vaccines
revere | February 8, 2007I sympathize with the Indonesians up to a point. Their outrage over what they perceive as the plundering by vaccine makers of their natural resources (in this case a lethal virus isolated from Indonesian bird flu cases) is understandable -- barely. Their subsequent actions to stop sharing samples of the virus with WHO and their attempt to justify it by blaming WHO is not understandable. Nor is it intelligent. But then very little in the way of effective and intelligent bird flu policies has come out of Indonesia anyway. This is part of the package, alas.
The complaint of the Indonesian…
revere | February 7, 2007This was an incident waiting to happen. Indonesia has signed a preliminary agreement with vaccine maker Baxter international an arrangement to supply with with viral vaccine seed in exchange for an unknown compensation. It is unclear whether the arrangement is exclusive to Baxter or not (see today's New York Times, says not). Until the deal is completed they will not continue to send viral isolates to other scientists for research or other purposes. Sharing of sequence data is said to be unaffected. The deal with Big Pharma Baxter International puts viral seed strains from the world's…
revere | January 31, 2007Exploration with new vaccine technologies is moving forward rapidly, although given the usual pace of the science and then necessary tests for safety and efficacy it isn't likely we will have a bird flu vaccine sooner than two or three years from now. Maybe that's enough time. Maybe it isn't. It would have been good if we'd have started earlier, but we didn't. Anyway, here's the latest entry, a skin patch vaccination (TransDermalImmunization, TDI). Naturally the news comes to us not through a scientific publication but through a press release. How else do you raise money these days? (That's a…
revere | January 5, 2007Since I started cogitating on the apparent dominance of H1 subtypes this flu season instead of the more common H3, I've continued to look at some previous papers on the subject. The take home message I am getting is that there is quite a bit we don't know about this disease, influenza, despite its long history and the interest of the medical and scientific community. We've commented on this before. Some problems are like that. Cancer is another example. A particularly interesting paper that illustrates the point by Hay et al. was published in 2002 (hat tip to a loyal reader who sent the link…
revere | December 25, 2006Measles is now uncommon in the US, thanks to vaccination. Last year there were only 66 cases. But half of them came from a single, unvaccinated 17 year old who traveled to Romania on a church mission that visited an orphanage. The next day she returned to the US and attended a gathering of other church members, 33 from Indiana and one from Illinois. Three wound up in the hospital.
Measles vaccination is not 100% effective but it is estimated to be over 90% in pre-school and school aged children. In this instance, 32 of the 34 cases were unvaccinated:
"The outbreak occurred because measles was…
revere | December 7, 2006There is a new paper in the Journal of Immunology I found more than a little disconcerting. University of Rochester scientists have found that the cells in the immune system responsible for antibody production, the B-cells, also express high levels of the enzyme cyclooxygenase-2 (Cox-2). Overproduction of Cox-2 can cause pain and fever, which frequently accompany reaction to infection. The problem is that treatment of B-cells with inhibitors of the enzyme (Cox-2 inhibitors) also markedly affected the ability of the B-cell to produce antibody. What are some Cox-2 inhibitors? Aspirin, Ibuprofen…
revere | November 7, 2006Nothing says more about the routinely nasty depths American politics than this story.
In Houston, the city health department got money from the Robert Wood Johnson and Amerigroup Foundations, two charities much involved in health care, to provide free flu shots near polling places in medically underserved areas. This isn't uncommon. Some twenty other cities, in several states, are said to have similar "vote and vaccinate" programs (see for example, here). The idea is to go where the people who need the services are.
Nothing is simple anymore. Not even free flu shots for the poor. The right…
revere | November 1, 2006The Chinese news agency Xinhua reported last week that scientists at the Wuhan Institute of Virology found H5N1 in the feces of sparrow, non-migratory urban birds two years ago (via Reuters). The brief news report only says the discovery followed an outbreak among poultry in nearby Henan province. It's not clear what took so long to report this or whether the H5N1 strain in sparrows differs from that in poultry.
Is this good or bad for public health?
It's hard to think of ways it could be good for public health to have another endemic source of a virus potentially capable of infecting humans…
revere | October 31, 2006Another vaccine "story" makes the wires, this time from Dynavax, a Berkeley biotech company. The story is pretty typical of the genre:
Drug companies typically design their seasonal flu vaccines to generate antibodies that neutralize two proteins, hemagglutinin and neuraminidase, on flu viruses. But because these two proteins are prone to mutate, new vaccines tailored to their changing characteristics usually have to be made every year.
That variability could prove devastating if the bird-flu virus suddenly mutates into a form that spreads quickly among people instead of just birds. By the…
revere | October 26, 2006When it comes to vaccinations, a high degree of safety is one of the paramount issues. This is because even a small risk, like one in a million, when multiplied by tens of millions will produce tens or more of adverse events. The trade-off, of course, is the prevention of the disease the vaccine is directed against. Unlike a therapeutic drug, when a vaccine works, nothing happens. When there is a side effect, a previously well person becomes sick from the vaccine itself. This becomes a tricky problem in public health education. The recent scare in Israel with influenza vaccine illustrates…
revere | October 21, 2006It seems like you can't turn around these days without seeing another vaccine story on the wires. Novartis has announced its cell culture vaccine technology has successfully passed its clinical trials and is preparing for regulatory approvals. Instead ofusing eggs to grow the vaccine seed strain, Novartis is using dog kidney cells which are permissive for influenza virus growth. By-passing eggs allows freedom from a precarious pathogen-free egg supply and faster start-up time from when the pandemic strain is identified. Novartis says it has successfully scaled up production methods and plans…
revere | October 19, 2006There's a report on the wires that scientists at the Vaccine Research Center (VRC) at U.S. National Institute of Allergy and Infectious Diseases have developed a DNA vaccine that protects mice against the reconstructed 1918 virus. The paper just appeared online in the Proceedings of the National Academy of Sciences (PNAS, also known as "penis" in the trade). At this point the paper is more important for what it reveals about how the mouse immune system protects against this notorious virus than as a demonstration of a vaccine technology for use in people. That is much further down the road.…
revere | October 16, 2006This story ("Scientists close to neutralizing all flu types") continues to circulate and frankly, I don't understand why.
British scientists believe they are close to finding a way to stop all flu viruses --including the deadly H5N1 virus, known as the bird flu.
Researchers at Warwick University say they have found a way to turn the flu virus against itself.
Although the research is still in its preliminary stage, the results are a source of optimism for the medical community concerned about the global spread of bird flu.
"We're very close. The lab data are as good as they can be. It works…
revere | September 14, 2006Whenever I hear about the latest H5N1 vaccine fix I have the same reaction. If only we'd started doing this several years ago when the threat of an avian influenza pandemic was plausible, we'd be so much farther ahead, if not "there" by now. But we didn't. CDC chased the bioterrorism phantom, to please King George, and Big Pharma was mainly interested in their obscenely profitable (and sometimes fatal) big items for aches and pains and impotence (oh, excuse, me; I mean erectile dysfunction). Oh, well. We'll take what we can get, now.
The latest is a live virus H5N1 vaccine from MedImmune, the…
revere | August 19, 2006WHO has taken note (.pdf) of the increasing genetic diversity of the H5N1 influenza/A viral isolates as the disease spreads geographically. Clades are genetically related viruses with common ancestors. Since 2003, two such clades have appeared (clades 1 and 2), distinct from the original H5N1 viruses from the 1997 Hong Kong outbreak (now called clade 3). Clade 1 viruses have been isolated in southeast asia (Vietnam, Cambodia, Thailand, Laos), sandwiched between clade 2 viruses from southern China and Indonesia and Malaysia.
Until now, the experimental human vaccines have been made with seed…
revere | August 10, 2006The lull in bird flu is over. At least the lull in the news about bird flu. The virus didn't go away. Editors got tired of it and national agricultural officials were quiet about it. Now Thailand is again engulfed with poultry infections and experiencing human cases and Indonesia continues to percolate away with both bird and human cases. In both countries the endemic poultry problem is the underlying cause.
"When you have trouble controlling infection among the chicken flocks, you are naturally going to see continuing infections among humans," Dr. Anthony Fauci, the US National Institutes of…
revere | July 27, 2006The human bird flu vaccine news from pharma giant GlaxoSmithKline sounds good and it probably is. Probably. There is a lot we don't know yet as the results have not been published in the open medical literature. Here's what GSK is claiming.
First, they claim to have produced a vaccine that raises antibodies in 80% of the test subjects (400 Belgians) with a very small amount of viral material (antigen), 3.8 micrograms given twice (7.6 micrograms, total). Previous attempts to make vaccines against H5N1 have required much more antigen. Because our ability to produce viral antigen in eggs is very…
revere | July 17, 2006An interesting Commentary on the problem of releasing the flu sequences has been posted on the blog Anthropologique by its proprietor, J. F. Brinkworth. I disagree with it, but he makes some pertinent points.
Brinkworth believes WHO is not at fault for failure to release the Indonesian sequences and he provides some information of which I, and probably most others, are not aware:
Indonesia has very, very stringent nucleic sequence I.P. laws. All genetic material recovered there is their property. Their Convention of Biological Dviersity Law No.5 (1994) and Cultural Practices Law No. 12 (1992…
revere | July 10, 2006The leaders of the G8 meet this weekend in St. Petersburg (aka Leningrad aka Petrograd) and they were supposed to announce a business-friendly scheme to get drug companies to make vaccines for the developing world. Looks like it isn't going to happen, though, because the US and France are arguing over whether the US will back a French proposal for an international airline ticket tax to pay for aid to poor countries (Wall Street Journal). Germany and Japan are also balking at contributing to the plan, so there it sits, despite former claims of support by all parties:
The situation marks a…
revere | July 6, 2006Several countries have elected to vaccinate poultry as a bird flu control measure. Vietnam and China both have such programs. The Vietnamese program is credited with their good record on bird flu this year. But poultry vaccination has some down sides:
The potential impact on human health of poorly implemented bird inoculations and experimental poultry vaccines needs to be carefully considered, according to a report prepared by the influenza team at the European Centre for Disease Surveillance and Control in Stockholm. A drop in the number of human cases in countries where fowl are vaccinated…