I write on a somewhat regular basis on here about vaccines: new research, new shots, addressing skepticism about how well they work or if they’re related to autism, etc. Recently, several vaccine stories have been in the news that I’ve not gotten to yet, so consider this a vaccine meta-post. More after the jump.
The first story is timely in that it discusses the influenza vaccination (and we’re heading into that season). Allow me to share an anecdote first. When I was pregnant with my daughter in 1999, I was in graduate school and the lab I worked in was affiliated with a hospital. So, of course they offered flu shots, particularly for those in high-risk groups (and pregnant women are one of those groups). When I went to get my vaccine, however, the nurse refused to give it to me, saying they were not allowed to vaccinate pregnant women due to “the risks.” I had to return later with the CDC’s recommendation guidelines to prove to her that I should get the vaccine. I wonder how many people–even health care workers–are similarly misinformed. The article suggests that there’s a lot of misunderstanding regarding pregnant women and the influenza vaccine:
The Centers for Disease Control and Prevention says pregnant women are at risk for serious medical complications from flu related to decreased lung capacity, increased heart rate and other conditions of pregnancy. But the message is not being heeded, says Gregory Poland, professor of medicine at the Mayo Clinic in Rochester, Minn.
“Among the groups for whom influenza vaccine is recommended, the lowest group (who receive it) is pregnant women, at 12.9%,” says Poland, who wasn’t involved in the study.
This is even more important now than we knew previously, because the study that’s mentioned found that pregnant women who get the influenza vaccine not only protect themselves, but also their newborn:
Babies born to mothers who received a flu shot during the last three months of pregnancy appear to be protected from infection during their first six months of life, a study suggested Wednesday.
The results of the study, presented at the Interscience Conference on Anti-microbial Agents and Chemotherapy, bolster recommendations for pregnant women to be immunized against flu, says researcher Mark Steinhoff of Johns Hopkins University in Baltimore.
Steinhoff says the results came as part of a study of a pneumococcal vaccine that involved 340 women in Bangladesh in their third trimester of pregnancy. Half of the women got the pneumococcal vaccine, and the other half got flu vaccine, which was used as a control.
Current vaccines are not licensed for babies under 6 months. The study suggests that immunizing pregnant women can protect babies during those months.
Another common problem for babies and toddlers are ear infections. The pneumococcal vaccine mentioned helps to protect against some of these (caused by Streptococcus pneumoniae), but they are still a huge pain for parents (and, of course, children). This vaccine has also reduced serious infections caused by this bacterium, including meningitis. Likewise, the vaccine against serotype B Haemophilus influenzae has reduced invasive infections due to that strain of bacterium since its introduction. However, non-typeable strains of H. influenzae still circulate, and while they rarely cause serious invasive disease, they’re a major cause of ear infections, sinus infections, and bronchitis. A new vaccine aims to reduce these as well:
U.S. researchers said on Tuesday they are starting trials of a new vaccine aimed at wiping out childhood ear and sinus infections and many cases of bronchitis in adults.
The vaccine will target Nontypeable Haemophilus influenzae or NTHi, which is the main remaining cause of ear and sinus infections and bronchitis, now that vaccines exist for various forms of streptococcal bacteria and Haemophilus influenzae B, the previous leading causes.
While ear infections are never fatal, they can cause serious damage in some children, Pichichero noted. He said 83 percent of U.S. children experience one or more ear infections by age 3 and in some cases hearing loss becomes permanent.
And the infections force children to visit clinics and emergency rooms, and are the leading reason for antibiotic prescriptions. Experts agree antibiotics are overused in the United States, which wastes money and also helps “superbug” bacteria evolve that resist the drugs.
But finally, not all vaccination news is good news. While there is residual anti-vaccine sentiment in the United States for a variety of reasons and across the political spectrum, it’s even worse elsewhere:
For Ramatu Garba, the polio vaccine is part of an evil conspiracy hatched in the West to sterilize Nigerian girls.
“Allah used Muslim scientists to expose the Western plot of using polio vaccines to reduce our population,” said the 28-year-old Muslim food vendor in Kano.
Each time health teams have tried to vaccinate her daughter, Garba has refused.
It’s been three years since local politicians began a campaign of fear and rumor, claiming the polio vaccine would sterilize children. Those unfounded fears still persist today, and it’s this myth, and others like it, that are largely responsible for the spread of polio into almost two dozen other countries where it was once stamped out.
“The world is still paying the price for what happened in Nigeria in 2003,” said Dr. David Heymann, the top official for polio eradication with the World Health Organization. Most of the new infections in other countries can be traced to Nigeria.
And for those who doubt how effective these vaccines are, Nigeria unfortunately can be used as a natural experiment documenting just how critical they are:
The number of polio cases in Nigeria continues to rise. There were 355 cases in 2003; so far in 2006, there are more than 800 cases, WHO reports.
Of course, once trust has been lost, it’s difficult to regain, and the US and Nigeria certainly aren’t the only countries dealing this this:
In Pakistan, a recent court petition — citing Nigerian documents that claim the vaccine contains estrogen — asks the government to end the polio eradication program. In the past, polio vaccinators in Quetta have been stoned and chased out by angry locals.
And in Kenya, there have been devil worship allegations: Parents feared that having their children take the oral vaccine would result in their tongues being magically removed.
And it is difficult to quell vaccination rumors once they start. In Nigeria, experts thought the polio vaccine issue was resolved when politicians lifted the vaccine ban in July 2004.
But for Nigerians like Sadiya Musa, the flip-flop causes even more suspicion.
“How can they say the vaccine is bad and then say it is good again?” asked the mother of six, who believes the vaccine causes sterility and HIV/AIDS. “I cannot be deceived.”
How can a public health professional counter an attitude like that?