vaccines
revere | February 15, 2008We've posted a bit (here and here) on this year's flu vaccine and some mismatches. Because of the time it takes to ramp up production the flu vaccines for the following season are made in the early spring of the year before, often, as now at the peak of the ongoing flu season. Yesterday WHO announced that they were changing all three of the strains in next year's vaccine, something that is unusual but not unprecedented.
This is all reported by the best of the best flu reporters, Canadian Press's Helen Branswell. I could do some pull quotes and summarize what she wrote, but instead I'll just…
revere | February 8, 2008We've discussed this already, but now CIDRAP News also has a story (which they got from AP) that this year's flu vaccine is not perfectly matched to the all the circulating viruses (of course we had it first, but hey, who's keeping track?). The data that are used to prepare vaccines for the next flu season come from predictions based on what is seen during the current season as determined by a global surveillance network (the same network at issue in the refusal of Indonesia to share H5N1 isolates, although this mismatch has nothing to do with the Indonesian situation). The circulating…
revere | January 30, 2008OK, they're not cities, they are states. Or cities in states. Whatever. But when it comes to flu shots they are quite different. First benighted Mississippi:
The Mississippi State Department of Health (MSDH) reports 27 laboratory-confirmed influenza cases in counties throughout Mississippi. The presence of influenza was documented by the MSDH Laboratory in the past few weeks.
"We are now in the peak season of influenza, which will last for the next couple of months," said State Health Officer Dr. Ed Thompson. "If you haven't gotten your flu shot, it's time to get it now. It's still not too…
revere | January 27, 2008There's no vaccine for the influenza subtype, H5N1, of most concern as the agent of the next pandemic but evidence exists that there is some cross-reactivity with existing seasonal vaccines (it's not clear how much if any, but it might not take much) or that previous vaccination with seasonal vaccine produces a much quicker response to an H5N1 vaccine. Moreover there remains a substantial toll in morbidity and mortality from the seasonal influenza which the current vaccines are designed for. So strategies to encourage key populations to get the existing flu vaccine are of interest to public…
revere | January 21, 2008A report late last night by Helen Branswell alerted me to a tabulation from a new tracking system WHO is putting into place to answer demands from a number of member states in the developing world that there be more transparency in how isolates of avian influenza (bird flu) submitted to WHO are used and by whom. About a third of confirmed cases have been registered in Indonesia, although that country has provided less than a quarter of the isolates, a reflection of the refusal by the country's health minister, Dr. Siti Fadilah Supari, to provide any more specimens until matters of vaccine…
revere | December 20, 2007Nature's senior correspondent, Declan Butler, was one of the first to raise the profile of a pandemic threat in the scientific community and has had done some superb reporting since, including several stories on sharing gene sequences. The problematic actors in his earlier stories were respected scientists and the business-as-usual way they were approaching release of genetic sequences even as the world worried that the virus they were studying, influenza A, was inexorably searching for the right recipe to enhance its own raison d'etre, to make still more copies of itself, potentially with…
revere | December 6, 2007YouTube is a phenomenon. We've gotten so used to it (and its user generated content cousins) sometimes we don't realize how potent it is. Potent and in the hands of all sorts of people. Creative, crazy, evil, well meaning, ordinary, boring . . . you get the idea. And getting ideas is another thing people get from YouTube. Sometimes the ideas are good. Sometimes not:
It may be better known as the place to go to watch a drunken David Hasselhoff eating a hamburger, but the video website YouTube has also become a popular and effective soapbox for people who believe vaccinations are harmful, a new…
revere | December 5, 2007Most people in the developed world think of measles as a pesky but fairly benign childhood disease. For the current generation, who has had the benefit of immunization with measles vaccine, it is also a historical curiosity. Not so for the developing world, where measles has been a major killer of children and infants. Africa has become the poster child for failed public health programs so it is nice to be able to say that when it comes to measles prevention, Africa is a special success story:
Africa, which has long had the most measles deaths, has seen the biggest drop, 91 percent. In many…
revere | December 5, 2007Indonesian Health Minister, Siti Fadilah Supari, has reiterated her refusal to share isolates of H5N1 virus (it's unclear if this is her decision alone or is the considered decision of the Indonesian government). This came at the current inter-minsterial conference on bird flu on underway in Delhi (how many of these conferences are there, anyway? It seems like every week there's another one.) Her demand is that every isolate have a Material Transfer Agreement (MTA) requiring a statement each time the isolate is shared with another laboratory, stating it is only for diagnostic purposes and not…
revere | November 26, 2007Indonesia's health minister, Siti Fadilah Supari, has answered the question whether the recently concluded Geneva summit on sharing of influenza viruses had produced sufficient agreement to induce that country to begin sharing again. Her answer seems to be "no":
Indonesia's health minister reiterated Sunday that she would not send bird flu specimens to the World Health Organization, saying poor nations needed assurances that any pandemic vaccines developed from the virus would be affordable.
Siti Fadilah Supari made the comments on her return from Geneva, where the WHO held an…
revere | November 24, 2007As you will see from the account below the fold, the flu summit was a contentious and complicated affair. Only time will tell if it was even a qualified success, but there are reasons to be hopeful. Tip of the hat to Ed Hammond, one of the NGO participants, who provided the public health community with his perspective at a time when no one else was talking. This involved late hours for him at the end of long days. We are grateful.
Here's his wrap-up:
Influenza Meeting Ends in Qualified Success
At the end of contentious meetings like the one on policies for sharing flu virus it is tempting to…
revere | November 24, 2007Yesterday was the fourth and final day of the important Geneva summit on sharing flu virus isolates. Like premature news of Mark Twain's death, the Reuters report the meeting had failed was exaggerated. On the contrary, the summit appeared to have moved things forward. We have the latest, below. You can find previous happenings and background here, here, here and here.
Status mid-day, Day 4 (3:26 pm Geneva time, November 23), as reported by Ed Hammond:
Some Things That Happened in the Night Session of Day 3 and Morning Session of Day 4
These sessions were the final negotiations before…
revere | November 23, 2007The critical summit on sharing influenza viruses entered its third day (previous coverage here and links therein). The big media outlets covered the opening but not since. Fortunately, you can read about developments here (Day 2, here). Ed Hammond is there and is keeping us abreast of developments.
A participant's view at the start of Day 3 (5:30 am, Thursday, Geneva time):
Halfway Through and No New Ideas from the US and EU
To be sure, Indonesia has not been the most effective leader for its cause. Its multiple failures at this meeting (if not previous ones) to put forward clear language…
revere | November 22, 2007We have an on-the-ground view of the critical influenza virus sharing summit, provided by Ed Hammond in Geneva. I am promoting his comment thread notes from earlier today and a fuller account from late in the evening on Wednesday (Geneva time) sent me by email. It is clear that the atmosphere is tense and not convivial.
First, if you haven't been following the issue here or elsewhere, here's a bit of background from an excellent piece at Intellectual Property Watch (h/t Agitant):
The politically explosive issue of ensuring everyone benefits from vaccines in the event of an influenza pandemic…
revere | November 21, 2007The first day of the scheduled four day showdown in Geneva over sharing bird flu virus isolates is now over. What seems to have been accomplished is statements of opening positions. How moveable everyone is remains to be seen, as does whether there is an Alexander the Great around to cut the Gordian Knot (you can see the strands of the knot in some of our previous posts, for example (chronologically) here, here, here, here, here, here, here, here, here, here, here, here, here, here and here).
Here is Reuter's version of Day 1:
Indonesia, the nation worst hit by bird flu with 91 human deaths,…
revere | November 20, 2007If a rogue H5N1 virus easiy tansmissible between people is to develop, the most plausible spot for it to happen is Indonesia, the world's fourth most populous with a vast reservoir of infected poultry (and who knows what else) and more human cases (113) and more deaths (91) than any other country. But Indonesia still refuses to share its human H5N1 isolates, contending they get nothing tangible from an arrangement which is likely to lead to vaccines they won't be able to afford. Under the current system, which allows intellectual property rights to cover vaccines developed from WHO supplied…
revere | October 25, 2007The "experts" have spoken to WHO and WHO has spoken to us: because of the march of science, there's been a large upswing in the estimates of how much vaccine the world could produce in a pandemic -- if such a vaccine existed and there was a way to deliver it. But if there was one and it could be delivered, then WHO thinks we could produce up to a 4.5 billion doses by 2010 as a result of new manufacturing technologies and techniques to make the produced antigen go farther. A lot of "ifs," to be sure, but without the ability to make the stuff the rest doesn't matter.
At the moment we make a…
revere | October 24, 2007There's a line forming for the pandemic vaccine that doesn't yet exist. Sort of like a new Harry Potter book except it's not first come first served. Like a sinking ship, it's (pregnant) women and children first -- or among the first. The deployed military? Police, I understand. But deployed military? They come ahead of critical infrastructure (power, water, communications) and older children? They come ahead of food and agricultural workers?
"Certain military personnel like deployed forces would get vaccinated before certain other military personnel," HHS science adviser William Raub said in…
revere | October 23, 2007If you have or have had small children you may be all too familiar with earaches. When our kids were small we felt as if we were single-handedly supporting the amoxicillin makers. A major cause of middle ear infection is the organism Streptococcus pneumoniae (S. pneumoniae), which sometimes it invades other tissues and causes bacterial meningitis (not the kind that you read about killing healthy teenagers, but bad enough) and sometimes other body sites. It is also a cause of pneumonia in adults and was a common cause of secondary bacterial pneumonia in the 1918 flu. That was then. Now there…
revere | September 30, 2007Bioterrorism defense dollars seem to be devoted mainly to procurement. This follows President Bush's prescription for how all Americans could defeat the terrorists after September 11: go shopping. Practicing what they preach, the federal government has gone on another buying spree for something we don't need: anthrax vaccine:
The federal government has awarded a $400 million contract to Emergent BioSolutions for another 18.75 million doses of anthrax vaccine, with a bonus to be paid if the company wins approval for extending the vaccine's shelf life.
The 3-year contract for BioThrax vaccine,…