Final Thoughts

Chapter 10

So its time to say auf wiedersehen! Today I will be entering my tenth and final blog on the topics of vaccines. I hope that over this ten week period you have been able to find my blog informative and helpful. We have discussed everything on vaccines from the history of vaccines to the uses of present day vaccinations. And how vaccine have completely changed the face of modern day humanity. I hope that I have been able to inform you on the importance of complying with the vaccine schedule . I also hope that I have brought awareness to the fallacies and controversies about vaccines. If you have any questions, please do not hesitate to comment below and I will be sure to respond. Thanks all for keeping up with me and don't forget to get your flu shots this year! One great resource that I found extremely helpful while writing this blog was the CDC's website. It is filled with insurmountable information on vaccine and vaccine schedules a long with many other statistical data that could be pertinent to you and your community. If you are ever interested in finding out more information on vaccine please visit this website.

How do vaccines work?

Chapter 9

Vaccines protect people from diseases. They have even been able to eradicate small pox from the earth, a disease that was once ran rampant on earth. Vaccines prevent a lot of diseases that cause death, disabilities and in the end they save money. 

When we are born, we are born with the ability to develop an immune system. The immune system is composed of many cells that patrol around in our fluids, organs and other tissues looking for foreign material/antigen. When the immune system comes in contact with a foreign invader/antigen, it makes antibodies against that antigen and some of those antibodies have the ability to store memory, just in case that same invader comes around again. These are called memory cells and they serve to fight a re-infection. 

Vaccines assist the immune system, because they contain certain antigens that belong to a pathogenic disease. Not to worry these antigens found in vaccine are either killed or weakened, they are not strong enough to cause disease but they certainly are enough to engage our immune system. Once we engage the immune system with our antigens from the vaccine, we make antibodies against them. And like we said before some of these antibodies form into memory cells, so if we ever get infected with that same pathogen in the future we would be able to readily fight the infection. This is a general description about the way vaccine prevent diseases. All in all, vaccines are very beneficial to humans because they allow us to fight an infection without ever actually getting the disease or feeling sick. 

MMWR Vaccine coverage among 2012-2013 kindergartners

Chapter 8

       School vaccination assessments are used to provide information for the state and local institutions about who in their community has vaccine coverage or vaccine exemption. This assessment can provide explanations when looking at where there is a clustering of vaccine preventable diseases. It allows state/local institutions to develop campaigning strategies on where and how to target a particular group where we see a clustering of vaccine preventable infections.

      An assessment like this was done on kindergartners entering the public school system year 2012-2013 in all 50 states by the CDC. The data was reported in the Morbidity and Mortality Weekly Report August 2, 2013.

      While reviewing the data I came upon some very interesting facts. Over all as a nation we did very well with vaccination coverage this academic year, it was reported that vaccine coverage was about 95%, which is the national target coverage rate recommended by HEALTHY PEOPLE 20/20. The HEALTHY PEOPLE 20/20 recommend that the nation keep a 95% coverage level for "2 doses of MMR vaccine, 4 doses of DTaP† vaccine, and 2 doses of varicella vaccine"( MMWR 62(30);607-612). Nevertheless, the rest of the 5% of people that were not covered could pose a problem. We see that high vaccine exemption rates and low vaccination could cluster in communities and that could lead to the introduction of a vaccine preventable disease that could cause an outbreak and potentially harm a lot of people. 

     The data reported that among all 50 states and D.C vaccine exemption were allowed. Specifically 46/50 of the states allowed religious exemptions, 18/50 allowed philosophic exemptions and 2/50 (Mississippi and West Virginia) did not allow either religious or philosophic exemptions but they did allow other exemptions. Regardless of all of these exemptions, 48 states and D.C reported a 94.5% median coverage of the mandatory 2 dose MMR vaccine. This percentage ranged from (85.7% coverage in Colorado to 99.9% coverage in Mississippi). The median percentage for DTap vaccine was 95.1% ranging from (82.9% in Colorado to 99.9% in Mississippi). And lastly the median percentage for the 2 dose varicella was 93.8% ranging from (84.6% in Colorado to 99.9% in Mississippi). It is important to note that 91,453 out of 4,242,558 kindergarteners surveyed reported exemptions. This is valuable information when trying develop "health communication strategies to help parents understand the risks for vaccine-preventable diseases and the benefits of vaccinations to the health of their children and other 
kindergarteners"(MMWR 62(30);607-612). 

     What this survey provided state/local programs with, was information on where a VPD outbreak could happen. The data reported in this article did have some data collecting set backs. For example, there were three different methods used to collect information. Those were a public census, a IIs immunization information systems, voluntary resopnse or  combination of the three. There were no data for home schooled children. There was also another discrepancy with the data collection only 12/50 states were concordant with the CDC requirements for data collection and that at the time of collection some children were in the process of filling out their vaccine schedules and once they were compliant with the vaccine schedule this information was not updated in the data. 

     If you would like to take a look at the report and analyze the data for carefully click here. You will find the full report and data. This picture below is just a representation of the states that had more than one vaccine exemption for kindergartner in the academic year 2012-2013. 

First Image: http://www.ubm1.org/vaccines.jpg

Article reference : "Vaccination Coverage Among Children in Kindergarten — United States, 2012–13 School Year." Centers for Disease Control and Prevention. Centers for Disease Control and Prevention, 02 Aug. 2013. Web. 30 Oct. 2013. <http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6230a3.htm>.

Using cat virus as a model for an HIV vaccine!

In this weeks blog we will be critiquing a virology paper on the development of an HIV vaccine using a cat virus as a model. The name of the paper is called Feline Immunodeficiency Virus Model for Designing HIV/AIDS Vaccines. You can click on this link if you would like to access the paper. 

Let me just start by saying this was a very interesting article and it definitely got me thinking about vaccine design. The paper focused on a feline virus called FIV(feline acquired immunodeficiency) that is a distant cousin of HIV and let me just make the distinction before we continue, the scientist claim that this FIV in cats is the equivalent of HIV in humans. The authors of this paper are researchers at UF and UCSF.

The researchers proposed that we use the FIV as a model to develop an HIV vaccine. The reason why this would be beneficial is because apparently the FIV is able to make a protein that has anti-HIV properties. They saw that when they incubated HIV infected T cells with FIV, "one particular peptide region on FIV triggered patients' T cells to kill HIV"(Yamamoto). The scientists in this paper think that they can develop a vaccine that targets human T cells, which is something that has never been done before. The researchers think they can design a T cell HIV vaccine that is able to activate a human's immune response against the FIV or AIDS. 

Reading this paper I was very excited because it proposed a new way to target the immune system. There were many reasons why this would be very hard to do. But the paper does propose many new ways in which we would be able to use FIV as a model for an HIV vaccine. 


Paper: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3721975/#!po=55.6818

Some Frequently asked question about vaccines

Chapter 6

http://www.ias.org.nz/wp-content/uploads/ID-10069184-300x300.jpg

FAQS about vaccines

1. Are there any vaccine side effects? And if there are side effects are they severe? There are side effects with vaccines, but they are usually mild and non life threatening.
2. Why should I vaccinate my child? Why is it important? Its is important to vaccinate your child so he/she has protection from deadly diseases. It is important every child is vaccinated because that would prevent the spread of disease among children and other populations.
3. Does the MMR vaccine really cause autism? No the MMR vaccine does not cause austism. There are no links between autism and the MMR vaccine. The article that suggested this has been disproven.
4. What disease do the vaccine prevent? Vaccines prevent a lot of diseases both bacterial and viral. Here is a link where you will find vaccine preventable diseases. http://www.cdc.gov/vaccines/vpd-vac/default.htm
5. Where can I get vaccines? You can get a vaccine at pharmacies, doctors offices, public clinics, and any other departments that offer health care services. 
6. How much do vaccine cost? Vaccines are usually covered by insurance and if you are not insured here is a link with detailed prices of vaccines. http://www.cdc.gov/vaccines/programs/vfc/awardees/vaccine-management/price-list/
7. What kind of materials are in vaccines? And do they hurt my body? Vaccines contain animal products, they sometimes contain yeast and other food products that could be harmful to people who have an allergic reaction to vaccines.
8. Do vaccine only apply to children? No they do not there are some vaccines that can be administered to adults and adults can also get booster shots. 
9. I am an uninsured illegal immigrant how can I get vaccinated? You can go to a doctors office and pay for your vaccine. Although some states offer free vaccines for undocumented workers. And definitely free vaccines should be offered to your child.
10. How are vaccines made? Are they really made in eggs? Some vaccines are made in eggs this picture below is how they make flu vaccines. 

http://wwwf.imperial.ac.uk/blog/lifesci-ug-blog/files/2011/11/Flu-vaccine.

What you should know about the flu this year.

So it's flu season and everyone is rushing to their clinics or pharmacies for the flu shot. It seems the flu has a way of always showing up around the fall and winter months. But what should you expect this flu season? Today we will talk about how to prepare for flu season, where to get the flu vaccine, and learn how many vaccines are available this year. Which is information that everyone has access to on the CDC website.

How to Prepare for Flu season 2013-2014

So flu season typically starts in January and February but flu activity usually starts around October. And because "epidemics of the flu happen every year, the timing, length and severity varies" (CDC). Therefore in order to prepare for the flu season the CDC recommends that anyone over the age of 6 months get a yearly flu vaccine. This is the most important step in protecting yourself from the flu. Even though the flu does change very often, the vaccine protects against the three main flu strains. In addition to the flu vaccine, "STAY AWAY" from sick people.



Where to get a flu vaccine

You can get a flu vaccine at your doctors office, pharmacy, public clinic, college health facility, and sometime they are even provided by your employer. And get the vaccine soon because manufacturers only project that about 135 million doses of flu vaccines will be available this 2013-2014 year which mean that about 200 million Americans will not get a chance to get the flu shot.

What kind of vaccine are available?

Like I had mentioned above most flu vaccines protect against three strains and that is why it is called "trivalent". But there are flu vaccines that are "quadrivalent". The differences in these vaccine has to do with the types of strains that it protects against and the how the vaccine was developed. The CDC does not recommend one vaccine over the other. Also most trivalent vaccines are in a injection form where as the quadrivalent comes in a nasal spray. Here is a link of the recommended flu vaccines, it shows how they were manufactured and what type of vaccine is recommended for you: http://www.cdc.gov/flu/protect/vaccine/quadrivalent.htm

In conclusion you should really plan on getting the flu vaccine this year, it gives you yearly protection against the flu and get it soon because once flu season really starts to get into gear, there might not be anymore shots left. Also if you want to you can click on this hyperlink that will take to the CDC website that will tell you everything you need to know about the influenza vaccine and its effectiveness.
http://www.cdc.gov/flu/about/season/flu-season-2013-2014.htm




First image: http://www.empowernetwork.com/donandnatalie/files/2013/01/Flu-1.jpg

Second Image: http://wakemedvoices.org/wp-content/uploads/2012/12/blowing-nose.jpg

Third image: http://www.funi-pics.com/album/I-hate-flu-season.jpg

The future of vaccines.

So over the past few weeks I have introduced vaccines and  I have given a little history on the development of vaccines i.e (Edward Jenner, Louis Pasteur).  We have also seen the benefits of vaccines on global health. But today we are going to look at something different; the future of vaccines. We will look at a paper titled "Reverse Vaccinology: Developing Vaccines in the Era of Genomics" which talks about all the cool new advances we have had in vaccine technology since  Louis Pasteur. 

Louis Pasteur, making vaccines

Since the day Louis Pasteur really learned how to develop vaccines we have been following his technique of inactivating and injecting the disease causing micro organism.  But recently in 1995 to be exact a scientist found a way to access the genome of an organism. Which was a huge discovery because now scientists did not have to use Pasteur's technique to develop a vaccine. They could use a computer to design a vaccine with the genome of the microorganism and this new technique was given the term "reverse vaccinology"(Sette, Rapouli 2010).

The paper goes on to explain the types of vaccines that they have been able to develop with this new technique. But the most important fact in the paper is that "reverse vaccinology uses the entire protein repertoire of each pathogen to select the best candidate vaccine antigens"(Sette, Rapouli 2010). What this means is that before when were only using Pasteur's technique there were only a handful of vaccines that we could make, but with this new technology we can make a ton of new vaccine that express antigens just like the micro organism does. 

It is amazing that technology in medicine has advanced in such a way that we have been able to use a pathogens own DNA to make a vaccine that would be effective against the pathogens own genome.

First Image: http://fineartamerica.com/featured/1-louis-pasteur-1822-1895-french-chemist-everett.html

Second image:http://www.biotech-now.org/health/2011/06/podcast-dr-herve-tettelin-on-vaccine-development

Paper: Sette, Allessandro. "Reverse Vaccinology: Developing Vaccines in the Era of Genomics." NIH Public Access, 29 Oct. 2010. Web. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3320742/pdf/nihms365496.pdf

The rise of the Anti Vaccine Era

So in the previous chapters, I introduced vaccines along with a little history. I also showed how vaccines over the century has a made a huge impact on life expectancy. Vaccines in general have had a grave influence on public health world wide. Today we are going to talk about this new rise of parents who are refusing to vaccinate their children because of a fraudulent scientific paper that came out 16 years ago. We will look at what started the controversy and how celebrities and public figures have paved the way to how parents approach vaccines.

 Who is Andrew Wakefield and why do we care about him?
 

Andrew Wakefield

Andrew Wakefield is a former British doctor who published a fraudulent research paper that linked the MMR (measles, mumps, rubella) vaccine to autism.Which as you can imagine caused a scare and controversy. Then researchers tried to reproduce 
Dr. Wakefield's findings and they found that they were unable to link the vaccine to autism. As you can imagine Dr. Wakefiled got a lot of heat, they found out he was financially bribed and they discredited his research. They also found that he broke a lot of ethical rules while conducting his research. So now basically Wakefield is not a doctor anymore who lost all of credibility. Nevertheless, it took about 12 years to discredit Wakefield.

Dr. Wakefield's research 

Andrew Wakefield's paper

The BMJ or the British Medical Journal published an article that disclosed the reasons as to why Andrew Wakefield conducted fraudulent research. This picture to the left is a copy of the first page of Wakefield's paper.  The article written by the BMJ said that his research was clearly fabricated and that it was not due to Dr. Wakefield being incompetent. The BMJ said that "A great deal of thought and effort must have gone into drafting the paper to achieve the results he wanted: the discrepancies all led in one direction; misreporting was gross. The panel found him guilty of dishonesty concerning the study’s admissions criteria, its funding by the Legal Aid Board, and his statements about it afterwards". (BMJ 2011;342:c7452) The BMJ clearly believes that Wakefield was dishonest. Also the article mentioned that Wakefield was funded by various institutions and that he was publishing the article for financial gain. This scare led to a global scare and according to the BMJ "vaccination rates in the United Kingdom have recovered slightly from their 80% low in 2003 but they are still below the 95% level recommended by the World Health Organization to ensure herd immunity. In 2008, for the first time in 14 years, measles was declared endemic in England and Wales. Hundreds of thousands of children in the UK are currently unprotected as a result of the scare, and the battle to restore parents’ trust in the vaccine is ongoing." (BMJ 2011;342:c7452)  Obviously this fraudulent research caused a very big problem and now has added to a public health risk. 

 How Wakefield's research triggered a dangerous cascade. 

Modern social media like instagram and twitter where celebrities are followed by millions and millions of people worldwide can be very dangerous when it comes to disease prevention. And not because diseases can be passed through social media. But because ideas can. Like the idea of vaccine refusal.  

So for example if Kim Kardashian who currently has around 19 million people following her, decided that a certain vaccine is not good for her baby North. That information will be passed down to whoever follows Kim and then it will be watched on television by fans and then ultimately Kim will end up going on The View and explaining to moms across America, why vaccines are bad. (God forbid). But this is exactly what has happened, celebrity parents or high profile people like Jenny McCarthy have built campaigns that discredit certain vaccines. 

What will happen if millions of people stop vaccinating their children?

 There will be pandemics that would be really difficult to stop. People will die from diseases that are preventable and eventually everyone would die. 

  

 Again this is a graph of how vaccines help keep diseases under control.

And just remember when you wake up and go outside every morning that you do not get sick because everyone around you has most likely been vaccinated. But where does that leave this new new generation? 

  


 









  First Image:

http://www.cmaj.ca/content/182/4/E199/F1.large.jpg

Second Image: http://seducehealth.org/wp-content/uploads/2011/02/people-magazine-e1296676978256.jpeg

Third Image: 

http://www.bmj.com/highwire/filestream/404580/field_highwire_fragment_image_l/0.jpg

Fourth Image: 
http://www.google.com/imgres?imgurl=&imgrefurl=http%3A%2F%2Fhistory-world.org%2Fblack_death.htm&h=0&w=0&sz=1&tbnid=Un5ZR7rJdjTGxM&tbnh=194&tbnw=259&zoom=1&docid=eZjBTtMUyGuiqM&ei=Syk_UuiQAZCg4APLt4HwAg&ved=0CAUQsCU

Fifth Image: http://www.whale.to/vaccine/New%20Picture%20%284%29.jpg

sixth image: http://australiansceptics.files.wordpress.com/2012/05/pertussis-graph.jpg

Seventh image: http://www.thepaltrysapien.com/wp-content/uploads/2010/12/Herd_Immunity_Crop.jpg

Chapter 2: Mandatory or not?

Are vaccines mandatory?

No, vaccines are not mandatory. 

This is a very interesting question because in the United States there are no federal laws that mandate vaccinations.  Nevertheless, all 50 states require immunizations for children entering the public school system. And depending on the state some states mandate certain vaccines while others do not. 

What are the vaccine preventable diseases?

Vaccine preventable disease are disease that are infectious in nature and can either kill, severely injure or cripple a persons quality of life.  This picture below is a man bedridden with small pox. A disease that has been globally eradicated thanks to global immunizations.

And below is a list of all the vaccine preventable diseases we currently have immunizations for. 

                            

What would happen if we stopped immunizing against infections?

• There will be no protection against disease.
• Epidemics of diseases would be uncontrollable.
• Diseases that have we have not seen in decades would be a problem once again.
• More people would die from a completely preventable disease.
• Healthcare costs would rise, with all the newly sick people.

This is a paragraph written by the CDC predicting what would happen to people if we stopped vaccinating against polio. If you click on the hyperlink underneath this box, there is a detailed analysis based on vaccines of what would happen to the world if vaccinations were stopped. 

Polio

"Stopping vaccination against polio will leave people susceptible to infection with poliovirus. Polio causes acute paralysis that can lead to permanent physical disability and even death. Before polio vaccine was available, 13,000 to 20,000 cases of paralytic polio were reported each year in the United States. Annual epidemics of polio often left victims—mostly children—in braces, crutches, wheelchairs, and, in serious cases, iron lungs. Many of the children that survived experienced life-long consequences from the disease.

In 1988, the World Health Assembly unanimously agreed to eradicate polio worldwide. As a result of global polio eradication efforts, the number of cases reported globally has decreased from more than 350,000 cases in 1988 to 187 cases in 2012 (as of November 14, 2012). Only three countries remain endemic for polio in 2012: Afghanistan, Nigeria, and Pakistan. Stopping vaccination before eradication is achieved would result in a resurgence of this preventable disease and threaten future generations of children."

http://www.cdc.gov/vaccines/vac-gen/whatifstop.htm

This picture below is a photo of a child with polio. A disease that is not really a problem in the United states but still a problem in certain parts of the world.

Here is a very brief video that reiterates the importance of the polio vaccine. A disease that is preventable by a single drop. And thanks to the global eradication of polio the world is 99% polio free.

http://www.youtube.com/watch?v=N8pABdq1Flk

Recap

In this chapter 2 of Are vaccines safe? We learned about what kind of diseases are preventable with vaccinations. We also discussed what some of the implications of stopping immunizations would have on global health using polio as an example. 
In the following chapters we will be looking at how costly immunization are? How can low income people have access to immunizations? And what kind of biological effects can vaccines have on people. We will also look at what would happen if we were subject to a bioterrorism attack.

Sources:

http://www.cdc.gov/vaccines/vac-gen/whatifstop.htm
http://www.cdc.gov/vaccines/vac-gen/why.htm

First image:http://www.acponline.org/clinical_information/resources/bioterrorism/smallpox_mimics.htm

Second image: http://www.uspharmacist.com/content/d/feature/i/783/c/14501/

Third image: http://www.polioeradication.org/Polioandprevention.aspxw.polioeradication.org

CHAPTER 1: Vaccine History 101

Introduction: Immunizations

Immunizations have been getting a lot of attention lately and it seems to be the trending topic at dinner parties. In this blog we will try to debunk the myths and fallacies of immunizations and look at the scientific facts. It is important that as a population we join together and educate people on the truth and importance of vaccines. Although it is true that some vaccines have caused sickness and fatality in the pass, we have to remember that like all medical procedures there is always a risk. And the likelihood that something bad might happen, is so minimal it does not outweigh the good.
We will hopefully find answers to questions like; should I delay vaccination for my infant? Does a vaccine really cause autism? Is it mandatory to immunize my child? But before we delve deeper into debunking myths about vaccines, we must first learn a little history on vaccines see how they have developed over the century.

A little lecture on vaccine history

In the early 1900s humans were dying of infections and diseases. Over the course of 100 years, right after the introduction of vaccines into the world, we have been able to significantly reduce death caused by a preventable infection. 

The concept of a vaccine was introduced to the world by a man named Edward Jenner. Edward Jenner was the first to successfully use cow pox as a form of inoculation against small pox.  And his method was used in developing a vaccine that completely eradicated small pox from the world some 200 years later.  Here is a timeline of the history of vaccines.

1798	Edward Jenner published his work on the development of a vaccination that would protect against smallpox.

1879	Louis Pasteur created the first live attenuated bacterial vaccine (chicken cholera)

1885	Louis Pasteur first used rabies vaccine in humans.

1896	Cholera and typhoid vaccines were first developed.

1945	Inactivated influenza vaccine was first licensed in the U.S.

July 18, 1973

Measles and mumps virus vaccine, live (M-M-Vax by Merck) was licensed.

1981	The first hepatitis B viral vaccines, developed by Merck and also by the Pasteur Institute, were licensed. Both had independently developed plasma-based hepatitis B viral vaccines.

June 8, 2006

FDA licensed the first vaccine developed to prevent cervical cancer (Gardasil by Merck)

http://www.historyofvaccines.org/content/timelines/all#.Ui_DbU2tK3Y.blogger
For a more detailed timeline of vaccine history please click the hyperlink above. 

So recapping a bit on the timeline and history of vaccines we notice that over the course of a century or so. We have come up with vaccines for a lot of infectious diseases.  And with the visual up top we see that for the most part, the majority of these diseases that were once the leading cause of death a century ago are no longer an issue. Drawing up a  conclusions on the visual above, it seems that after the introduction of vaccines our leading cause of diseases are no longer of an infectious origin.  Learning the truth about vaccines is very important, over the years we forget how horrible these diseases really are. Lets not get caught up in all the frenzy of "parents against vaccines" lets make educated decisions and protect ourselves from deadly diseases. 

Please watch a fun CDC psa video at bottom of page. Getting your vaccines could save you from the zombie apocalypse! 


Citations

Acquired from http://www.immunize.org/timeline/  on September 10, 2013. We thank the Immunization Action Coalition.

"The Vaccine Effect." Infographics & Data Visualization. N.p., n.d. Web. 11 Sept. 2013.

First image:http://profiles.nlm.nih.gov/ps/retrieve/Narrative/VC/p-visuals/true  
Second image: http://www.vaclib.org/chapter/njexempt.htm
last image:http://visual.ly/vaccine-effect