vaccines
revere | May 9, 2007Last week another mathematical modeling paper made the newswires. If you wonder how this happens, the answer is that universities and companies have PR departments that put out press releases. Services like ScienceDaily aggregate and package these press releases for journalists and others (like us). Since a mathematical paper in a specialized journal (in this case it is PLoS Computational Biology) is not likely to be read by a reporter, especially a reporter on deadline, it isn't surprising the news stories follow the press release rather than the paper. In this case, I am sorry to say, the…
scientificactivist | April 28, 2007On Monday, 23 April, the Texas Senate voted 30-1 in favor of its version of HB1089, a bill overturning Rick Perry's February executive order mandating that all girls entering the sixth grade receive the HPV (human papilloma virus) vaccine Gardasil. On Wednesday, 25 April, the Texas House approved the Senate version of the bill by a 135-2 vote. On Thursday, 26 April, the bill was sent to Governor Rick Perry, who has ten days to sign the bill into law, veto the bill, or do neither (which would have the same effect as signing the bill). Even if Perry vetoes the bill, both the House and the…
revere | April 26, 2007The wound opened by Indonesia's balk on supplying H5N1 viral isolates to WHO for vaccine surveillance (see here and here) has now been fixed -- with a band-aid:
Indonesia and other five countries are being awarded grants by the World Health Organization to establish in-country manufacturing capacity for influenza vaccine, according to Indonesian branch of WHO.
As part of a concerted effort to ensure more equitable access to a potential pandemic influenza vaccine, up to 2.5 million U.S. dollars sponsored by the governments of Japan and the United States will go towards Brazil, India, Mexico,…
revere | April 18, 2007I wasn't going to post on the announcement yesterday by the US FDA that it had approved the Sanofi Pasteur H5N1 vaccine. We've discussed it before. It was pretty much a failure, requiring too much viral antigen, two doses, and resulting in putative protection of less than half of those who receive it. There is a stockpile (or will be) of about 3 million doses in the national stockpile, only enough for a tiny fraction of those who would need it, with doubtful value for many of them. It was approved because, like the crooked gambling wheel, it's the only game in town. Who would get it isn't…
revere | April 13, 2007I admit to being prejudiced, here, but my experience living in Sweden (a long time ago, it is true), knowing a bit of the language and seeing what goes on there makes me think of the Swedes as one of the most rational people on earth. It's true most other peoples don't give them a lot of competition on that score, and I am sure there will be Swedes reading this who will protest I've done their country an injustice. It's far worse than I'm making out, they'll tell me. Sure. Come over here and live. Don't forget to bring your Swedish health insurance. We don't provide it here.
Sweden is a small…
revere | April 12, 2007The newswires are on it again. This one has a good hook. A flu vaccine made in insect cells. So I read the paper. And in truth, it's pretty interesting.
Genetically engineered flu vaccine made from yellow striped caterpillars instead of hen eggs has been shown for the first time to keep people from getting the flu, scientists say.
The results are preliminary but suggest the insect method could be a quicker, easier alternative to the lengthy, antiquated egg-based procedure now used and could lead to a more rapid response to a pandemic, the study authors say. (Lindsey Tanner, AP)
There's more…
revere | March 30, 2007Tamiflu side effects have been much in the news and we have concurrently been posting our mega-series on modeling antiviral resistance in influenza control. The two subjects are related in two ways, one obvious (Tamiflu is the main antiviral being stockpiled for influenza control) and one not so obvious: both topics are related to the fact that million, tens of millions or hundreds of millions of doses are contemplated. For antiviral resistance this means even very rare mutations producing a fully transmission-competent resistant virus can spread widely through the population (you will see…
revere | March 28, 2007So the vaccine sharing summit in Jakarta is over and Indonesia says they will begin sharing virus again. The proviso is that they can't be shared with pharmaceutical companies until a vaccine-sharing agreement is hammered out with WHO and that will take an estimated 3 months. I'll be surprised if it is done that quickly, but Hope springs Eternal. Meanwhile the scientific community will be able to see the sequences (at least that's how I read it) and WHO can prepare seed strains but not distribute them. The agreement should also allow determination if any markers of antiviral resistance have…
revere | March 27, 2007Indonesia, as usual, presents us with a dilemma. It is one of the least effective nations in dealing with their bird flu problem, exhibiting massive incompetence spiced by corruption. This has helped make them the bird flu epicenter of the world, with more deaths (by a long way) than any other nation and fast approaching Vietnam for most number of recorded cases. At the same time they have raised a legitimate issue: developing nations like Indonesia provide essential information to WHO on how to make effective vaccines against circulating influenza virus strains. WHO in turn shares the…
revere | March 21, 2007Indonesia has still to provide the WHO flu surveillance program with any H5N1 viral isolates since the first of the year. The issue is access to what will certainly be a scarce vaccine supply if a pandemic would start in the next five or or even ten years. The leading candidate for a pandemic strain at the moment is one that starts in Indonesia, the world's current hotspot for avian influenza both in poultry and people. So controlling access of vaccine makers to H5N1 isolate from within its borders recognizes they have something the rich countries that have the vaccine plants need. One reason…
revere | March 18, 2007Vaccine reactions are almost inevitable, and even when rare, if you are vaccinating hundreds of thousands or millions or tens of millions, you get them. Some are worse than others, and generalized vaccinia from a smallpox vaccination is one of the worst. Vaccinia is cowpox, not smallpox, but since Jenner first discovered that milkmaids who had localized cowpox lesions then didn't get smallpox, infection with this live virus has been used to protect us against smallpox. Except we don't need to be protected anymore, because the last smallpox case died in 1978, ironically on September 11. The…
revere | March 14, 2007A few weeks ago an FDA advisory committee recommended approval of Sanofi-Aventis's prepandemic H5N1 vaccine, despite data that it required very large amounts of viral antigen (90 mcg) in two doses. At the time it seemed there were far better vaccines available or about to be available. What set this vaccine apart was that Sanofi had been making it to fill an order placed by the US Department of Health and Human Services (DHHS) and there was enough for 3.75 million people in the US stockpile, although because of elapsed shelf life that was down to about 3 million. Ninety micrograms is a lot…
scientificactivist | March 13, 2007The Texas House voted today 119-21 to overturn governor Rick Perry's executive order requiring mandatory vaccination against HPV (human papilloma virus) for girls entering the sixth grade. The bill, HB1098, still requires final approval in the House before moving along to the Texas Senate. Perry could attempt to veto the bill, but his veto could be overridden with a two-thirds majority in both the House and the Senate. The House demonstrated today that it already has the necessary votes to counter a veto.
The House bill takes things a step further by preventing the adoption of any HPV…
revere | March 12, 2007We've discussed the problem of an affordable vaccine for the developing world several times (here, here, here). We advocate ten to a dozen regional international vaccine institutes to make influenza vaccine at cost, license and patent free. Another suggestion has come from Dr. Carl Nathan from Cornell Medical College in a Commentary published in Nature Medicine and summarized at the Cornell news site:
Weill Cornell Medical College scientist Dr. Carl Nathan has issued a bold call for reforming the pharmaceutical development and patent systems in order to increase the number of vaccines and…
scientificactivist | March 11, 2007On 2 February, Texas became the first state in the nation to enact a mandatory vaccination scheme for human papilloma virus (HPV), the primary cause of cervical cancer. The vaccine, Gardasil, is produced by Merck. Although welcomed by many, this was a surprising development since it was brought about by an unusual executive order from conservative Republican governor Rick Perry.
The executive order requires all girls entering the sixth grade to undergo the series of vaccinations, although concerned parents are given the choice to opt out if they so desire. Not surprisingly, there was an…
revere | March 5, 2007If the best you can say about the human bird flu vaccine made by Big Pharma's Sanofi Aventis SA is that it is "better than nothing," are you even correct about that?
The Food and Drug Administration is considering a recommendation from an outside panel of expert advisers that it approve the Sanofi vaccine. Those experts endorsed the vaccine's safety and efficacy Feb. 27, but with a caveat: that it's only the first step in developing a way of successfully immunizing humans against the deadly H5N1 strain of bird flu.
Sanofi said it recognizes the vaccine is only an interim solution, since…
revere | March 3, 2007When Indonesia withdrew from the longstanding system whereby countries shared influenza virus with WHO there was widespread consternation in the public health community. The sharing system has been used for many years to determine the candidate strains for the following year's vaccine. The regular seasonal flu vaccine has three components corresponding to the prediction of which of the influenza A H1N1, H3N2 and influenza B strains will be circulating during the next flu season. Usually the guess is correct, although sometimes it misses. In any event, global surveillance of circulating virus…
revere | February 27, 2007The bird flu news hasn't been that good this week. New outbreaks in Afghanistan, Kuwait, Vietnam's previously quiet north, continuing infestations in Russia, and human cases in Egypt and Laos (although confusion over the Egyptian case) (see rundown in CEDRAP News here and here). How about some good news? Like, tests have shown the experimental vaccine now being considered for licensing by the FDA is safe. Of course there is also other news about the vaccine:
The federal government is weighing approval of a bird flu vaccine that is even less effective than previously thought.
Sanofi Aventis SA…
revere | February 17, 2007One thing at which WHO is spectacularly successful -- sending mixed messages. In October avian influenza was a major public health threat and the world needed to do more.
While the deadly bird flu virus has not spread as widely as feared in Africa, vigilance is still needed across the world to counter its advance and deal with its impact on humans, the United Nations coordinator for the disease said today, expressing in particular "very great concern" over Indonesia, where practically the whole country has been affected. (UN's David Nabarro, October 2006)
Now we are on the verge of having an…
revere | February 14, 2007A new paper has just appeared in PLoS Medicine on an old topic: whether seasonal influenza vaccines might also cause enough cross-reactivity to protect against H5N1. The basic idea is simple. The immune system "sees" the surface proteins on the flu virus and makes protective antibodies against them. The major stimulant for this is the hemagglutinin protein (HA), the H part of H5N1. There are 16 different immunological flavors of HA that cross-react very little. Since the human population has never had widespread infection with a flu virus that has the H5 subtype (we have had H1, H2 and H3…