in 1955.

Vaccines don't destroy your life force...
Vaccines don’t destroy your life-force…

Anti-vaccine folks still try to downplay the number of doses of vaccines folks got back in the 1950s and 1960s though.

Why?

To scare you.

Kids do get more vaccines, but they have far fewer antigens, and more vaccines means more protection against more diseases.

In the 1950s, 60s, and 70s, kids were dying of diseases that are now vaccine preventable, including rotavirus, hepatitis A and B, chicken pox, pneumococcal meningitis, epiglottitis, Hib meningitis, and meningococcal meningitis, etc.

What about the idea that all of the extra vaccine doses were added right after the passage of the National Childhood Vaccine Injury Act of 1986?

Believe it or not, it was almost nine years, 1995, before a new vaccine (Varivax) was added to the immunization schedule. Others were slowly added after that, including:

  • hepatitis A (1996)
  • rotavirus (1998)
  • Prevnar (2000)
  • Menactra (2006)
  • Tdap (2006)
  • Gardasil (2006)

The biggest change? The one that helps boost the numbers of doses so that anti-vaccine folks can try and say that kids get 72 doses of vaccines?

That was when we started recommending flu shots for healthy kids, beginning with infants for the 2004-05 flu season. Remember, nearly a third of their list is just flu shots…

What about Hib and Hep B? They were both added right before the passage of the National Childhood Vaccine Injury Act of 1986.

Guess what?

Nothing about their little anti-vaccine memes are true.

Vaccines are safe, with few risks, and are necessary.

More on Too Many Too Soon Revisited


Making a Better Pertussis Vaccine

So we know that we need a better pertussis vaccine.

DTaP and Tdap just aren’t doing the job that they should be doing.

Whooping Cough is back, again.
Whooping Cough is back, again.

So when will we get one?

Making a Better Pertussis Vaccine

Since anti-vaccine folks are always talking about the 300 new vaccines in the pipeline, you would think that we would have had several new pertussis vaccines by now…

Unfortunately, we don’t.

What we do have is some good candidates, including:

  • new acellular pertussis vaccines, either with more antigens or an adjuvant
  • a new live attenuated nasal vaccine, BPZE1
  • new whole-cell vaccines with reduced endotoxin contents (so should have fewer side effects that then original whole-cell pertussis vaccine – DTP)

Before you get too excited, keep in mind that none of these vaccines will be available in your pediatrician’s office any time soon. Developing a new vaccine takes a lot of time.

BPZE1 has started phase 2a trials though.

What do we do until we get new pertussis vaccines?

“We should be more vigilant than we have been in the past to recognize and treat pertussis in all age groups so that transmission to young infants is reduced. Most important (although not discussed in this review) is to ensure that all pregnant women receive the Tdap vaccine between 27 and 36 weeks’ gestation with each pregnancy. Also, we should consider routinely administering Tdap vaccine every 3 years to all adolescents and adults who were primed with a DTaP vaccine.”

James D. Cherry on The 112-Year Odyssey of Pertussis and Pertussis Vaccines—Mistakes Made and Implications for the Future

We should keep using the pertussis vaccines we have!

Vaccines work, even when they aren’t as effective as we would like.

More on Making a Better Pertussis Vaccine

Choose to Stop Spreading Anti-Vaccine Propaganda

You have a choice.

Right now.

You can continue to share and spread anti-vaccine propaganda, helping scare other folks away from vaccinating and protecting their kids, or you can stop.

Choose to Stop Spreading Anti-Vaccine Propaganda

Why is the above meme anti-vaccine propaganda?

For one thing, there aren’t 200 vaccines in the pipeline!

There are actually very few new vaccines being developed that have any chance of making it onto the immunization schedule anytime soon. Many of the so-called vaccines in the pipeline are either not for infectious diseases (many are therapeutic vaccines for cancer!) or are for the same disease.

Even more importantly though, removing non-medical vaccine exemptions, which are often abused, doesn’t force anyone to vaccinate their kids.

Vaccine mandates are laws about getting vaccinated to attend daycare and school, etc. You still have a choice if you don’t want to get vaccinated.

What’s the problem that some folks have?

They don’t like their choices!

They want to be able to skip or delay their child’s vaccines and be able to send them to daycare or school.

“…the increased risk of disease in the pediatric population, in part because of increasing rates of vaccine refusal and in some circumstances more rapid loss of immunity, increases potential exposure of immunodeficient children.”

Medical Advisory Committee of the Immune Deficiency Foundation

And they want to take away everyone else’s choice to decrease their risk of getting a vaccine-preventable disease.

You don’t have a right to do that though!

Are you still spreading anti-vaccine propaganda?

Then you are part of the problem. You just don’t realize it yet.

And you are the reason that rates of vaccine-preventable diseases are going up and why Legislators are having to tighten the rules to prevent exemption abuse.

More on Choosing to Stop Spreading Anti-Vaccine Propaganda

Where are the Saline Placebos?

Remember when anti-vaccine folks used to say that there were no double-blind, placebo-controlled randomized clinical trials for vaccines?

What happened once they realized that there actually were?

They moved the goal posts…

Where are the Saline Placebos?

Okay, they said.

So you have done double-blind, placebo-controlled randomized clinical trials when testing vaccines, but what placebo did you use?

Was it a pure saline placebo?

“Placebo Control – A comparator in a vaccine trial that does not include the antigen under study. In studies of monovalent vaccines this may be an inert placebo (e.g. saline solution or the vehicle of the vaccine), or an antigenically different vaccine. In combined vaccines, this may be a control arm in which the component of the vaccine being studied is lacking.”

WHO on the Guidelines on clinical evaluation of vaccines: regulatory expectations

Although no guidelines actually call for using a pure saline placebo, that’s all anti-vaccine folks will accept these days.

Why?

That’s there MO – or method of operation.

When one theory or myth gets squashed – they move to another.

They move the goalposts.

It doesn’t matter that there are often ethical and logistical problems with using pure saline placebos, that’s all they want to hear about it.

That they wouldn’t be satisfied and start vaccinating their kids if all vaccine studies started to use saline placebos should be evident when you consider that many vaccine studies have already used saline placebos!

There are many more vaccine studies that have used saline placebos and like other vaccine studies, have found vaccines to be safe and effective.

But how do you know that they used a real saline placebo and not some kind of saline solution with other stuff in it?

If it isn’t clear to you in the methods section of the study, go to the source – the original clinical trials record and it will be listed there.

What are you going to be worried about now?

More on Saline Placebos

Are You Ready for DNA Vaccines?

Believe it or not, vaccines aren’t a one-size-fits-all kind of a thing.

“There are several different types of vaccines. Each type is designed to teach your immune system how to fight off certain kinds of germs — and the serious diseases they cause.”

Vaccine Types

In addition to live vaccines, like MMR, there are inactivated vaccines, toxoid vaccines, and subunit, recombinant, polysaccharide, and conjugate vaccines.

Are You Ready for DNA Vaccines?

Vaccines made with current technology have helped save millions of lives.

It’s time for some new approaches though, especially as we are seeing the limitations of some of our current vaccines, especially the seasonal flu vaccine.

“DNA vaccines take immunization to a new technological level. These vaccines dispense with both the whole organism and its parts and get right down to the essentials: the microbe’s genetic material. In particular, DNA vaccines use the genes that code for those all-important antigens.”

NIH on Vaccine Types

While a DNA vaccine might sound like something out of the 23rd century, researchers have been studying them since the 1990s.

“Researchers have found that when the genes for a microbe’s antigens are introduced into the body, some cells will take up that DNA. The DNA then instructs those cells to make the antigen molecules. The cells secrete the antigens and display them on their surfaces. In other words, the body’s own cells become vaccine-making factories, creating the antigens necessary to stimulate the immune system.”

NIH on Vaccine Types

Does the idea of being injected with the genes for a microbe’s antigens scare you?

“The original concerns associated with the DNA platform were the potential for genomic integration and development of anti-DNA immune responses. Exhaustive research has found little evidence of integration, and the risk for integration appears to be significantly lower than that associated with naturally occurring mutations”

Ferraro et al on Clinical Applications of DNA Vaccines: Current Progress

What do you think happens when you get the flu?

The flu virus and it’s DNA is taken up by your cells, and those cells then start making more flu proteins.

“This approach offers a number of potential advantages over traditional approaches, including the stimulation of both B- and T-cell responses, improved vaccine stability, the absence of any infectious agent and the relative ease of large-scale manufacture.”

WHO on DNA Vaccines

So where are all of the DNA vaccines?

“However, the results of these early clinical trials were disappointing. The DNA vaccines were safe and well tolerated, but they proved to be poorly immunogenic. The induced antibody titers were very low or nonexistent, CD8+ T-cell responses were sporadic, and CD4+ T-cell responses were of low frequency. However, these studies provided proof of concept that DNA vaccines could safely induce immune responses (albeit low-level responses) in humans.”

Ferraro et al on Clinical Applications of DNA Vaccines: Current Progress

After getting disappointing results in the 1990s, researchers have since moved on to second-generation DNA vaccines, which are being tested for HIV treatment and prevention, Zika, Dengue fever, influenza (DNA vaccine prime), HPV, cancer treatment (metastatic breast, B cell lymphoma, melanoma, prostate, colorectal), chronic hepatitis B treatment, chronic hepatitis C treatment, herpes, and malaria.

There are many completed trials for DNA vaccines.
There are already many completed trials for DNA vaccines.

While many of these DNA vaccines are now in phase I and II trials, unfortunately, that means we are still a long time away from having a DNA vaccine on the immunization schedule.

More on DNA Vaccines

How Are Vaccines Related to News About Food Recalls and Food Poisoning?

Do you ever think about vaccines when you think about food recalls?

How about when you think about food poisoning?

Well, maybe you should, after all, we do have vaccines to prevent hepatitis A infections and typhoid fever, both are which can be spread through contaminated food.

How Are Vaccines Related to News About Food Recalls and Food Poisoning?

That’s not exactly what we were talking about though…

Anti-vaccine folks have a new conspiracy theory about food recalls and food poisoning.
Surprise! Anti-vaccine folks have a new conspiracy theory about food recalls and food poisoning. How often do these types of posts correlate with the truth? What do you guys think? Zero?

That’s right, some folks think that the recent food recalls are correlated to vaccines. They are “creating a market” for a new Salmonella enterica serovar Typhimurium vaccine!

“We evaluated the extent of attenuation and immunogenicity of the ΔlppAB and ΔlppAB ΔmsbB mutants of Salmonella enterica serovar Typhimurium when delivered to mice by the oral route.”

Erova et al on Protective Immunity Elicited by Oral Immunization of Mice with Salmonella enterica Serovar Typhimurium Braun Lipoprotein (Lpp) and Acetyltransferase (MsbB) Mutants

At least they are if mice are monitoring our outbreaks and are in the market for a Salmonella enterica serovar Typhimurium vaccine?

How would that work anyway? No, not mice watching the news and ordering vaccines…

Do they actually think that someone is contaminating our food with Salmonella bacteria so that folks will want these vaccines, when they become available?

Food poisoning is horrible!

Whether it is for Listeria, Salmonella, or E. coli, it likely won’t be very hard to get folks vaccinated, if and when they become available.

More on Propaganda About Vaccines and Food Recalls

Should You Get an Extra Dose of Gardasil9?

Believe it or not, the first human papillomavirus (HPV) vaccine was approved way back in 2006.

HPV Vaccine is Cancer Prevention.

And believe it or not, we are now on our third version of the vaccine, which provides protection against even more strains of HPV.

HPV Vaccine Timeline

So we have gone from:

  • Cervarix – HPV serotypes 16, 18 (2006)
  • Gardasil – HPV serotypes 6, 11, 16, 18 (2006)
  • Gardasil9 – HPV serotypes 6, 11, 16, 18, 31, 33, 45, 52, and 58 (2014)

And with each new vaccine, there comes more protection against anal and genital warts and anal, genital, head and neck, and cervical cancers.

Gardasil9, the only HPV vaccine available in the United States, increases the protection level against cervical cancer from 70 to 90%!

Should You Get an Extra Dose of Gardasil9?

Has your child already finished their HPV vaccine series?

With which HPV vaccine?

To be clear, if they have finished the series, then they are considered to be fully vaccinated and protected.

“Persons who have completed a valid series with any HPV vaccine do not need any additional doses.”

National Cancer Institute on Human Papillomavirus (HPV) Vaccines

Remember, the key, high-risk strains that cause most HPV-associated cancer are HPV-16 and 18, which are present in all of the HPV vaccines.

The extra coverage in Gardasil9 to HPV strains 31, 33, 45, 52, and 58 could prevent an additional 10% of invasive HPV associated cancers or about 3,800 cases each year though, mostly in women.

Should you get any extra doses of Gardasil9 for this extra coverage?

“Administration of a 3-dose regimen of 9vHPV vaccine to adolescent girls and young women 12-26 years of age who are prior qHPV vaccine recipients is highly immunogenic with respect to HPV types 31/33/45/52/58 and generally well tolerated.”

Garland et al on Safety and immunogenicity of a 9-valent HPV vaccine in females 12-26 years of age who previously received the quadrivalent HPV vaccine.

While safe to do and it works, there is no formal recommendation that anyone actually get any extra doses of Gardasil9 at this time.

It is something to consider if you want the extra protection though.

Will we get even more coverage in future HPV vaccines? The future might come in different types of vaccines or even in therapeutic vaccines. There doesn’t seem to be a new version of Gardasil with expanded strain coverage in the immediate pipeline though.

More on Getting an Extra Dose of HPV9