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