Vaccines and vaccinations
Vaccine basics
Measles and other disease- and age-specific vaccines
Possible vaccine side effects
Vaccine resistance and vaccine undercoverage
Other problems in the vaccine world
Vaccine info for medical professionals
Books about vaccines and immunization
Available vaccines ***Children's vaccinations*** Adult vaccinations***Coronavirus (Covid) vaccines ***
DTaP/Tdap/Td ACIP (Pertussis, Tetanus, Diphtheria)***Ebola vaccine***Flu shots (influenza vaccine)***Hepatitis vaccine***Herpes vaccine***Human papillomavirus (HPV) vaccine***Malaria vaccine***Measles vaccine*** Meningitis vaccine***Mumps vaccine***Pneumococcal vaccine***Polio vaccine***Rabies vaccine***RSV vaccine***Shingles (herpes zoster) vaccine ***Tuberculosis vaccine***Typhoid vaccine***Yellow fever vaccine
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Measles and other disease- and age-specific vaccines
Available vaccines ***Children's vaccinations***Adult vaccinations***DTaP/Tdap/Td ACIP (Pertussis, Tetanus, Diphtheria)***Ebola vaccine***Flu shots (influenza vaccine)***Hepatitis vaccine***Herpes vaccine***Human papillomavirus (HPV) vaccine***Malaria vaccine***Measles vaccine*** Meningitis vaccine***Mumps vaccine***Pneumococcal vaccine***Polio vaccine***Rabies vaccine***Shingles (herpes zoster) vaccine ***Typhoid vaccine***Yellow fever vaccine
Available vaccines
• Index of available vaccines. Recommended U.S. immunizations and non-routine immunizations for people in certain jobs and travel situations, organized by disease : Chickenpox (Varicella), Diphtheria, Flu (Influenza), Hepatitis A, Hepatitis B, Hib (Haemophilus influenzae type b), HPV (Human Papillomavirus), Measles, Meningococcal, Mumps, Pneumococcal, Polio (Poliomyelitis), Rotavirus, Rubella (German Measles), Shingles (Herpes Zoster), Tetanus (Lockjaw), and Whooping Cough (Pertussis). (Centers for Disease Control and Prevention)
• Recommended vaccines by age (CDC) These vaccines are recommended for infants, children, teenagers and adults of certain ages.
• Vaccines You’ll Need After 50 (Barbara Stepko, AARP, 1-14-2020) Information and explanations about flu vaccine, pneumococcal vaccine (pneumonia), Tdap (tetanus, diphtheria, pertussis) vaccine and/or the Td (tetanus, diphtheria) booster, Shingrix--the new shingles (herpes zoster) vaccine, hepatitis A vaccine, and hepatitis B vaccine.
Medicare Part D in 2023 covers these vaccines and more at no cost to those enrolled in Medicare:
Shingles, RSV, Tetanus/diphtheria (Td), Tetanus, diphtheria, and pertussis (whooping cough) (Tdap)
Hepatitis A Hepatitis B, if you're at low risk for the virus
Also, Medicare still covers flu shots, COVID-19 vaccines, and pneumococcal shots. See Wh
Children's vaccinations
Straight Talk about Vaccination (Matthew F. Daley, Jason M. Glanz, Scientific American, 9-1-11) Parents need better information, ideally before a baby is born
• Why it’s a bad idea to space out your child’s vaccination shots (Lena H. Sun, WaPo, 4-17-17) "The longer a child waits for a vaccination, the greater the risk that he or she will be exposed to these diseases while unprotected."
"Thirty years ago, children received vaccines that protected against eight diseases: measles, mumps, rubella, diphtheria, tetanus, pertussis, Haemophilus influenzae type b and polio. The total number of bacterial and viral proteins contained in earlier versions of these vaccines was a little more than 3,000.
"Today, young children receive vaccines that protect against 14 diseases: the eight earlier ones plus hepatitis A, hepatitis B, rotavirus, influenza, chickenpox and pneumococcal disease. But the total number of bacterial and viral components in these vaccines is only about 150.
"When the vaccine for pertussis, or whooping cough, was developed, for example, it had about 3,000 such components, Feemster said. Now the vaccine contains three to five proteins."
Adult vaccinations
• Vaccines are not just for kids (Anna Gorman, KHN, 7-13-16) Millions of people newly covered under the Affordable Care Act can get certain vaccinations — for the flu, tetanus, measles, hepatitis A and B, meningococcal disease and other illnesses — with no copay or other out-of-pocket cost. Why vaccines are important for adults and what is being done to increase their vaccination rates.
• Adults Skipping Vaccines May Miss Out On Effective New Shingles Shot (Michelle Andrews, KHN, 3-20-18) Federal health officials recommend that adults get a number of vaccinations, including protections against shingles, the flu, pneumonia, tetanus, diphtheria and pertussis. But immunization rates are generally low.
• Should you get vaccinated at the pharmacy? (Theresa Carr, Consumer Reports, 4-29-17) Yes. "CVS, Rite Aid, Walgreens, and other chains and some independent pharmacies offer more than the flu shot—they typically also administer other immunizations recommended by the Centers for Disease Control and Prevention (CDC), including vaccines against pneumonia, polio, shingles, Tdap (tetanus, diphtheria and pertussis), and varicella (chicken pox). In addition, many also offer travel immunizations for meningitis, typhoid, yellow fever, and other diseases." "Under the Affordable Care Act, private [insurance] plans are required to fully cover the cost of recommended vaccinations for adults and children as preventive medical care." (Medicare Part B covers only flu, pneumonia, and hepatitis B vaccines. Read article for further details on savings.
• Seniors Need 2 Pneumonia Vaccines, CDC Panel Says (Steven Reinberg, HealthDay News, 2-3-15) Adults 65 and older need two vaccines to better protect them from bacterial infection in the blood (called sepsis), meningitis and pneumonia, according to a revised vaccination schedule from the 2015 Advisory Committee on Immunization Practices (ACIP). Vaccinations need to be given a year apart, expert recommends. According to the National Foundation of Infectious Diseases (NFID), about 1 million U.S. adults get pneumococcal pneumonia every year. As many as 7 percent die from these infections. Although fewer people get pneumococcal meningitis or sepsis, the death rate is higher -- 10 percent or more, according to the foundation.
• Stop Treating 70- and 90-Year-Olds the Same (Louise Aronson, NY Times, 8-11-17) Just as we don’t confuse toddlers with teenagers, or young adults with their middle-age parents, so, too, are we able to distinguish 70-year-olds from the nonagenarians a generation ahead of them. Those two groups — the “young old” and the “old old” — don’t just differ in how they look and spend their days; they also differ biologically. As a result, it’s likely that we are incorrectly vaccinating a significant number of the 47 million Americans over 65. With advancing age, the immune system weakens so older adults are more susceptible to infections — more likely to get sick, more likely to require hospitalization and more likely to die. At the same time, immunizations provide less protection. Older people may need different dosing or even biologically different vaccines. And, given lengthening life spans, we may also be routinely undervaccinating older adults. There are simply different risk-benefit ratios for older adults; the frailest and oldest often incur all the immediate harms of treatments, from prevention to intensive care, without seeing the benefits. center>
DTaP/Tdap/Td ACIP (Pertussis, Tetanus, Diphtheria) Vaccine
• An Unvaccinated Boy Got Tetanus. His Oregon Hospital Stay: 57 Days and $800,000. (Sarah Mervosh, NY Times, 3-9-19) An unvaccinated 6-year-old boy had the first pediatric case of tetanus in Oregon in more than 30 years. The boy was playing on a farm when he cut his forehead, a laceration that was simple enough to tend to at home. But six days later, his parents realized something was seriously wrong: He was clenching his jaw, having trouble breathing and experiencing involuntary muscle spasms. Oregon has one of the highest rates of unvaccinated residents in the country. Mervosh describes the boy's harrowing recovery and warns of the dangers associated with the preventable disease: He spent 57 days in the hospital and racked up medical bills of more than $800,000. Tetanus, a life-threatening disease that is transmitted through open wounds and causes painful muscle spasms, declined drastically in the United States after the introduction of a vaccine in the 1940s. A series of shots are recommended in infancy and childhood, as well as at certain other times throughout life. Today, the disease occurs “almost exclusively” in people who have not been vaccinated or who have been undervaccinated. The pain that he experienced was difficult for Dr. Guzman-Cottrill to forget. “When you see someone suffer from this disease, you completely understand why we immunize,” she said, adding, “This should never happen in our country.”
• The preventable tragedy of diphtheria in the 21st century (L.H. Blumberg et al, International Journal of Infectious Diseases, June 2018) The diphtheria outbreak in the Rohingya refugee population in Bangladesh, the outbreak in Yemen due to war, and the more recent outbreaks in Venezuela and Haiti should raise concern that diphtheria remains a public health issue in 2017/2018, almost a century after an effective and safe toxoid vaccine was developed. Both wide vaccination and booster vaccines are required to prevent outbreaks of the disease,
• Prevention of Pertussis, Tetanus, and Diphtheria with Vaccines in the United States: Recommendations of the Advisory Committee on Immunization Practices (ACIP)
Vaccine basics
" The effort to vaccinate the nation against COVID-19 relies on chemists, factory workers, truck drivers, pilots, data scientists, bureaucrats, pharmacists and health-care workers. It requires ultracold freezers, dry ice, needles, masks and swabs converging simultaneously at thousands of locations across the country."~ Wall Street Journal
• Coronavirus vaccines and vaccine trackers (in a full section on COVID-19).
• Vaccine basics (Vaccines.gov)
• Vaccines and immunizations (Centers for Disease Control and Prevention Immunization schedules for children and adults). See also (VaxView,CDC)
• Recommended Vaccines by Age (CDC)
• What Would Happen If We Stopped Vaccinations? (CDC)
• How Vaccines Work (MedlinePlus) And I quote: Vaccines "teach" your body how to defend itself when germs, such as viruses or bacteria, invade it: They expose you to a very small, very safe amount of viruses or bacteria that have been weakened or killed. Your immune system then learns to recognize and attack the infection if you are exposed to it later in life. As a result, you will not become ill, or you may have a milder infection. This is a natural way to deal with infectious diseases.
Four broad types of vaccine are currently available for various diseases:
---Live virus vaccines use the weakened (attenuated) form of the virus. The measles, mumps, and rubella (MMR) vaccine and the varicella (chickenpox) vaccine are examples.
---Killed (inactivated) vaccines are made from a protein or other small pieces taken from a virus or bacteria. The whooping cough (pertussis) vaccine is an example.
---Toxoid vaccines contain a toxin or chemical made by the bacteria or virus. They make you immune to the harmful effects of the infection, instead of to the infection itself. Examples are the diphtheria and tetanus vaccines.
---Biosynthetic vaccines contain manmade substances that are very similar to pieces of the virus or bacteria. The Hepatitis B vaccine is an example.
• There are four types of COVID-19 vaccines: and how they work (Gavi, the Vaccine Alliance) All vaccines work by exposing the body to molecules from the target pathogen to trigger an immune response – but the method of exposure varies. There are four categories of vaccines in clinical trials: whole virus, protein subunit, viral vector and nucleic acid (RNA and DNA). Some of them try to smuggle the antigen into the body, others use the body's own cells to make the viral antigen.
Whole virus vaccines (15 in development) "Many conventional vaccines use whole viruses to trigger an immune response. There are two main approaches. Live attenuated vaccines use a weakened form of the virus that can still replicate without causing illness. Inactivated vaccines use viruses whose genetic material has been destroyed so they cannot replicate, but can still trigger an immune response. Both types use well-established technology and pathways for regulatory approval, but live attenuated ones may risk causing disease in people with weak immune systems and often require careful cold storage, making their use more challenging in low-resource countries. Inactivated virus vaccines can be given to people with compromised immune systems but might also need cold storage."
Protein subunit vaccines (13 in development) Protein subunit vaccines use fragments of protein from the disease-causing virus to trigger protective immunity against it.
Nucleic acid vaccines (20) use genetic material from a disease-causing virus to trigger protective immunity against it. COVID-19 mRNA vaccines give instructions for our cells to make a harmless piece of what is called the "spike protein." The spike protein is found on the surface of the virus. "Messenger RNA vaccines—also called mRNA vaccines—are some of the first COVID-19 vaccines authorized for use in the United States." (Pfizer+BioNTech and Moderna)
Viral vector vaccines (15) use a harmless virus to smuggle the instructions for making antigens from the disease-causing virus into cells, triggering protective immunity against it. (Johnson & Johnson, Astra Zeneca use a harmless version of a cold virus)
• Clear Answers and Smart Advice About Your Baby’s Shots (Ari Brown, MD, FAAP, Immunization Action Coalition) An excellent Q&A--parents, start here!)
• Recommended Immunization Schedules For Children, Teens, and Adults (CDC)
• Frequently Asked Questions about Thimerosal
• Vaccine Safety: Answers to Parents’ Top Questions (California Dept. of Public Health)
• Questions and Answers About Vaccines During Pregnancy (CDC)
• Which vaccinations to get at which ages (infancy through later adulthood) (Infographic, Generations United)
• Glossary of vaccine terms
• Vaccine Acronyms & Abbreviations (CDC) This vaccine abbreviations page lists abbreviations used for vaccines, including some “old” or non-standard abbreviations used on immunization records.
• Translating Foreign Immunization Records (PDF, 2 pages, Immunization Action Coalition) Quick chart of vaccine-preventable disease terms in multiple languages.
• Why immunize? (CDC).
• California’s vaccination requirement is constitutional, says federal court (Eugene Volokh, WaPo, 8-29-16 ) California recently repealed its "personal belief exemption" to the requirement that public and private school students be immunized.
• Bill to stiffen California’s vaccine law must first get past single-issue voters (George Skelton, Los Angeles Times, 5-9-19) Some bills are just more trouble than they’re worth for nervous legislators who must worry about voter support. One such bill is a current measure to tighten the requirement that children be vaccinated against contagious diseases — like measles — before being admitted to school for the first time. Kids can be excused from that edict for medical reasons, such as having a weak immune system caused by leukemia. But a few unscrupulous doctors are peddling medical exemptions for phony reasons to parents who obsessively fear vaccinations. Many of these parents get very hostile when lobbying lawmakers and attacking vaccine advocates.
• San Francisco Investigates Doctor Over Measles Vaccination Exemptions (Jim Carlton, WSJ, 5-8-19) City officials here are investigating whether a pediatrician illegally gave medical exemptions to parents seeking to not vaccinate their children for school entry, as the U.S. struggles to get control of a growing measles outbreak. A subpoena by City Attorney Dennis Herrera requests the patient records of Dr. Kenneth Stoller, an outspoken opponent of vaccination requirements. The patients’ names were redacted. California is one of three states in which only certain medical exemptions—such as having an allergy to a vaccine or undergoing chemotherapy—can be used to allow a child to attend school without inoculation against measles and other communicable diseases. West Virginia and Mississippi are the others
• Top 20 Questions About Vaccination (History of Vaccines)
• Writing about vaccine hesitancy? There’s a study for that (Tara Haelle, Covering Health, AHCJ, 3-22-19)
'For far too long, false balance was the biggest problem plaguing media coverage of vaccination, a trend that only slowly began fading after The Lancet retracted Andrew Wakefield’s fraudulent study. By the time of the Disneyland measles outbreak in 2015, most journalists were finally avoiding the he-said-she-said “objective” reporting that creates false equivalence. The dominant media narrative had become the accurate one: that scientific evidence supports the safety and effectiveness of vaccines, and not vaccinating children endangers public health....
"Mocking and shaming parents who want to make the best health decisions for their children but feel anxious or frightened about vaccines doesn’t help public health goals of maintaining or increasing immunization rates. (While it’s not journalists’ role to further public health goals, it certainly isn’t our job to make them harder either.) Parents with genuine questions and concerns about vaccines who then feel shamed and castigated may slink away — not to vaccinate their kids but to avoid doctor visits altogether and ignore all the haughty “pro-vaccine” folks who might have helped them understand the information they need to make evidence-based decisions."
"...I tried to counter some of the vitriol and misconceptions about non-vaccinating parents with a series of articles debunking misconceptions about “anti-vaxxers” (parts one, two and three). The first misconception I addressed was the incorrect belief that any parent who doesn’t vaccinate is automatically an “anti-vaxxer.”'
• Vaccines for travelers (CDC) Travelers may need these vaccines because there is a risk of certain diseases in countries they are visiting.
• State vaccination requirements (CDC)
• CDC vaccine price list (Vaccines for Children Program (VFC)
• Glossary of Vaccines and Immunizations Terms (Vaccines.gov)
• Guide to Federal Immunization Web Sites (Vaccines.gov) Agencies that regulate or administer vaccine/immunization programs (CDC, FDA, NIH, Vaccine Injury Compensation Program, BARDA, NVPO, Department of Defense, Veterans' Affairs, HIV.gov, Healthfinder.gov, Healthcare.gov)
• Valuing vaccinations across generations (Infographic, Generations United, 2-18-16). Three illnesses that can be passed between older and younger generations--flu, pneumonia, and whooping cough--are preventable with immunizations.
• Advocacy for Immunization How to generate and maintain support for vaccination programs.
• Lack of vaccinations leaves some older adults vulnerable (Bara Vaida, Covering Health, Association of Health Care Journalists, 5-3-18) "“The flu vaccine gets this bum rap,” he said. “We focus on the effectiveness of it and the incidence of preventing the flu, but what we aren’t talking about is the benefits of (the vaccine) if you happen to get the flu. The complications will be ameliorated (and you will be sick for fewer days). If you are 65 and you get the flu and have to be hospitalized, you will come out of the hospital in a walker because your muscles will have atrophied. So I ask my older adult patients, do you want to risk your independence by not getting vaccinated?”
• For Immunization Managers (CDC, various resources, including vaccination coverage articles and reports)
• Immunization Action Coalition (IAC). See Ask the Experts
• GAVI, The Vaccine Alliance Created in 2000, Gavi is an international organization - a global Vaccine Alliance, bringing together public and private sectors with the shared goal of creating equal access to new and underused vaccines for children living in the world’s poorest countries
• Oregon dentists become first in U.S. to be able to give all vaccines (Molly Harbarger, The Oregonian/Oregon Live, 5-8-19) Oregon is the first state in the country to allow dentists to administer vaccines to patients. In a year marked with heated debate about the state’s involvement in boosting vaccination rates, the bill was quietly passed and signed into law with little fanfare. But it sets a new precedent for the role dentistry plays in the health care system. Two other states have laws that allow dentists to give flu shots to adults, but in Oregon, dentists will soon be able to give out any vaccine available at a primary care doctor’s office.
• History of Vaccines. An educational resource by the College of Physicians of Philadelphia.
• Antibodies: Friend & Foe (Thomas Packard, Healthcare in America,12-29-16)
• 14 Diseases You Almost Forgot About Thanks to Vaccines (HealthyChildren.org, based on information from the CDC) Read about diphtheria, chicken pox, mumps, rotavirus, pneumococcal disease, whooping cough (Pertussis), measles, rubella (German measles, MMR vaccine), Hib, hepatitis A, hepatitis B, the flu (influenza). For each disease there are links to more information.
• Bacille Calmette-Guérin (CDC) BCG is a vaccine for tuberculosis (TB) disease. This vaccine is not widely used in the United States, but it is often given to infants and small children in other countries where TB is common.~ CDC
• How a Big Pharma Company Stalled a Potentially Lifesaving Vaccine in Pursuit of Bigger Profits (Anna Maria Barry-Jester, ProPublica, 10-4-23) A vaccine against tuberculosis, the world’s deadliest infectious disease, has never been closer to reality, with the potential to save millions of lives. But its development slowed after its corporate owner GSK focused on more profitable vaccines.
Covid 19 (Coronavirus) vaccines
• COVID-19 Vaccines (CDC) Learn about COVID-19 vaccine recommendations, what to expect when getting a vaccine, and vaccine effectiveness.
--- Get an updated COVID-19 vaccine (CDC) How to look for vaccine providers near you. Most vaccination providers schedule appointments online. Who should and shouldn't receive the vaccine.
• Vaccines.gov
Vaccines can help you stay healthy. Get yours now. Enter your zip code. Choose a pharmacy. Make an appointment to get a vaccination.
• Comparing the COVID-19 Vaccines: How Are They Different? (Kathy Katella, Yale Medicine, 9-3-24)
• WHO COVID-19 dashboard (World Health Organization Data)
Great on numbers and percentages.
• Why is trust in vaccines declining? (Kristen Panthagani, Your Local Epidemiologist, 9-24-24)
A look back at the pandemic, what was said, and where communication broke down. Part 1 of a 4-part series.
• COVID-19 Basics
Types of vaccine:
mRNA vaccines (Pfizer-BioNTech or Moderna) and how they work.
Protein subunit vaccines (Novavax) and how they work.
---Benefits of vaccination
---Vaccines for moderately to severely immunocompromised people
---COVID-19 vaccination for people who would like to have a baby, people who are pregnant or breastfeeding, for long-term care residents
---Vaccine effectiveness
---Frequently asked questions about COVID-19 vaccines
Vaccine side effects
• Vaccine Side Effects (Vaccines.gov) Most people don’t have any serious side effects from vaccines. The most common side effects — like soreness where the shot was given — are usually mild and go away quickly on their own.
• Información Importante Sobre El Coronavirus (Creaky Joints, espanol) Información general y recursos para condiciones reumatológicas
• Vaccine Side Effects and Adverse Events (The History of Vaccines, College of Physicians of Philadelphia)
• Vaccines and Side Effects: The Facts (HealthyChildren.org, American Academy of Pediatrics)<
• National Vaccine Injury Compensation Program (VICP) (Health Resources & Services Administration, Department of Health & Human Services) VICP compensates people injured by certain vaccines given routinely to children and adults. These include the seasonal flu vaccine, measles, mumps, rubella or polio.
• Countermeasures Injury Compensation Program (CICP) (Health Resources & Services Administration, Department of Health & Human Services) CICP compensates individuals for serious physical injuries or deaths from pandemic, epidemic, or security countermeasures. This includes the 2009 pandemic H1N1 influenza vaccine (swine flu vaccine), Tamiflu, Relenza or Peramivir, identified in declarations issued by the Secretary of the U.S. Department of Health and Human Services.
• Preventing Shoulder Pain After Vaccine Injection (SIRVA) (Jonathan Cluett, MD, Verywell Health, 8-25-18) Sometimes shoulder pain can become a chronic problem after a vaccination. There is even a name for the condition : Shoulder Injury Related to Vaccine Administration, or SIRVA. In these patients, the shoulder pain can be long-lasting and debilitating. SIRVA is thought to be the result of incorrect placement of the vaccine into the shoulder joint or the shoulder bursa, rather than into the deltoid muscle tissue. When the vaccine is injected into the synovial tissue of the joint or bursa, an immune response may occur causing severe inflammation. Dr. Cluett provides steps to take to be sure your vaccine is administered correctly.
• Do Vaccines Cause Autism? (The History of Vaccines, College of Physicians of Philadelphia) Short answer: No. And the history of the falsified study that suggests otherwise is interesting./p>
Ebola vaccine
• First Ebola therapy approved by the FDA (Helen Branswell, STAT, 10-14-2020) With the approval, there are now both a vaccine — Merck’s Ervebo — and a therapeutic to battle Ebola Zaire, tools that for decades were out of reach for Ebola, one of the deadliest infections known to humankind.
• What Happened to Ebola? (Emma Varvaloucas, What Could Go Right? The Progress Network, 5-23-24) There’s a reason why you haven’t heard about it in years. During the 2014–16 outbreak, pharmaceutical companies began developing and trialing a world-first Ebola vaccine. In 2019, the World Health Organization (WHO) prequalified one for the first time, meaning that they were comfortable recommending its use. A second vaccine followed in 2020. By 2021, the WHO had established a stockpile that was at the ready for rapid sendout in the event of another outbreak.
• New Hope for Ebola (Helen Branswell, Scientific American, March 2015)
• Everything You Need to Know about the Ebola Vaccine (Dina Fine Maron, Scientific American, 5-17-18) Public health workers are preparing to roll out inoculations even as the disease has spread to an urban location
• ‘You’re holding your breath’: Scientists who toiled for years on an Ebola vaccine see the first one put to the test (Helen Branswell, STAT, 5-22-18) "An Ebola outbreak has once again commanded global attention, eliciting feelings of dread, anxiety, and concern. But for a small community of researchers who have toiled for years to develop a vaccine against Ebola — one that is being used for the first time to try to contain an outbreak — it is also thrilling. These scientists take no joy in knowing as they do the devastation that the virus can wreak. But after years of frustration with the global response to Ebola outbreaks — and a sense of helplessness in the face of so much misery — they see what’s happening now in the Democratic Republic of the Congo as a possible watershed moment, one that could forever shape the way in which health officials respond to Ebola epidemics."
• Researchers Develop Portable Diagnostic Test For Ebola And Malaria (Miriam Wasser, Commonhealth, WBUR, 12-13-18) "High fever, vomiting, diarrhea, abdominal pain: These are all early symptoms of Ebola hemorrhagic fever. They’re also symptoms of malaria, a mosquito-borne blood infection that’s endemic in regions where Ebola tends to break out. For public health officials working in West Africa during the 2014-2016 Ebola outbreak, distinguishing between the two wasn’t always easy, says Dr. John Connor, associate professor of microbiology and researcher at Boston University. Connor is part of an international team working on a portable, easy-to-use, battery-powered test that can identify Ebola, as well as malaria and other diseases, in less than 30 minutes."
• Ebola vaccine reaches Congo as death count grows (Reid Wilson, The Hill, 5-21-18) A massive vaccination campaign began in Congo on Monday in an effort to stem an outbreak of the Ebola virus that has spread for more than a month. The World Health Organization (WHO) and a nongovernmental organization that delivers vaccines, Gavi, said Monday that more than 7,500 doses of a new vaccine had been deployed to the Equator Province.
• An Ebola Vaccine Gets Its First Real-World Test (Adam Rogers, Science, Wired, 5-21-18)
• Articles about ebola virus
Flu shots (the search for fully effective influenza vaccine)
"Only about half of adults and about 60 percent of children get the flu shot annually. The majority of the children who died from the flu during the 2017-2018 flu season didn't get a flu shot."~ Covering Health
• Who Needs a Flu Vaccine and When (CDC) Getting a flu vaccine is more important than ever during 2020-2021 to protect yourself and the people around you from flu, and to help reduce the strain on healthcare systems responding to the COVID-19 pandemic. Plus: Who Should and Who Should NOT get a Flu Vaccine and Who Should be Prioritized for Flu Vaccination During a Vaccine Shortage.
• Coronavirus vaccine technology is paving the way for a whole new approach to flu shots (Lindsey Bever, Washington Post, 4-11-21) Are MRNA Flu Shots In The Works? Yes, But Not For The Upcoming Flu Season. The technology used in two of the coronavirus vaccines authorized by the Food and Drug Administration may enable scientists to develop flu shots in record time, but also make inoculations that could be more effective and protect against numerous flu strains for years at a time. The messenger-RNA technology — used in the Pfizer and Moderna coronavirus vaccines — would be a leap forward for flu shots, some of which still rely on a process developed in the 1950s involving chickens, petri dishes and dead viruses. Researchers are hopeful that the success of those coronavirus vaccines will grease the wheels for mRNA flu shots and help expedite what is typically a lengthy process involving years of research, clinical trials and regulatory review and approval.
• What to Know About Getting a Flu Shot This Year, No Matter Who’s Paying (Tara Siegel Bernard, NY Times, 11-15-18) Flu season is here, and there are at least six types of vaccine to choose from. It’s worth studying the options to determine which is likely to protect you the most.
• Flu Season 2018-19: When, Where to Get Your Shot, How Bad Will It Be This Year (Nina Godlewski, Newsweek, 9-4-18) When you get the flu, at first you may think you are getting a cold: Fever, runny nose, sore throat, muscle aches. Even if the flu vaccine is 5 to 30% effective, it is worth getting--because with the vaccine it will usually be a less severe form of the illness. You should stay home from work, but if you do go, wash your hands, wear a mask, clean your environment, and clean and avoid high-touch surfaces (the phone, sharing pens), to avoid spreading the disease.
• News stories about the flu shot spawn debates about vaccines in general (Chloe Reichel, journalist's Resource, 3-25-19) Chloe Reichel describes a new analysis of 2,042 reader responses to 33 articles about the flu vaccine, which appeared on the Canadian Broadcasting Company news website between 2015 and 2016. As she explains, these comments sections “turned into polarized ‘echo chambers,’ where like-minded people reinforced and amplified each other’s beliefs about vaccination in general.”
• 80,000 Deaths Caused By Last Year's Flu Season, CDC Reports (Here & Now's Peter O'Dowd learns more from Helen Branswell, STAT's infectious diseases and public health reporter, 9-27-18). New data from the U.S. Centers for Disease Control and Prevention say an estimated 80,000 Americans died of the flu and its complications last winter, making it the deadliest flu season in decades. Branswell explains how vaccines are less effective against certain strains of flu and more effective against others, and there's no way to predict which strains will be more common in any given year.
• CDC urged US Customs and Border Protection (CBP) to vaccinate migrants, but CBP rejected the idea (Amir Vera, Dave Alsup and Sheena Jones, CNN, 11-26-19) In the 2018-2019 flu season, at least three children died of the flu while in CBP custody.
• Pediatricians say all children should get flu shots ASAP (Fox News, 9-4-18) That's what the American Academy of Pediatrics says (Sept. 2018). The Centers for Disease Control and Prevention (CDC) says either a flu shot or FluMist (a nasal spray) is fine. In 2017 FluMist wasn't recommended because "it was less powerful against some strains of influenza."
• Get ready for the flu season with some new angles for coverage (Bara Vaida, Covering Health, for journalists, AHCJ, 9-11-18) "Last season was a severe one. More than 30,400 people (mostly 65 and older) were hospitalized due to the flu and at least 180 children died, the most since the 2009 swine flu pandemic. About 80 percent of the children who died in 2017-18 hadn’t gotten a flu shot." See what happened in your state by reviewing FluView Interactive (CDC state-by-state data). William Schaffner " cautions that 'flu is fickle' and the CDC has stopped predicting whether a season will be mild or severe based on southern hemisphere activity, because 'they missed the target as much as they hit it. Strains can mutate quickly and if you have seen one flu season, you have seen one flu season.' For that reason, the CDC recommends everyone over the age of 6 months get an annual flu shot. In general, only about half of Americans usually get a flu shot."
• Big Pharma Has the Flu (Maryn McKenna, Wired, 1-18-09) Flu vaccines make pharma companies $3 billion a year and aren't very effective. Without a Manhattan Project-style initiative to modernize immunizations, things aren’t going to get any better. "The flu virus itself is to blame. The measles virus that threatens a child today is no different from the one that circulated 50 years ago, so across those 50 years, the same vaccine formula has worked just fine. But flu viruses—and there are always a few around at once—change constantly, and each year vaccine formulators must race to catch up....Now consider this: Right now, millions of people, roughly 100 million just in the United States, receive the flu vaccine every year. If those shots were converted to once or twice or four times in a lifetime, manufacturers would lose an enormous amount of sales and would need to price a new vaccine much higher per dose to recoup."
• ****Despite push for a universal flu vaccine, the ‘holy grail’ stays out of reach (Helen Branswell, STAT, 3-5-18) There is some momentum, but we're not even close. "[I]t isn’t clear if antibodies are enough to protect against flu. It could be that other parts of the immune arsenal — T cells, for instance — have to be harnessed if a vaccine is to be more broadly effective. There are also many questions about the impact of 'imprinting' on our ability to respond effectively to flu vaccines. That term refers to the shaping of each individual’s immune profile, created by the flu viruses each of us encountered, both through infection and vaccination — and the order in which they happened. It’s thought, for instance, that we will always generate the best response to the type of flu virus that triggered our first infection.)" "Monto thinks moving away from the need to vaccinate annually could improve the impact of next-generation vaccines. There are many complexities, such as the repeat vaccination question, that stand between us and those better flu vaccines." I recommend you read the full article.
• Should You Get a Flu Shot? We Settle the Debate (LindseyMetrus, The Thirty, 2-7-18)
• Nearing development of a universal influenza vaccine, experts caution there’s more to accomplish to combat the flu (Claudia Adrien, Homeland Preparedness News, 12-5-19) The constantly changing nature of the influenza virus makes it an annual effort of scientists, manufacturers, and the medical community to devise and disseminate vaccines to combat the disease. This year, the NIH began its first human clinical trial of a universal influenza vaccine candidate, one that attacks a different part of the virus than previous vaccines, making it less likely the candidate needs to be updated each season. Beyond the seasonal flu, officials are equally concerned about the emergence of pandemic influenza. Domestic manufacturing is critical particularly for pandemics, because other nations the United States relies on for pharmaceutical production will allocate resources and protect their populations first, Kadlec said. More than 80 percent of the raw materials, finished products, and active pharmaceutical ingredients the United States counts on for pandemics emanate from China and India. When it comes to the U.S antiviral drug supply—the drugs needed to treat influenza once it is contracted— there are 67 million courses, short of the 80 million-person requirement for the U.S. stockpile, Kadlec said. The active ingredients for those antivirals come from Asia. Developing improved technologies may lessen U.S. dependence on foreign sources. For example, messenger RNA technology will produce faster and better-matched vaccines to prevent both seasonal and pandemic flu."
• The flu vaccine is being oversold – it’s not that effective (The Conversation, 6-5-18) With the flu vaccine “The infection rate in adults drops from 2% per year to 1%. You could say that’s halved, but it effectively only drops by 1%. So this means that out of every 100 healthy adults vaccinated, 99 get no benefit against laboratory confirmed influenza.” H/T to Joan Young Writes.
• Fact sheet on Fluzone (Rxlist.com)
• ****We're underfunding research on vaccines that may be able to prevent another terrible flu season (Henry I. Miller, LA Times, 1-19-18) "Since the 2004-05 season, the flu vaccines' effectiveness has varied from 10% to 60%. This year, the vaccine is an especially poor match, in part because what's going around is predominantly a virulent strain called H3N2. Although that strain is targeted by this season's flu shot, most of the vaccine is prepared from fertilized chicken eggs, a method known to reduce its effectiveness against certain strains, particularly H3N2....Regulators could encourage manufacturers to stop using chicken eggs and instead prepare vaccines in "cultured cells" — cells that are removed from animals and grown in controlled conditions."...The federal budget for flu vaccine research is meager compared with $1 billion spend to develop HIV vaccines and the many billions spent on vaccins for the Zika and Ebola viruses. (A vaccine specialist explains what needs to happen.)
• Covering U.S. efforts to create a universal flu vaccine (Bara Vaida, Covering Health, AHCJ, 3-12-18) As NASW puts it, "Why journalists should cover the Pandemic and All Hazards Preparedness and Response Act reauthorization."
• Pregnant women need a flu shot (CDC)
• Why do you need to get a flu shot every year? (Melvin Sanicas, TEDEd video, animation by Andrew Foerster) All year long, researchers at hospitals around the world collect samples from flu patients and send them to top virology experts with one goal: to design the vaccine for the next flu season. But why do we need a new one every year? Vaccines for diseases like mumps and polio offer a lifetime of protection with two shots early in life; what’s so special about the flu? Melvin Sanicas explains.
• Time for My Annual Flu Shot: Does it Really Work? (Elise Welburn Martin, Healthcare in America, 10-6-16)
• The Flu Shot Can't Give You The Flu (Thomas Packard, Healthcare in America, 10-14-16) Subunit and Inactivated Vaccines Explained With a Picture'
• The flu: What you need to know (blog post, this site)
• A Century After 1918, Flu Pandemic Preparedness Still Lacking (Jackie Powder interviews Anthony Fauci, Global Health Now, 11-15-1). “A hundred years after the lethal 1918 flu we are still vulnerable … public health infrastructure has improved greatly, but without a universal vaccine a single virus could result in a world catastrophe,” said Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, speaking at the forum “The Next Pandemic: Are We Prepared?” Particularly concerning to Jaime Yassif, program officer for Biosecurity and Pandemic Preparedness with the Open Philanthropy Project, is the predictable cycle of “panic and neglect.” We are currently in a neglect phase. Said Yassif: “As soon as the acute phase of an emergency passes, attention diminishes. It’s really incumbent on us … to maintain sustained attention.” Major vulnerabilities include inadequate pandemic warning systems, delays in vaccine development and the movement of viruses between animals and humans, according to researchers, US public health officials and global health experts.
• State's top court defends city's flu vaccine mandate for children (Jonathan LaMantia, Crain's New York Business, 6-28-18) New York's highest court said today that the city Board of Health and Health Department can mandate annual flu vaccines for children in city-regulated day care and preschool, reversing lower court rulings. The Health Department said it would begin enforcing the rule immediately.
• Influenza Pandemics (College of Physicians of Philadelphia, The History of Vaccines)
• The Great Influenza: The Story of the Deadliest Pandemic in History by John M. Barry. (Hear him talk about 1918 on C-SPAN. Very interesting.)
FACT CHECKERS RESPOND TO FAKE NEWS WARNINGS AGAINST FLU SHOTS:
FIRST, DR. MERCOLA: "Harmless Procedure" Can Cause Narcolepsy, Muscle Weakness (Dr. Mercola, 2-28-12)
THEN FACT CHECKERS:
• No, the flu shot was not designed to spread cancer ( Amy Sherman, PunditFact, 3-9-18)
• Dr. Joseph Mercola Ordered to Stop Illegal Claims (Stephen Barrett, Quackwatch, 1-9-17)
Many of Mercola's articles make unsubstantiated claims and clash with those of leading medical and public health organizations. For example, he opposes immunization [10] fluoridation. [11], mammography [12], and the routine administration of vitamin K shots to the newborn [13,14]; claims that amalgam fillings are toxic [15]; and makes many unsubstantiated recommendations for dietary supplements. Mercola's reach has been greatly boosted by repeated promotion on the "Dr. Oz Show."
• 10 Flu Myths (Harvard Medical School, 11-29-17) Dispelling misinformation about the flu vaccine, sickness, treatment, and recovery
• Setting the Record Straight: Debunking All the Flu Vaccine Myths (Tara Haelle, Gizmodo, 10-31-13)
Hepatitis vaccine
• Hepatitis A Is Surging and Cities Don’t Have the Resources to Stop It (Lauren Weber and Alissa Scheller, HuffPost, 11-4-17)
• Vaccine Shortage Complicates Efforts To Quell Hepatitis A Outbreaks (Stephanie O'Neill, Kaiser Health News, 11-14-17)
• Viral Hepatitis: New U.S. Screening Recommendations, Assessment Tools, and Treatments (Corinna Dan et al., American Journal of Nursing, July 2015) center>[Back to Top]
Herpes vaccine
• Years Before Heading Offshore, Herpes Researcher Experimented On People In U.S. (Marisa Taylor, Kaiser Health News, 11-21-17) Three years before launching an offshore herpes vaccine trial, an American researcher vaccinated patients in U.S. hotel rooms in brazen violation of U.S. law, a Kaiser Health News investigation has found. Southern Illinois University associate professor William Halford administered the shots himself at a Holiday Inn Express and a Crowne Plaza Hotel that were a 15-minute drive from the researcher’s SIU lab. Halford injected at least eight herpes patients on four separate occasions in the summer and fall of 2013 with a virus that he created, according to emails from seven participants and interviews with one participant. Offshore Human Testing of Vaccine Ignites Debate in U.S. (Rebecca Gibian, Real Clear Life, 8-21-17) An American university and a group of wealthy libertarians, including tech billionaire and Trump adviser Peter Thiel, are backing the offshore testing of an experimental herpes vaccine. Their actions defy U.S. safety protections for human trials, reports Kaiser Health News. With the debate over vaccination safety raging in the US, American researchers are increasingly going offshore (and away from current FDA regulations) to conduct clinical trials. Meanwhile, researchers at several universities and private research centers have been working on two different herpes vaccines under FDA and IRB oversight, one which is expected to undergo final trials by 2018. It will then be submitted to the FDA for approval.
• Offshore Human Testing of Herpes Vaccine Stokes Debate Over U.S. Safety Rules (Marissa Taylor, KHN, 8-28-17) Defying U.S. safety protections for human trials, an American university and a group of wealthy libertarians, including a prominent Donald Trump supporter, are backing the offshore testing of an experimental herpes vaccine. The American businessmen, including Trump adviser Peter Thiel, invested $7 million in the ongoing vaccine research, according to the U.S. company behind it. Southern Illinois University also trumpeted the research and the study’s lead researcher, even though he did not rely on traditional U.S. safety oversight in the first trial, held on the Caribbean island of St. Kitts....The push behind the vaccine is as much political as medical. President Trump has vowed to speed up the FDA’s approval of some medicines. FDA Commissioner Scott Gottlieb, who had deep financial ties to the pharmaceutical industry, slammed the FDA before his confirmation for over-prioritizing consumer protection to the detriment of medical innovations.
• Participants In Rogue Herpes Vaccine Research Take Legal Action (Marisa Taylor, Kaiser Health Network, 3-13-18) Three people injected with an unauthorized herpes vaccine by a Southern Illinois University researcher have filed suit against his company, demanding compensation for alleged adverse side effects from the experiments. SIU professor William Halford, who died in June, had injected Americans with his experimental herpes vaccine in St. Kitts and Nevis in 2016 and in Illinois hotel rooms in 2013 without safety oversight that is routinely performed by the Food and Drug Administration or an institutional review board.
Human papillomavirus (HPV) vaccines
• When Is HPV a Problem? (Jen Gunter, NY Times, 4-30-19) The Gardasil vaccine, which is given to both men and women, protects a person from seven of the most high-risk (cancer-causing) types of HPV, as well as the two types that cause most genital warts. The vaccine is highly effective, and it is recommended for everyone between the ages of 9 and 45. Most people who contract HPV will get rid of the virus on their own, but those who don’t are at risk for cancer and genital warts. This vaccine is vital in the war against HPV....Some HPV types are of greater concern medically speaking as they can cause precancer and cancer of the genital tract (cervix, vagina, vulva, penis or anus) and of the oropharynx (mouth and throat). We call these potentially cancer-causing HPV types high-risk HPV. The low-risk types cause genital warts.
• Even a Single Dose of HPV Vaccine May Provide Protection (Nicholas Bakalar, NY Times, 1-6-2020) The HPV vaccine is highly effective against the cancer-causing types of human papillomavirus, but only half of teenagers and young adults have gotten all three of the doses recommended by the Centers for Disease Control and Prevention. Now a new study in women ages 18 to 26 suggests that one shot might be enough.
• What we can learn from Marcia Cross about HPV vaccination (Brian Kim, KevinMD, 6-14-19) Recently, Desperate Housewives star Marcia Cross made headlines by discussing her diagnosis of anal cancer and her husband’s diagnosis of throat cancer, revealing that both had been related to the human papillomavirus, or HPV. HPV doesn’t get nearly the publicity it warrants. The sexually transmitted virus is associated with 34,000 cancers annually, with numbers rising every year, yet it is completely preventable through a vaccine. You can protect your child against a majority of head/neck, cervical and anal cancers with a vaccine. This is where pediatricians can come in, guiding parents and giving them a chance to explore the topic and get educated – rather than just springing it on them during a well-child visit. Marcia Cross realized that stigma and misconceptions are standing in the way of cancer prevention for an entire generation of young people, and she took the brave step of talking about it.
• Federal Experts’ Advice On HPV Vaccine Could Leave Adults Confused (Michelle Andrews, KHN, 8-8-19) Because HPV is so common among people who are sexually active, the best time to vaccinate is before people start having sex and risk being exposed to the virus. The CDC’s Advisory Committee on Immunization Practices recommends HPV vaccination for all 11- and 12-year-old girls and boys. Catch-up immunizations for young people outside that age window are recommended through age 21 for men and 26 for women.In its June meeting, the immunization committee, which includes public health experts, recommended widening the vaccination window to include adults between 27 and 45. The vaccine won’t protect people against types of HPV to which they’ve already been exposed, and many sexually active people have been exposed to at least some HPV types by their late 20s.However, it’s unlikely that people in the older group have been exposed to all nine types of HPV the vaccine protects against. Vaccine experts have some suggestions about which people older than 26 might consider getting the three-shot series. They include people with multiple sex partners and those who are newly single and dating after being in a monogamous marriage or relationship.
• Cancer doctors leading campaign to boost use of HPV vaccine (Laurie McGinley, WashPost, 6-19-16) The 64,000-member American Academy of Pediatrics has urged members to use the HPV vaccine. But Cleveland pediatrician Margaret Stager, who works on adolescent health issues for the organization, said it remains “brand-new territory” for many doctors, especially older physicians. “They have seen whooping cough, meningitis, measles and mumps and have real-life evidence of the power of vaccines to save lives,” she said. “Now we have a whole new fundamental concept, because this vaccine is trying to prevent cancer several decades from now.” The nation’s leading cancer doctors are pushing pediatricians and other providers to help increase use of the HPV vaccine, which studies show could help avert tens of thousands of cancer cases during young Americans’ lives. Yet a decade after its controversial introduction, the vaccine remains stubbornly underused even as some of those diseases surge. The vaccine’s low uptake among preteens and adolescents belies its universally acknowledged effectiveness in preventing the most common sexually transmitted infections linked to the human papillomavirus. Those infections can cause a half-dozen cancers, including more than 90 percent of anal and cervical cancers; 70 percent of vaginal, vulvar and oropharyngeal, or middle throat, cancers; and 60 percent of penile cancers.
• The HPV Vaccine: Access and Use in the U.S. (Women's Health Policy, Kaiser Health News, 10-17-17) The human papillomavirus (HPV) vaccine is the first and only vaccination that helps protect women and men from getting many different types of cancer that are associated with different HPV strains. This new fact sheet discusses HPV and related cancers, use of the HPV vaccines, and insurance coverage and access.
• Cancer doctors leading campaign to boost use of HPV vaccine (Laurie McGinley, WaPo, 6-19-16) We have a vaccine for certain cancers. Why don't more people get it? The 64,000-member American Academy of Pediatrics has urged members to use the vaccine. But Cleveland pediatrician Margaret Stager, who works on adolescent health issues for the organization, said it remains “brand-new territory” for many doctors, especially older physicians. “They have seen whooping cough, meningitis, measles and mumps and have real-life evidence of the power of vaccines to save lives,” she said. “Now we have a whole new fundamental concept, because this vaccine is trying to prevent cancer several decades from now.”
• New Vaccine Recommendation Cuts Number Of HPV Shots Children Need (Michelle Andrews, KHN, 3-28-17)
• How to increase your HPV vaccination rates (Elizabeth Copeland, KevinMD, 3-20-19) As chair of general pediatrics for a large medical group, Dr Copeland flagged the barriers and shares what she learned.
Malaria vaccine
"Malaria is a parasite transmitted to people through a mosquito bite. The pathogen develops in the liver and then destroys the body’s red blood cells. There is currently no vaccine available for humans. CIDR has developed a vaccine that is in phase I clinical trials, and will publish results “soon,” Aitchison says. The vaccine would prevent the malaria parasite from entering the liver and multiplying. In 2016, 216 million people developed malaria worldwide and 445,000 died, according to the World Health Organization. UNICEF estimates that about 3,000 children die daily from malaria. About 1,700 people in the U.S. are diagnosed with malaria annually, but almost all of the cases are in travelers returning from sub-Saharan Africa and south Asia..." Newly merged infectious disease organization offers journalists’ resources (Bara Vaida, Covering Health, AHCJ, 8-14-18)
• Scientists discover antibody that prevents malaria, opening door for new treatments and vaccines (Clare McGrane, GeekWire, 3-19-18)
• Barriers to Developing a Malaria Vaccine (Centers for Disease Control) Although progress has been made in the last 10 years toward developing malaria vaccines, there is currently no effective malaria vaccine on the market. More than a dozen vaccine candidates are now in clinical development, and one, GlaxoSmithKline Biologicals’ RTS,S, is in Phase III clinical testing—the first malaria vaccine candidate to advance this far.
• Frequently asked questions about malaria (CDC)
Measles and measles vaccine
See also Vaccine resistance (articles on measles vaccine resistance)
• Measles (World Health Organization, 8-9-23)
---Measles is a highly contagious, serious airborne disease caused by a virus that can lead to severe complications and death.
---Measles vaccination averted 56 million deaths being between 2000 and 2021.
---Even though a safe and cost-effective vaccine is available, in 2021, there were an estimated 128 000 measles deaths globally, mostly among unvaccinated or under vaccinated children under the age of 5 years.
---In 2022, about 83% of the world's children received one dose of measles vaccine by their first birthday through routine health services – the lowest since 2008.
• 4 Ways Vaccine Skeptics Mislead You on Measles and More (Amy Maxmen and Céline Gounder, KFF Health News, 5-22-24) In the first quarter of this year, the number of cases was about 17 times what it was, on average, during the same period in each of the four years before, according to the CDC. Half of the people infected — mainly children — were hospitalized. Many parents have been influenced by a flood of misinformation spouted by politicians, podcast hosts, and influential figures on television and social media.
• How Well Does the MMR Vaccine Work? MMR vaccine is very effective at protecting people against measles, mumps, and rubella, and preventing the complications caused by these diseases. People who receive MMR vaccination according to the U.S. vaccination schedule are usually considered protected for life against measles and rubella. While MMR provides effective protection against mumps for most people, immunity against mumps may decrease over time and some people may no longer be protected against mumps later in life. An additional dose may be needed if you are at risk because of a mumps outbreak.
One dose of MMR vaccine is 93% effective against measles, 78% effective against mumps, and 97% effective against rubella.
Two doses of MMR vaccine are 97% effective against measles and 88% effective against mumps.
• According to the CDC: ".....From January 1 to June 17, 2011, more measles cases were reported in the United States compared with the same period since 1996." As more parents opt not to vaccinate - we could lose herd immunity. We may see more vaccine preventable infectious diseases in our country imported by travelers. Indirect costs are astronomical."
Read the facts about the measles-mumps-rubella (MMR) vaccine and measles' resurgence.
• Everything you need to know about measles (Lenny Bernstein and Charity Brown, WaPo, 2-3-15) Measles is an extremely contagious respiratory infection caused by a virus. Once common in the United States, it was eliminated here in 2000 but is resurgent today, mostly because of the growing number of people who are refusing to vaccinate their children or delaying those vaccinations, experts say. Fatalities are rare in the United States, but one or two of every 1,000 children who contract measles will die from the disease, according to Anne Schuchat, director of the CDC’s National Center for Immunization and Respiratory Diseases. More common complications include pneumonia, encephalitis (swelling of the brain) and deafness. Here is the information you need to understand the burgeoning debate about measles....
• Why Measles Keeps Popping Up in Pockets of the U.S. (Emily Hutto, video + transcript, MedPage Today, 1-26-24) In this video interview, Paul Offit, MD, of Children's Hospital of Philadelphia and a member of FDA's Vaccines and Related Biological Products Advisory Committee, discusses the history of measles and the MMR (measles, mumps, and rubella) vaccine and examines why there are currently several outbreaks of this vaccine-preventable disease in the U.S. "...I think the bigger reason was COVID, because what happened with COVID was we mandated vaccines in what many considered to be a draconian fashion. You had to be vaccinated or you couldn't go to work or you couldn't go to school or you couldn't go to your favorite restaurant or you couldn't go to a sporting event or you couldn't go to your place of worship. And there was a real rebellion to that. People didn't like that.
"...as a consequence, over the last year, there have been hundreds and hundreds of pieces of legislation pushing back against mandates, including school vaccine mandates. What's happened is about 35% of American parents don't think there should be any school vaccine mandates, period.
"If you look in November of this year, the CDC published a paper in Morbidity and Mortality Weekly Report showing that for the first time you see a clear drop in kindergarten immunization rates from about 95% to 92%, which puts us below the level of herd immunity necessary for protection against measles.
• Getting to the truth when covering measles outbreak (Bara Vaida, Covering Health, AHCJ, 11-1-19) Health care journalist Melba Newsome on how to cover vaccinations for a disease anti-vaxxers have discouraged getting vaccinations for.
• Measles Outbreak Sends Vaccine Demand Soaring, Even Among the Hesitant (JoNel Aleccia, KHN, 2-6-19) Demand for measles vaccine has surged in the Washington county where the highly contagious virus is linked to more than 50 confirmed illnesses this year — including among people who had previously shunned the shots. The outbreak includes 43 cases among those who were not immunized, six cases where immunization has not been verified and one case where the person had received a single dose of vaccine. Research has confirmed that vaccines don’t cause autism, a common reason cited by parents who reject vaccinations.
• Measles and the Limits of Facts (James Hamblin, The Atlantic, 4-26-19) At its core, the resurgence of the once-defeated disease in the U.S. is a failure of communication. "Research suggests that the reason informed people fall into conspiracy-theory mind-sets often has less to do with a lack of information than with social and emotional alignment. Facts are necessary, but not at all sufficient...The work of global inoculation requires first rebuilding a social contract, which means meeting people on the platforms where they now get their information, in the ways they now consume it."
• When Measles Arrives: Breaking Down the Anatomy of Containment (Apoorva Mandavilli, Undark, 4-29-19) Health officials are learning firsthand how quickly and insidiously the measles virus can spread once it finds a foothold in a community. The story of how one community contained a disease’s spread. In some parts of the world, measles is still endemic, and among the leading causes of death in children. But it is easily preventable, requiring just two doses of a widely available vaccine. Because of unfounded fears of autism, however, rising public mistrust in vaccines has resulted in a resurgence of measles across Western countries. When a child with measles arrived at a health center near Boston, staff went to work — and learned some lessons, too. Contact tracing revealed 179 exposed people with no evidence of vaccination — even though the center tried to reach them — suggesting that the fallout at a less-prepared facility could be disastrous.
• What You Should Know About Measles, After A Case Confirmed In Mass. (Carey Goldberg, WBUR CommonHealth, 4-3-19) Informative answers to several questions: 1. I’ve been exposed to someone who has measles. What should I do? 2. Am I protected against measles? (How do you know?) 3. Can I still get measles if I am fully vaccinated? 4. Do I ever need a booster vaccine? 5. What should I do if I’m unsure whether I’m immune to measles? "CDC considers people who received two doses of measles vaccine as children according to the U.S. vaccination schedule protected for life, and they do not ever need a booster dose. There is no harm in getting another dose of MMR vaccine if you may already be immune to measles (or mumps or rubella)."
• When Measles Arrives: Breaking Down the Anatomy of Containment (Apoorva Mandavilli, Undark, 4-29-19) When a child with measles arrived at a health center near Boston, staff went to work — and learned some lessons, too. "One was that pediatricians should give children heading abroad their second dose of MMR before the trip. Another: Divvying up call lists by language from the start makes for shorter work — a lesson that came in handy when responding to the second suspected case." And this: Do not imagine there is a measles SWAT team; there is not.
• How Measles Detectives Work To Contain An Outbreak (Jenny Gold, KHN, 6-10-19) Across the nation, public health departments are redirecting scarce resources to try to control the spread of measles. Their success relies on shoe-leather detective work that is one of the great untold costs of the measles resurgence. On any given day, more than 4,000 people pass through the library at California State University-Los Angeles. On April 11, one of them had measles. The building has only one entrance, which means that anyone who entered or exited the library within two hours of that person’s visit potentially was exposed to one of the most contagious diseases on Earth. It’s the stuff of public health nightmares: Everyone at the library between 11 a.m. and 3 p.m. that day had to be identified, warned and possibly quarantined. Measles is so contagious that up to 90% of people close to an infected person who are not protected by a vaccine or previous case of the disease will become infected.
• My parents didn’t tell me they skipped my vaccines. Then I got sick. (Josh Nerius, Opinion, Washington Post, 4-25-19) My sore throat and fever kept getting worse. I developed a rash. Then I collapsed....I contracted the disease as an adult in good health, and it landed me in the hospital. To this day, I still feel its effects. Years after people seem to recover, measles can suppress the immune system, effectively creating an “immune amnesia” that leaves them more vulnerable to other infections. When someone close to me gets the sniffles, I end up coughing for weeks. Worry about panencephalitis — in which virus lingering in the brain triggers a deadly immune response — also weighs on me."
• Colleges for Deaf Taxed By '60s 'Rubella Bulge' (Thomas O'Toole, Washington Post, 10-15-82) A German measles epidemic swept the United States about 18 years ago, and its 20,000 victims are now inundating the limited facilities of the nation's colleges for the deaf, causing some qualified students to be turned away. The epidemic came a few years before a vaccine was developed to immunize pregnant women against rubella, and it resulted in almost three times the number of infants who are normally born deaf each year. The rubella virus can infect a developing fetus through the placenta crippling the still-developing ears, and in a smaller number of cases the eyes and brain.
• ‘It will take off like a wildfire’: The unique dangers of the Washington state measles outbreak (Lena H. Sun and Maureen O'Hagan, Washington Post, 2-6-19) Amber Gorrow is afraid to leave her house with her infant son because she lives at the epicenter of Washington state’s worst measles outbreak in more than two decades. Born eight weeks ago, Leon is too young to get his first measles shot, putting him at risk for the highly contagious respiratory virus, which can be fatal in small children. Gorrow also lives in a community where she said being anti-vaccine is as acceptable as being vegan or going gluten free. Almost a quarter of kids in Clark County, Wash., a suburb of Portland, Ore., go to school without measles, mumps and rubella immunizations, and Washington Gov. Jay Inslee (D) recently declared a state of emergency amid concern that things could rapidly spin out of control.
"The Pacific Northwest is home to some of the nation’s most vocal and organized anti-vaccination activists. That movement has helped drive down child immunizations in Washington, as well as in neighboring Oregon and Idaho, to some of the lowest rates in the country, with as many as 10.5 percent of kindergartners statewide in Idaho unvaccinated for measles.
• ‘Monkey, Rat and Pig DNA’: How Misinformation Is Driving the Measles Outbreak Among Ultra-Orthodox Jews (Tyler Pager, NY Times, 4-9-19) “The lack of a comprehensive secular education has raised a generation of some parents who do not appreciate modern science and do not have trust in the health system,” said Dov Bleich, a Hasidic father of two who lives in Monsey and emphasized that most rabbis are supportive of vaccines. “It’s leaving them vulnerable to the anti-vaccine crusade.” Handbooks distributed in some Jewish communities in New York, as well as messages on hotlines and four-hour, pseudoscientific conference calls, contradict the scientific consensus that vaccines are safe and highly effective. Mayor Bill de Blasio declared a public health emergency in parts of Brooklyn in an effort to contain the spread of measles in ultra-Orthodox neighborhoods there.
• Why one case of measles is a public health emergency (Erin Archer Kelser, Germ Nurse, 1-9-15) The short answer: Measles can cause significant illness and death, is highly contagious, and we don’t want it to gain a foothold again in the United States. Kelser also provides the longer answer.
• Many parents who intentionally refuse to vaccinate their children believe "they are trying to do the right thing," said Gary Marshall, a pediatrics professor at the University of Louisville School of Medicine in Kentucky. "Unfortunately, they're mistaken. The right thing to do to protect their children is to vaccinate them to prevent them from getting measles and getting a horrible complication."...Measles is an extremely contagious respiratory infection caused by a virus. Once common in the United States, it was eliminated nationally in 2000, but has made a comeback, mostly because of the growing number of people who refuse to vaccinate their children or delay those vaccinations, experts say...In 2014, the United States experienced a record 667 cases of measles, the largest number since the disease's elimination here, according to the Centers for Disease Control and Prevention. One major outbreak occurred primarily among unvaccinated Amish communities in Ohio....Unvaccinated babies can be infected with measles and later develop this complication, which is called subacute sclerosing panencephalitis, or SSPE....[R]esearchers at the David Geffen School of Medicine at the University of California in Los Angeles and the California public health agency, found that for babies who get measles before being vaccinated, the rate is 1 in 609. See also SSPE: A Deadly and Not-That-Rare Complication of Measles (Clay Jones, Science-Based Medicine, 2-27-15).
• Measles sweeps an immigrant community targeted by anti-vaccine activists (Helen Branwell, STAT, 5-8-17) For years, anti-vaccine activists have worked on the sizable Somali-American community in Minnesota, urging them to refuse to let their children receive the MMR vaccine. They’ve been successful: The vaccination rate has plunged. And now, the state is struggling to contain a large and growing measles outbreak that is spreading rapidly through the Somali community and threatens to move beyond it....The last large outbreak of measles in the United States occurred from 1989 to 1991 with over 55,000 cases reported. Most of the cases involved unimmunized preschool children. 11,000 patients were hospitalized and 123 died, which was consistent with the expected 1-2 deaths per 1,000 cases."
• Quiz: Are You Prepared to Confront the Measles Outbreak? (Russel W. Steele, Medscape, 2-10-15) A good way to test your knowledge before you read these other articles, all interesting (in different ways) on an important topic.
• The communications gap on vaccines (Sharron Kahn Luttrell, Harvard Gazette, 9-16-13). Panelists call for more outreach, research to counter misinformation. “Why would anybody hesitate to vaccinate their kids?” said Barry R. Bloom, Harvard University Distinguished Service Professor and Joan L. and Julius H. Jacobson Professor of Public Health at HSPH. “Where do they get their information? How good is the information? Is it social networks? Is it over the back fence? Is it from moms at school? It’s very hard to develop a strategy if in fact we don’t know the values people are bringing when they come to the pediatrician.” Critical to developing a comprehensive communications strategy is research into why parents are anxious and how they make decisions about whether to vaccinate their children on time, on a delayed schedule, or not at all, the panelists agreed.
• Measles Outbreak, Measles Vaccine: Top Questions Answered (Tia Ghose, Rachael Rettner and Tanya Lewis, LiveScience, 2-5-15) "The U.S. measles outbreak now includes at least 102 infected people in 14 states. Most of the cases have been tied to Disneyland in Southern California. The outbreak has many people wondering why a disease that was eradicated from the United States in the year 2000 is now infecting so many people, and what role vaccination requirements may have had in the outbreak. We asked experts to explain how the vaccine works and why the outbreak is happening now.
• How to Cause a Measles Epidemic in Five Easy Steps (Paul Marantz, The Doctor's Tablet blog, Einstein College of Medicine, 2-5-15)
• Anti-Vaccine Movement Ushers Measles into the Limelight (AllGov California, with links to other articles)
• Two Infants Too Young For Vaccinations Contract Measles From Unvaccinated People At Disneyland (Tara Culp-Ressler, ThinkProgress, 1-8-15)
• Vaccine Critics Turn Defensive Over Measles (Jack Healy and Michael Paulson, Science, NY Times, 1-30-15) As officials in 14 states grapple with a measles outbreak, the parents at the heart of America's anti-vaccine movement are being blamed for incubating an otherwise preventable public-health crisis.
• Measles Is A Killer: It Took 145,000 Lives Worldwide Last Year (Jason Beaubien, All Things Considered, 1-30-15) The uproar over the U.S. outbreak glosses over a bigger problem: Measles takes a tragic toll in poor countries. But a vaccine can effectively stop this deadly — and highly contagious — disease.
• Measles Deaths Fall to a Record Low Worldwide (Donald G. McNeil Jr., Health, NY Times, 12-26-17) For the first time in history, annual deaths around the globe from measles have fallen below 100,000, the World Health Organization announced this year. As recently as the 1980s, measles killed 2.6 million people a year. The decline — a public health triumph, as measles has long been a leading killer of malnourished children — was accomplished by widespread donor-supported vaccination that began in the early 2000s....The disease kills up to 6 percent of malnourished children in poor countries, the W.H.O. estimates, and up to 30 percent in some outbreaks among refugees. Half of the world’s unvaccinated children live in six countries: Congo, Ethiopia, India, Indonesia, Nigeria and Pakistan."
• I Read the Anti-Vaccine Doctor’s Manifesto so You Don’t Have to (Anna G. Mirer, Worse for the Fishes, 1-30-15)
• Journalists around the country tracking vaccination rates (Pia Christensen, Covering Health, 2-5-15)
• Goodnight Measles: Bedtime Stories for Your Unvaccinated Child (Hannah Levintova, Mother Jones, 2-13-15) The anti-vaccine movement has no problem innoculating kids with propaganda.
• Addressing Vaccine Hesitancy (Barry R. Bloom, Edgar Marcuse, and Seth Mnookin, Science, 4-25-14) A recent report concluded that current public health communication about vaccines may actually increase misperceptions or reduce vaccination intention, and that attempts to increase concerns about communicable diseases or correct false claims about vaccines may be counterproductive. we need research that addresses how and when attitudes and beliefs about vaccines are formed, how people make decisions about immunization, how best to present information about vaccines to hesitant parents, and how to identify communities at risk of vaccine-preventable disease outbreaks.
Thanks to Norman Bauman for important links on this topic.
Meningitis vaccine
• Meningococcal ACWY VIS (CDC information)Meningococcal ACWY vaccine can help protect against meningococcal disease caused by serogroups A, C, W, and Y. Two existing vaccines, Menactra and Menveo, prevent the first four types of bacterial meningitis and are currently recommended by the Centers for Disease Control and Prevention for all preteens and adolescents. Many schools and colleges require students to receive a meningitis vaccine before enrolling. A different meningococcal vaccine is available that can help protect against serogroup B.
• Meningitis B is rare but deadly. Parents who lost children to the disease wonder why no one mentioned a vaccine. (Sarah Elizabeth Richards, Washington Post, 9-16-19) Since her son’s death, AracellyBibl has tried to make sense of his swift-killing illness. She’d dutifully taken him to his pediatrician for required vaccinations just a year earlier, which included a booster shot for four meningitis strains (known as the meningococcal conjugate vaccine, or MenACWY) that’s routinely given to children at age 11 or 12 (with a recommended booster at 16). But she’d never heard about meningitis B or that two vaccines for it had been on the market for several years. “The doctor never brought it up,” Bibl says. “There wasn’t even a poster in his office.” The advisory committee that guides vaccination policies at the CDC has said that distribution of the meningitis B vaccine should be based on “shared clinical decision-making.” In other words, unless a teen has compromised immunity, an abnormal spleen condition or is a college student in the middle of an campus outbreak, it’s up to individual doctors to decide whether to broach the topic. And not all doctors do. See also First vaccine for deadly form of meningitis approved in U.S. (Julie Zauzmer, WaPo, 10-29-14) The vaccine, Trumenba, protects against serogroup B, one of five forms of bacterial meningitis. It is manufactured by Pfizer. One problem:
• Meningitis B Vaccine’s High Price Poses A Health Care Conundrum For College-Bound (Shefali Luthra, Kaiser Health News, 9-8-17)
• Paralympic Champion Makes the Case for Meningitis Vaccine (Alison Bruzek, Shots, NPR, 1-4-15) Amy Purdy, who lost both lower legs because of bacterial meningitis, performed with Derek Hough on Dancing With The Stars (see photo). At age 19, she was diagnosed with bacterial meningitis. "It affects only about 4,000 people a year in the United States, according to the Centers for Disease Control and Prevention, but more than 10 percent of those people die. Others, like Purdy, suffer devastating consequences, including hearing loss, brain damage, or the loss of limbs from bloodstream infection" (sepsis). College students are especially vulnerable, because meningitis is spread by living in close quarters and sharing drinking and eating utensils, or kissing. That's why the CDC recommends meningitis vaccine for all teenagers, especially if they weren't vaccinated as preteens. Purdy wasn't living in a dorm and she was incredibly healthy when she contracted the infection. "For me, it was life-changing. I nearly died multiple times in the hospital. I lost my legs, I lost my spleen, I lost my kidney function. I lost the life that I knew."
Mumps vaccine
• Rise in mumps outbreaks prompts U.S. panel to endorse 3rd vaccine dose ( Lena H. Sun, WaPo, 10-25-17) A federal expert panel on Wednesday recommended a third dose of the mumps vaccine when an outbreak occurs. The move was in response to the rise in mumps outbreaks since 2006, especially among highly vaccinated college students. More than 6,000 cases of the contagious viral illness were reported last year in the United States, the most in a decade. Unlike outbreaks of measles, which have taken place in populations with significant numbers of unvaccinated people, the mumps outbreaks have occurred in communities with high rates of immunization and people who often have received both recommended doses of the vaccine. The committee did not recommend an extra shot for everyone. It voted unanimously to recommend a third dose of mumps-containing vaccine only for people who are determined by public health officials to be at increased risk for mumps because of an outbreak.
Pneumococcal vaccine
• Pneumococcal shots (Medicare) About a million people go to the hospital every year with pneumonia. Pneumonia is a lung infection caused by pneumococcal disease, which can also cause blood infections and meningitis. The bacteria that causes pneumococcal disease spreads by direct person-to-person contact.The pneumococcal shot is the best way to help prevent certain types of pneumonia and other pneumococcal infections. Medicare Part B covers the initial shot, plus a second shot (a year after you’ve gotten the initial shot). Talk with your doctor to see if you need one or both shots.
• Adults: Protect Yourself with Pneumococcal Vaccines (CDC) Many adults are at risk for pneumococcal disease. Two vaccines provide protection against this serious and sometimes deadly disease. Talk to your healthcare professional to make sure you are up to date on these and other recommended vaccines. PCV13 protects against 13 strains of pneumococcal bacteria and PPSV23 protects against 23 strains of pneumococcal bacteria. Both vaccines provide protection against illnesses like meningitis and bacteremia. PCV13 also provides protection against pneumonia. CDC says who should and shouldn't get the vaccine, and not to get them both at once.
• Pneumococcal Disease (CDC primer) Streptococcus pneumoniae, or pneumococcus, is a type of bacterium that causes pneumococcal [noo-muh-KOK-uhl] disease. Pneumococcal infections can range from ear and sinus infections to pneumonia and bloodstream infections. Children younger than 2 years old and adults 65 years or older are among those most at risk for disease.
• The Ratcheting Cost of the Pneumococcal Vaccine: What Gives? (Shefali Luthra, Kaiser Health News, 11-29-17) The notice that comes every November from the drug company Pfizer yane — or Coke in an airport. They charge what they want to.” The Advisory Committee on Immunization Practices (ACIP), a consultatory panel to the federal Centers for Disease Control and Prevention, recommends Prevnar 13 for all children younger than 2 — given at 2, 4, 6 and 15 months — as well as for adults 65 and older. A full pediatric course of the vaccine typically involves four shots. In 2010, a single shot cost about $109, according to pricing archives kept by the CDC. It currently costs about $170, according to those archives. Next year, Pfizer says, a shot will cost almost $180. Physicians have to stock it and although they will mostly be reimbursed through insurance, it can take months for that to come through, which is an especially tough proposition for small practices on tight budgets. “The cost of vaccines is definitely something in primary care we worry about, because we’re on thin margins. … You don’t want to provide a service you lose money on, even if it’s as important as immunization.”
• There is no such thing as “free” vaccines: Why we rejected Pfizer’s donation offer of pneumonia vaccines. (Jason Cone, Executive Director of Doctors Without Borders in the United States, Medium.com, 10-10-16) Pneumonia claims the lives of nearly one million kids each year, making it the world’s deadliest disease among children. As the only producers of the pneumonia vaccine, Pfizer and GlaxoSmithKline (GSK) are able to keep the price of the vaccine artificially high; since 2009, the two companies have earned $36 billion on this vaccine alone. For years, we have been trying to negotiate with the companies to lower the price of the vaccine, but they offered us donations instead. By giving the pneumonia vaccine away for free, pharmaceutical corporations can use this as justification for why prices remain high for others, including other humanitarian organizations and developing countries that also can’t afford the vaccine. Critically, donation offers can disappear as quickly as they come. Donations can also undermine long-term efforts to increase access to affordable vaccines and medicines. They remove incentives for new manufacturers to enter a market when it’s absorbed through a donation arrangement. Pfizer should lower the price of its lifesaving pneumonia vaccine for humanitarian organizations and all developing countries to $5 per child. Only then, will we have a meaningful step towards saving children’s lives both today and in the future.
Polio vaccine
Pronounced [PO-lee-oh] See separate section on Polio and post-polio syndrome
• Polio Vaccination (CDC) One of the recommended vaccines. Inactivated polio vaccine (IPV) is the only polio vaccine that has been given in the United States since 2000. It is given by shot in the arm or leg, depending on the person’s age. Oral polio vaccine (OPV) is used in other countries.
• Polio fears rise in New York amid possible community spread (AP, 8-4-22) New York state health officials issued a more urgent call Thursday for unvaccinated children and adults to get inoculated against polio, citing new evidence of possible “community spread” of the dangerous virus. The polio virus has now been found in seven different wastewater samples in two adjacent counties north of New York City, health officials said. Based on earlier polio outbreaks, “New Yorkers should know that for every one case of paralytic polio observed, there may be hundreds of other people infected.”
• Critical Vaccine Shortage Threatens Polio Eradication Efforts (Maryn McKenna, Newsweek, 12-29-16) Polio remains endemic in Pakistan after the Taliban banned vaccinations, instigated attacks targeting medical staffers and spread suspicions about the inoculations.
• Ghost Viruses and the Taliban Stand in the Way of Wiping Out Polio (Jason Beaubien, All Things Considered, 10-24-19) The oral polio vaccine used in lower income countries in most parts of the world contains live virus as opposed to the killed virus used in the injectable vaccine administered in the U.S. and Europe....The point of the oral vaccine is that it has been weakened in the laboratory so that the virus will provoke an immune response without causing the actual disease....the risk of contracting polio from the vaccine is very rare, but "as billions of doses of vaccine were doled out around the world, some of them started to do what viruses do and spread from one person to another. In places where there's poor sanitation, the vaccine is excreted into sewage, ends up in someone else's drinking water and can survive for months if not years....slowly some of that vaccine-derived virus reverted to a virus just as dangerous as wild polio....Racaniello, the virologist at Columbia, says there are now more outbreaks of vaccine-derived polio than of the original disease." (A complex story--read the whole thing!)
• Polio vaccination may continue after wild virus fades (Maryn McKenna, Center for Infectious Disease Research and Policy, 10-16-08) "The oral vaccines are inexpensive, costing about 12 cents per dose, and simple to administer. But they are not foolproof. In one out of every few million recipients, they cause polio paralysis. Immune-impaired individuals can become long-term shedders of the virus. And the viral replication that enables passive immunization can go awry and allow the weakened strain to mutate and regain its virulence, a process that caused outbreaks of vaccine-derived poliovirus in Hispaniola in 2000 and Nigeria since 2005." The injectable vaccine is safer, but must be administered by healthcare workers (more difficult in poor countries), and poses an additional problem of needle disposal.
• Polio Vaccine (Children's Hospital of Philadelphia) Since travel makes the world a much smaller place, a recurrence of polio is merely a plane ride away.The inactivated polio vaccine (IPV) is given as a series of four shots at 2 months, 4 months, 6 to 18 months, and again at 4 to 6 years of age. Because IPV has no serious side effects, the benefits of the vaccine clearly outweigh its risks.
• FDA Accelerates Development of Polio Virus Treatment for Brain Cancer (Silas Inman, Cure, 5-17-16) The FDA granted the recombinant oncolytic poliovirus PVS-RIPO a breakthrough therapy designation as a potential treatment for patients with recurrent glioblastoma multiforme (GBM), citing evidence from an ongoing phase 1 study that is exploring overall survival rate in patients with grade 4 malignant glioma, according to a statement by the developer of the immunotherapy, Duke Medicine.
ABOUT THE FASCINATING HISTORY OF POLIO VACCINATION:
• A “Polio Warrior” Recounts Decades of Struggle Toward Eradication (Maryn McKenna, National Geographic, 4-12-15) Maryn interviews John Sever about his role and that of Rotary International in campaigns to vaccinate every child, in an attempt to eradicate polio around the world, about the relative roles of the Salk and Sabin vaccines, and about changes in thinking about the two.
• The Last Time a Vaccine Saved America (Howard Markel, New Yorker, 4-12-21) Sixty-six years ago, people celebrated the polio vaccine by embracing in the streets. Our vaccine story is both more extraordinary and more complicated.
• The Cutter Incident: How America’s First Polio Vaccine Led to the Growing Vaccine Crisis by Paul Offit (as reviewed by Michael Fitzpatrick (Journal of the Royal Society of Medicine, March 2006) "The Cutter incident had an ambivalent legacy. On the one hand, it led to the effective federal regulation of vaccines, which today enjoy a record of safety `unmatched by any other medical product'. On the other hand, the court ruling that Cutter was liable to pay compensation to those damaged by its polio vaccine—even though it was not found to be negligent in its production—opened the floodgates to a wave of litigation. As a result, `vaccines were among the first medical products almost eliminated by lawsuits'. Indeed, the National Vaccine Injury Compensation Program was introduced in 1986 to protect vaccine manufacturers from litigation on a scale that threatened the continuing production of vaccines. Still, many companies have opted out of this low-profit, high-risk field, leaving only a handful of firms to meet a growing demand (resulting in recent shortages of flu and other vaccines)."
• Debunked: The Polio Vaccine and HIV Link (College of Physicians of Philadelphia, The History of Vaccines)
Rabies vaccine
• Rabies Vaccine: What You Need to Know (Centers for Disease Control)
• Rabies Prevention (CDC, in animals and in humans)
• Pre-Exposure Vaccinations (CDC)
• Rabies (CDC, broader-based information, including global statistics and links to technical articles)
• Administration of Rabies Vaccination State Laws (American Veterinary Medical Association, for animals)
• Why a simple, lifesaving rabies shot can cost $10,000 in America ( Sarah Kliff, Vox, 2-7-18) Untreated rabies is always fatal — but key drugs leave families with thousands in medical debt.
Respiratory syncytial virus (RSV) vaccine
See long section on
• RSV (the disease, especially on the treatment of infants with RSV)
• High demand for new RSV treatment for infants outpaces national supply Amna Nawaz joints Dr. Céline Gounder, an epidemiologist and senior fellow at KFF, on PBS, 11-10-23)
• Respiratory Syncytial Virus Infection (RSV) (CDC) "Respiratory syncytial (sin-SISH-uhl) virus, or RSV, is a common respiratory virus that usually causes mild, cold-like symptoms. Most people recover in a week or two, but RSV can be serious. Infants and older adults are more likely to develop severe RSV and need hospitalization. If you are age 60 or older, a vaccine is available to protect you from severe RSV. Talk to your healthcare provider to see if it’s right for you. If you are pregnant, you can get an RSV vaccine between 32–36 weeks of pregnancy to protect your infant after birth, or a preventive antibody can be given to your baby after birth."
• RSV Vaccination: What Parents Should Know (CDC)
• Is it RSV or Covid 19? (Health Matters, New York Presbyterian) Scroll down for chart showing symptoms of RSV.
Shingles vaccine
• Shingles on the Rise Among Younger People (Stephanie Watson, WebMD, 9-4-18) If you've had chicken pox, you can get shingles. Get the vaccine!
• The Scramble For Shingrix: What To Know About The Shingles Vaccine Shortage (Miriam Wasser, CommonHealth, WBUR, 12-7-18) The previous shingles vaccines, Zostavax, is recommended for healthy people over 60, and was found to be about 51 percent effective in them. Shingrix, meanwhile, is 97 percent effective in healthy adults between 50 and 69 years old, and 91 percent effective in adults 70 years or older, according to the Centers for Disease Control and Prevention. This may explain why there has been such a run on the vaccine.
• GoodRx guide to discounts on Shingrix vaccine
• Shingles (herpes zoster Read about the disease, which should convince you to get the vaccine.
• Shingrix Side Effects Reviewed (Brian Leonard, GoodRX, 5-3-22) Shingrix is generally well tolerated. Still, you may have arm pain, headache, or fever for a couple of days after the vaccine.
• Vaccine Finder (find out where to ask if the vaccine is available, and to get yourself on their waiting list)
• No Excuses, People: Get the New Shingles Vaccine (Paula Span, New Old Age, NY Times, 11-10-17) Dr. William Schaffner, preventive disease specialist at the Vanderbilt University School of Medicine, said, “This vaccine has spectacular initial protection rates in every age group. The immune system of a 70- or 80-year-old responds as if the person were only 25 or 30.” Large international trials have shown that the vaccine, Shingrix, from the firm GlaxoSmithKline, prevents more than 90 percent of shingles cases, even at older ages. It is far more effective in the elderly than the old Shingles vaccine, Zostavax.
• Adults Skipping Vaccines May Miss Out on Effective New Shingles Shot (Michelle Andrews, KHN, 3-20-18) Federal officials have recommended a new vaccine that is more effective than an earlier version at protecting older adults against the painful rash called shingles. But persuading many adults to get this and other recommended vaccines continues to be an uphill battle, physicians and vaccine experts say. “I’m healthy, I’ll get that when I’m older,” is what adult patients often tell Dr. Michael Munger when he brings up an annual flu shot or a tetanus-diphtheria booster or the new shingles vaccine. Sometimes they put him off by questioning a vaccine’s effectiveness
• Should I Get the Shingles Vaccine? (Mark A. Kelley, Health Web Navigator, 1-11-17)
• The New Shingles Vaccine: What You Should Know About Shingrix (Diane Umansky, Consumer Reports, 1-25-18) The CDC now recommends this vaccine for its strong, longer-lasting protection
• Why Does My Shingles Vaccine Cost So Much? (Teresa Carr, Consumer Reports, 4-28-17) Medicare may not provide good coverage for this vital protection
• CDC Panel Recommends a New Shingles Vaccine (Sheila Kaplan, NY Times, 10-25-17) CDC recommends a new vaccine to prevent shingles over an older one that was considered less effective. The new vaccine, called Shingrix and manufactured by GlaxoSmithKline, is recommended for adults ages 50 and older. The panel’s recommendation gives preference to the new vaccine over Merck’s Zostavax, which has been the only shingles vaccine on the market for over a decade and was recommended for people ages 60 and older. The disease, also known as herpes zoster, can range in severity from barely noticeable to debilitating. It is caused by the varicella-zoster virus, which also causes chickenpox. GlaxoSmithKline said its new vaccine would cost about $280 and would be available next month. Zostavax costs about $223.
• Older Adults Are Still Skipping Vaccinations (Paula Span, NY Times, 12-2-16) By not being vaccinated, older adults are exposing themselves to higher risk from shingles; tetanus, diphtheria and whooping cough (Tdap vaccine); and flu, all of which can hit harder in old age. "Shingles results from the same virus that causes chickenpox, which nearly all older Americans have had. The virus typically remains dormant for decades, but the odds of its reactivation rise steeply after 50 as the immune system weakens. The lifetime risk of shingles is one in three, rising to one in two for those over 85." “Don’t delay, as the consequences of shingles can be devastating,” advises Consumer Reports’ medical director, Orly Avitzur, a neurologist who has seen firsthand the painful effects of lingering nerve damage. See Why Does My Shingles Vaccine Cost So Much? (typically about $200, Theresa Carr, Consumer Reports, 4-28-17) Carr suggests getting your shots at the pharmacy to save money.
Tuberculosis vaccine (TB)
• Tuberculosis resurges as top infectious disease killer (World Health Organization, 10-29-24) Approximately 8.2 million people were newly diagnosed with TB in 2023 – the highest number recorded since WHO began global TB monitoring in 1995. This represents a notable increase from 7.5 million reported in 2022, placing TB again as the leading infectious disease killer in 2023, surpassing COVID-19. A significant number of new TB cases are driven by 5 major risk factors: undernutrition, HIV infection, alcohol use disorders, smoking (especially among men), and diabetes. Overall, the U.S. TB rate increased by 15%, from 2.5 per 100,000 persons in 2022 to 2.9 in 2023
• How a Big Pharma Company Stalled a Potentially Lifesaving Vaccine in Pursuit of Bigger Profits (Anna Maria Barry-Jester, ProPublica, 10-4-23) A vaccine against tuberculosis, the world’s deadliest infectious disease, has never been closer to reality, with the potential to save millions of lives. But its development slowed after its corporate owner GSK focused on more profitable vaccines. Importantly, the shingles vaccine shared a key ingredient with the TB shot, a component that enhanced the effectiveness of both but was in limited supply.
• Bacille Calmette-Guérin (BCG) is a vaccine for tuberculosis disease. This vaccine is not widely used in the United States, but it is often given to infants and small children in other countries where TB is common.~ CDC
• Promising tuberculosis vaccine gets US$550-million shot in the arm (Lilly Tozer, Nature, 6-28-23) The candidate is moving to long-awaited phase III trials — if successful, it would be the first new jab against the disease in more than 100 years.
• New TB Vaccine Research (World Health Organization)
Typhoid vaccine
Inactivated typhoid vaccine (shot) One dose provides protection. It should be given at least 2 weeks before travel abroad to allow the vaccine time to work. A booster dose is needed every 2 years for people who remain at risk.
• Typhoid vaccine information statement (CDC) Generally, people get typhoid from contaminated food or water. Typhoid is rare in the U.S., and most U.S. citizens who get the disease get it while traveling. Generally, people get typhoid from contaminated food or water. Typhoid strikes about 21 million people a year around the world and kills about 200,000. There are two vaccines to prevent typhoid. One is an inactivated (killed) vaccine given as a shot. The other is a live, attenuated (weakened) vaccine which is taken orally (by mouth).
• We’re Out of Options’: Doctors Battle Drug-Resistant Typhoid Outbreak (Emily Baumgaertner, NY Times, 4-13-18) The first known epidemic of extensively drug-resistant typhoid is spreading through Pakistan, infecting at least 850 people in 14 districts since 2016, according to the National Institute of Health Islamabad. The typhoid strain, resistant to five types of antibiotics, is expected to disseminate globally, replacing weaker strains where they are endemic. Experts have identified only one remaining oral antibiotic — azithromycin — to combat it; one more genetic mutation could make typhoid untreatable in some areas
• W.H.O. Approves a Safe, Inexpensive Typhoid Vaccine (Donald G. McNeil Jr., NY Times, 1-3-18) A new, highly effective typhoid vaccine — the only one safe for infants — has been approved for global use by the World Health Organization.
Yellow fever vaccine
Yellow fever is a serious viral infection that still occurs in certain parts of Africa and Latin America. It is spread through the bite of an infected mosquito. Yellow fever vaccine is given only at designated vaccination centers. Most people begin to develop immunity within ten days and 99 percent are protected within a month of vaccination. "The yellow fever vaccine provides lifelong protection for most people. Booster doses and new vaccination certificates used to be recommended every 10 years for people who continued to be at risk of the infection, but this is no longer necessary in most cases." But check well in advance against the WHO country list, if you will be traveling in Africa or Latin America.
• Planning A Trip To Brazil? Do Not Forget Your Yellow Fever Vaccine (Melvin Sanicas, Healthcare in America)
• Yellow Fever Vaccination (CDC)
• WHO Country list (countries that require proof of vaccination for yellow fever (and sometimes malaria), because travelers may be exposed to it within that country.
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ZIKA
• Scientists infect volunteers with Zika in hunt for vaccines, treatments (Jennifer Rigby, Reuters, 10-21-23) For the first time, scientists have deliberately infected people with Zika virus to learn whether such a strategy could help to test vaccines against the pathogen. The virus can cause severe birth abnormalities in babies born to parents infected during pregnancy.
Books about vaccines and immunization
I have not personally reviewed all these books, but I have included only books that got good reviews.
• Vaccines 2.0: The Careful Parent's Guide to Making Safe Vaccination Choices for Your Family by Mark Blaxill and Dan Olmsted.
• The Panic Virus: The True Story Behind the Vaccine-Autism Controversy by Seth Mnookin. Interesting comments by readers/parents on Goodreads.
• Calling the Shots: Why Parents Reject Vaccines by Jennifer A. Reich. “Calling the Shots treads confidently into the explosive terrain of vaccine refusal. In this must-read exploration of the burdens of modern mothering, Reich takes seriously the desires of mothers to make their own decisions to protect their children from risks. But she also shows how anti-vaccine stances by the privileged few may undermine the social compact and threaten the public good. This is a well-written, important, and very timely book.”--Steven Epstein, author of Inclusion: The Politics of Difference in Medical Research
• The Vaccine-Friendly Plan: Dr. Paul's Safe and Effective Approach to Immunity and Health-from Pregnancy Through Your Child's Teen Years by Paul Thomas and Jennifer Margulis. This story. It’s Time to Start a New Conversation About Vaccines explains where the authors stand on "to vaccinate or not to vaccinate": Yes, but know what you're doing, and where there may be dangers. For example, it explains why parents should never give their children Tylenol before or after vaccines. (Story linked to:
Acetaminophen as a cause of the autism pandemic? It makes absolutely no sense … at first. (SafeMinds). “Children who used acetaminophen at age 12 to 18 months were more than eight times as likely to be in the autism group when all children were considered and more than 20 times as likely to be in the autism group when limiting cases to children with regression....There was no similar autism effect with ibuprofen. In fact, as Schultz explained to me recently by email, “I did not see a direct association with any of the vaccines themselves. It was only the combination of acetaminophen and the MMR vaccine which increased autism risk.”
• Foreign Bodies: Pandemics, Vaccines, and the Health of Nations by Simon Schama, a history of vaccines, as reviewed and discussed in The Economist (9-23): Simon Schama’s “Foreign Bodies” tracks the history of vaccines
• The Vaccine Race: Science, Politics, and the Human Costs of Defeating Disease by Meredith Wadman. The story behind the book's genesis: How a debate over patient consent rules led to a book on vaccine history (Bara Vaida, Covering Health, AHCJ, 2-6-18), and see also Author reflects on writing a book about vaccines, medical research (Bara Vaida, AHCJ). The book "tells the story of how vaccines for diseases such as rubella and rabies were created and how the research led to an understanding of how and why humans age. The book also takes an unflinching look at the dark side of medical research, including the use of vulnerable populations for vaccine clinical trials, before the U.S. developed patient consent laws."
• The Vaccine Book: Making the Right Decision for Your Child by Robert W. Sears (Sears Parenting Library)
• Miller's Review of Critical Vaccine Studies: 400 Important Scientific Papers Summarized for Parents and Researchers by y Neil Z. Miller. Studies critical of vaccination.
MMR vaccine, a fraudulent report on autism, and the anti-vaxxer movement
The problems with the anti-vaccine movement
• Ethan Lindenberger Testifies On Why He Got Vaccinated Against His Mother's Will (C-SPAN video, 3-5-19) During a surge in measles outbreaks, Ethan Lindenberger, whose mother is an anti-vaccine advocate, shares his story on how he decided to go against her and get vaccinated. He also voices concern over misinformation on the internet and support for education around the issue. He questioned his own mother’s anti-vaccination beliefs, did research and ended up getting his shots after he turned 18, when he no longer needed her authorization. He put the blame for what he called his mother’s well-intentioned decisions on “deeply rooted misinformation” online, which, he told lawmakers, should be at the forefront of the vaccine debate. “Charlatans and internet fraudsters who claim that vaccines aren’t safe are preying on the unfounded fears and daily struggles of parents, and they are creating a public health hazard that is entirely preventable,” said Sen. Lamar Alexander (R-Tenn.), who chairs the panel that held the hearing. (Drawn from Factually report.)
• The tide is turning: a pro-vaccine Facebook thread (Dyan Hes, KevinMD, 3-17-19) "A local mother had written a post on a Facebook page that she learned there are many unvaccinated children in her New York City-based pediatrician’s office. She was very nervous going there with her child. Followed by that were many pro-vaccine posts recommending our practice. Mothers were praising the fact that we have a zero tolerance policy on vaccines. This is my red line. If you do not trust me about the safety of vaccines, then why should you trust me about any of my medical opinions?...One must remember that pro-vaccine doctors are facing increasing amounts of online abuse. Recently, anti-vaxxers in the community have been targeting pro-vaccine physicians who express their views online, in scientific forums, or even in Congress....It is going to take time and many more epidemics to undo all the anti-vax nonsense out there, but we physicians can do it if we stand firm together in support of science and health."
• What makes some parents fall for anti-vaccine messaging (Julia Belluz, Vox, 12-5-17) Public health officials may not be hitting on the right morals in their quest to get all children vaccinated. Parents who are concerned about vaccines prize liberty and purity. Anti-vaccine messaging has emphasized purity and liberty, while public health campaigners have been focused on harm and fairness.
• Anti-vaxxers trolled a doctor’s office. Here’s what scientists learned from the attack. (Lena H. Sun, WaPo, 3-21-19) Across the nation and around the world, pediatricians and other practitioners are increasingly coming under digital attack from a global movement that spreads misinformation about vaccines. Instead of enduring the abuse, Kids Plus fought back, tracking comments and turning its Facebook page data to researchers at the University of Pittsburgh. They found, in a study released Thursday in the journal Vaccine, is that most commenters weren’t from Pittsburgh at all but were from across the United States and around the world. Only five were from Pennsylvania. Within eight days, the page was flooded with 10,000 negative comments from about 800 commenters. Some messages threatening, such as “You’ll burn in hell for killing babies.” Others were conspiratorial, such as “You have been brainwashed,” the doctors said. The people at Kids Plus decided to investigate who was behind the attack and how it was carried out. The majority of commenters to the Pittsburgh practice were mothers. "The top two political affiliations were on opposite ends of the political spectrum, with 56 percent expressing support for President Trump and 11 percent expressing support for Sen. Bernie Sanders... Among the anti-vaccine themes in the comments were a mistrust of the scientific community, concerns about personal liberty, perceived risks about vaccine safety and the belief that government and pharmaceutical companies are part of a conspiracy to hide information....Kids Plus was able to figure out the social media attack was directed from inside closed anti-vaccine Facebook groups, in which members have to be approved to join. Together with the researchers’ analysis, the information provides the first systematic analysis of how anti-vaccine activists coordinate a harmful social media campaign, experts said....The pediatric practice said it is taking the information gleaned from the research to put together a primer for other physician practices and a pro-vaccine rapid-response network of physicians and others who will post pro-vaccine information to combat anti-vaccine social media campaigns."
• Teen who defied anti-vax mom says she got false information from one source: Facebook (Michael Brice-Saddler, WaPo, 3-5-19) An 18-year-old from Ohio who famously inoculated himself against his mother’s wishes in December says he attributes his mother’s anti-vaccine ideology to a single source: Facebook. In an interview with The Washington Post, Lindenberger said Facebook, or websites that were linked on Facebook, is really the only source his mother ever relied on for her anti-vaccine information. He testified that his mother had vocalized her anti-vaccination views over the course of his entire life and that over time he began to notice that the benefits of vaccinations outweighed the perceived risks. This became apparent when his mother would share videos and people would dispute her claims in the replies. “She didn’t trust any sources," he told The Post. “She thought vaccines were a conspiracy by the government to kill children.”
• Anti-vaccine conspiracies are drawing scrutiny in Washington. But what can lawmakers do? ( Daniel Funke and Susan Benkelman, on Factually, a newsletter about fact-checking and accountability journalism, from Poynter’s International Fact-Checking Network & the American Press Institute’s Accountability Project, 3-17-19) "CNN reported last week that Facebook is working with public health experts to find ways to make anti-vaccine posts “less prominent.” YouTube is preventing ads on anti-vaccination videos. Amazon removed anti-vaccine documentaries from its Prime video service after a letter from Schiff. Pinterest is deliberately manipulating its search function to turn up nothing when a user looks for content on vaccinations.
"It’s hard to know whether these actions are a response to political pressure alone. But at a time when lawmakers are examining privacy laws, antitrust issues and the companies’ role in disseminating political disinformation in advance of the 2020 election, such moves could help the industry stave off attempts to regulate content, at least for now."
• A physician who’s angry at the anti-vaxxers (Karen S. Sibert, MD, Kevin MD, 3-5-19) If you’re a parent who is still on the fence, trying to decide whether or not to vaccinate your children, I’m going to try to be kind and helpful. Here is a link to a video by a physician and father, Dr. Zubin Damania, with facts that may address some of your fears.
• What Really Makes a Difference in Vaccination Rates? (Brendan Nyhan, NY Times, 3-6-19) Social media platforms play a role in spreading misinformation, but state legislatures have the power of law. State policies on vaccination exemptions might be a more appropriate target.
• A Brief History of Vaccine Conspiracy Theories (Kate Wheeling, Pacific Standard, 1-13-17) Vaccine skepticism is as old as the idea of inoculation itself, but the recent politicization of vaccination is putting us all at risk.
• Journal Retracts 1998 Paper Linking Autism to Vaccines (Gardiner Harris, Research, NY Times, 2-2-10) The Lancet, a prominent British medical journal retracted a 1998 research paper that set off a sharp decline in vaccinations in Britain after the paper’s lead author suggested that vaccines could cause autism.
• History of Anti-vaccination Movements (College of Physicians of Philadelphia, The History of Vaccines)
• Anti-vaccine conspiracies are still getting engagement on Facebook — despite being fact-checked as false (Daniel Funke, Poynter, 2-20-19) As Facebook faces rising pressure to remove anti-vaccine conspiracy theories from its recommendations, antivaxxer hoaxes are still getting plenty of engagement on the platform. Over the weekend, the Agence France-Presse debunked a fake news story that claimed an American court had found a link between the mumps, measles and rubella vaccine and autism. The hoax was a copy of one that (Poynter-owned) PolitiFact rated “Pants-on-Fire” last week — except it was translated into French....But while PolitiFact’s fact check got more reach than the antivaxxer hoax last week, the AFP had one-tenth of the Facebook engagements the fake racked up in France. (Disclosure: Being a signatory of the International Fact-Checking Network’s code of principles is a necessary condition for joining Facebook’s project.) See also The Small, Small World of Facebook’s Anti-vaxxers (Alexis C. Madrigal, The Atlantic, 2-27-19)
• An Anti-Vaxxer’s New Crusade (Davud Armstrong, ProPublica, 11-27-18) Dr. David Ayoub used to be active in the anti-vaccination movement. Now he’s challenging mainstream science again — as an expert witness for accused child abusers.
• Denialism: what drives people to reject the truth (Keith Kahn-Harris, The Guardian, A Long Read, 3-8-18) From vaccines to climate change to genocide, a new age of denialism is upon us. Why have we failed to understand it?
• How to Talk to Anti-Vaxers (Olga Khazan, The Atlantic, 6-26-17) Anthony Fauci, head of the National Institute of Allergy and Infectious Diseases, on persuading anti-vaxers, predicting the next outbreak, and working with Trump. "There is a core of people who no matter what you say, they will not believe you. They are convinced that vaccines are dangerous or they feel they don't want to take the risk of their child, even though there's two reasons to give vaccine: one is to protect your child, the other is a duty that you have to society to keep society protected. Yet there is also a pretty good core of people who if you explain it to them in a non-pejorative way … one of the things that I've learned works is that you don't criticize people. That's not the way to their hearts. And you've gotta approach it in saying that you could understand their concern, but these are the reasons. In the realm of science, you have to rely on the evidence base."
• How the case against the MMR vaccine was fixed (Brian Deer, British Medical Journal, 2011) A 1998 Lancet paper, chiefly by Andrew Wakefield, implied a link between the measles, mumps, and rubella (MMR) vaccine and a “new syndrome” of autism and bowel disease. Clear evidence of falsification of data in that article should now close the door on this damaging vaccine scare, write BMJ's top editors. In a seven-part series, journalist Brian Deer shows the extent of Wakefield's fraud and how it was perpetrated. Others have criticized this series for being overhyped.
• The Wakefield MMR verdict (Ben Goldacre, Bad Science, 1-28-10) An excellent summary of what happened, with the media sharing blame with Wakefield.
• 20 years ago, research fraud catalyzed the anti-vaccination movement. Let’s not repeat history. Julia Belluz, Vox, 2-27-18) How Andrew Wakefield’s shoddy science fueled autism-vaccine fears, and the media helped his claim go viral.
• California doctor, renowned vaccine skeptic, placed on probation for exempting child from all vaccinations (Deepa Bharath, Mercury-News, 6-30-18) Dr. Bob Sears, a renowned Dana Point pediatrician who has been sought out by parents who wish to opt out of the state’s mandatory vaccine requirements, has been placed on probation for 35 months by the Medical Board of California. The June 27 order, which will go into effect on July 27, allows Sears to continue his medical practice but requires him to go through 40 hours of educational courses for each year of probation and a professional ethics course.
• Anti-vaccine activists spark a state’s worst measles outbreak in decades (Lena H. Sun. WaPo, 5-5-17) The young mother started getting advice early on from friends in the close-knit Somali immigrant community here. Don’t let your children get the vaccine for measles, mumps and rubella — it causes autism, they said. Suaado Salah listened. And this spring, her 3-year-old boy and 18-month-old girl contracted measles in Minnesota’s largest outbreak of the highly infectious and potentially deadly disease in nearly three decades.
• Fake news and distrust of science could lead to global epidemics (Heidi Larson and Peter Piot, Wired UK, 1-9-18) "Vaccines are one of the most important scientific inventions of all time, preventing millions of cases of disease every year and helping to consign once-deadly outbreaks to history. Yet these vital public-health tools are under threat from growing public mistrust in immunization and the rise of so-called "fake news" drowning out expert voices. This "anti-vax" sentiment and pushback against scientific evidence threatens public health around the world, from measles outbreaks in the US and across Europe, prompting stricter vaccination laws, to persisting polio in Pakistan and Afghanistan. If this trend continues, 2018 could see a devastating resurgence of deadly diseases previously on the brink of eradication....These are disruptions that set back, rather than advance, scientific progress. Examples range from the 2017 WhatsApp and Facebook anti-vaccination campaigns in South India, which sparked fear and refusal of the measles rubella vaccine - some linked to now debunked autism anxieties around the MMR vaccine nearly 20 years ago in the UK - to similar social-media-propagated false rumours provoking vaccine refusals, measles outbreaks and diphtheria deaths in Malaysia. As a result of declining immunisation levels, between 2016-2017 Europe experienced 35 deaths due to measles, a disease that was nearly wiped out. All of those deaths were preventable."
• The Vaccine War (Frontline, PBS, 4-27-10) Public health scientists and clinicians tout vaccines as one of the greatest achievements of modern medicine. But for many ordinary Americans vaccines have become controversial. Young parents are concerned at the sheer number of shots — some 26 inoculations for 14 different diseases by age 6 — and follow alternative vaccination schedules. Other parents go further. In communities like Ashland, Oregon, up to one-third of parents are choosing not to vaccinate their kids at all. This is the vaccine war: On one side sits scientific medicine and the public health establishment; on the other a populist coalition of parents, celebrities, politicians and activists.
• The enduring appeal of conspiracy theories (Melissa Hogenboom, BBC, 1-24-18) In certain pockets of America, measles diagnoses have been spreading at previously unprecedented rates. Less than a decade earlier, measles had been largely eliminated in the US. The gradual resurgence can, researchers say, be directly attributed to people who were not vaccinated.
• Misinformation lingers in memory: Failure of three pro-vaccination strategies ( Sara Pluviano, Caroline Watt, and Sergio Della Sala, PLOS One, 7-27-17) Strategies to correct vaccine misinformation are ineffective and often backfire, resulting in the unintended opposite effect, reinforcing ill-founded beliefs about vaccination and reducing intentions to vaccinate--according to an evaluation of three vaccine promotion strategies.
• On Vaccines and Autism: An Open Letter to Larry Wilmore (David Kyle Johnson, Psychology Today, 1-29-15) The Nightly Show's Larry Wilmore knows vaccines are safe...If you have an anti-vaccination advocate (i.e., anti-vaxer) on your panel, include someone who has the skills or knowledge to debunk her claims.
• Distributors of Anti-Vax Film Are Trying to Keep an Autistic Rights Advocate from Criticizing It (Anna Merlan, Jezebel, 7-27-16). "Vaxxed is the anti-vaccination film made by Andrew Wakefield" and is shown "to breathless audiences who see Wakefield as a personal savior and believe the government is engaged in a vast coverup of the fictional autism-MMR link." Fiona O’Leary, an Irish mother of five, a woman with Aspergers syndrome and the founder of an organization called Autistic Rights Together, says the film “is spreading misinformation and harm.” "She’s also promoting a longshot petition addressed to Texas Attorney General Ken Paxton. It reads, in part: VACCINES DO NOT CAUSE AUTISM! VACCINES SAVE LIVES!"
• The problems with the BMJ’s Wakefield-fraud story by Seth Mnookin, author of The Panic Virus: The True Story Behind the Vaccine-Autism Controversy. Booklist review: "Over the last three decades, the incidence of autism spectrum disorder, better known simply as autism, has risen dramatically in the U.S., from approximately 1 in 1,000 children to 1 in 110, arousing widespread concern among parents and psychiatrists alike. A few of the many potential possible culprits scientists have targeted are faulty genes and thimerosal, a mercury-laced preservative in vaccines. Former Newsweek senior journalist Mnookin focuses his masterful investigative skills primarily on the latter, highly controversial possibility, illustrating how the current, misguided anti-vaccine movement can be blamed almost equally on panic-driven parents, sensation-hungry media, and PR-challenged health authorities. In making his case, Mnookin covers a wide swathe of medical history, from polio outbreaks to the scare tactics of fringe British researcher Andrew Wakefield, who first forged the dubious vaccine-autism link. While Mnookin dismantles this link convincingly, his argument that multivaccine cocktails have been proven safe is ultimately less persuasive. Still, he’s an able, engaging wordsmith, and this cautionary tale about misinformed medical alarmism is thoroughly compelling." --Carl Hays, Booklist. Author's summary here: The Panic Virus: Who decides which facts are true? One study after another failed to find any link between childhood vaccines and autism. Yet the myth that vaccines somehow cause developmental disorders lives on. Meanwhile millions of dollars have been diverted from potential breakthroughs in autism research, families have spent their savings on ineffective “miracle cures,” and declining vaccination rates have led to outbreaks of deadly illnesses like Hib, measles, and whooping cough. Most tragic of all is the increasing number of children dying from vaccine-preventable diseases. See also Talking to Vaccine Resisters (Seth Mnookin, New Yorker, 2-4-15) and The Panic Virus, Seth Mnookin's blog on PLOS (the Public Library of Science).
• Islamic anti-vaxxers undermine efforts to prevent diphtheria outbreak in Indonesia (Adam Harvey, ABC News, 1-15-18) Now, a vaccination campaign against diphtheria in Indonesia is being undermined by alternative health practitioners and some hardline Muslim clerics who claim immunisations are un-Islamic. "The Prophet shows us that immunisation should come from the regular daily consumption of healthy substances : honey, herbs, olive oil; dates and goat's milk. If we don't follow that, we can be easily infected with diseases," she said.
• Vaccines are not associated with autism: an evidence-based meta-analysis of case-control and cohort studies (LE Taylor, AL Swerdfeger, and GD Eslick, Vaccine, 6-17-14, on PubMed) Findings of this meta-analysis suggest that vaccinations are not associated with the development of autism or autism spectrum disorder. Furthermore, the components of the vaccines (thimerosal or mercury) or multiple vaccines (MMR) are not associated with the development of autism or autism spectrum disorder.
• Anti-Vaxxers Are Using Twitter to Manipulate a Vaccine Bill (Renee DiResta, Wired, June 2015) One small, vocal group can have a disproportionate impact on public sentiment and legislation. Welcome to Anti-Vax Twitter.
• Penn and Teller on Vaccines (video) Measles in Disneyland should be a wake-up call for the anti-vaccine movement. Will it? Magicians Penn and Teller do their part and show us why anti-vaccination is nonsense. (Warning: explicit language.)
• Mercury, Vaccines, and Autism: One Controversy, Three Histories (Jeffrey P. Baker, Am J Public Health. 2008 February) The controversy regarding the once widely used mercury-containing preservative thimerosal in childhood vaccines has raised many historical questions that have not been adequately explored. Why was this preservative incorporated in the first place? Was there any real evidence that it caused harm? And how did thimerosal become linked in the public mind to the “autism epidemic”?
• Seriously flawed’ study linking behavioral problems to Gardasil has been retracted (Rachel Feltman, WaPo,2-25-16) Retraction Watch reports that a paper published online in the journal Vaccine last month and temporarily removed weeks later has now officially been retracted.
• Why Facts Don't Change Our Minds (Elizabeth Kolbert, New Yorker, 2-27-17)
• How My Daughter Taught Me that Vaccines Do Not Cause Autism (Juniper Russo, Voices for Vaccines)
• Article linking autism to vaccination was fraudulent. Fiona Godlee, editor in chief, Jane Smith, deputy editor, and Harvey Marcovitch, associate editor, British Medical Journal 5 Jan 2011. A 1998 Lancet paper, chiefly by Andrew Wakefield, implied a link between the measles, mumps, and rubella (MMR) vaccine and a “new syndrome” of autism and bowel disease. Clear evidence of falsification of data in that article should now close the door on this damaging vaccine scare, write BMJ's top editors. In a seven-part series, journalist Brian Deer shows the extent of Wakefield's fraud and how it was perpetrated: How the case against the MMR vaccine was fixed
• Vaccines Don't Cause Autism (Sabin Vaccine Institute).
• Vaccines and Autism: A Tale of Shifting Hypotheses (Jeffrey S. Gerber and Paul A. Offit, Clinical Infectious Diseases, 2-15-09, doi: 10.1086/596476). Although child vaccination rates remain high, some parental concern persists that vaccines might cause autism. Three specific hypotheses have been proposed:
(1) the combination measles-mumps-rubella vaccine causes autism by damaging the intestinal lining, which allows the entrance of encephalopathic proteins;
(2) thimerosal, an ethylmercury-containing preservative in some vaccines, is toxic to the central nervous system; and
(3) the simultaneous administration of multiple vaccines overwhelms or weakens the immune system.
The authors discuss the genesis of each of these theories and review the relevant epidemiological evidence.
• Unfounded Autism Fears Are Fueling Minnesota's Measles Outbreak (Mark Zdechlik, Shots, NPR, 5-3-17) In Minnesota, the vast majority of kids under two get vaccinated against measles. But state health officials say most Somali-American 2-year-olds have not had the vaccine — about six out of ten. "It is a highly concentrated number of unvaccinated people," he says. "It is a potential kind of gas-and-match situation...Somali-American leaders here are in firm agreement with the Minnesota health department in trying to knock down the pseudoscience behind the unfounded claims that getting vaccinated can lead to autism." Understanding The History Behind Communities' Vaccine Fears (Emily Sohn, NPR, 5-3-17) Fewer than half of Minnesota children of Somali descent have received the MMR shot that protects against measles, mumps and rubella, according to the Minnesota Department of Public Health. Multiple studies have shown spikes in vaccine-preventable diseases (including pertussis, polio, mumps and measles) in schools and regions around the world with low vaccination rates, such as affluent neighborhoods in Northern California and an Amish community in Ohio, it is extremely challenging to change people's opinions about vaccines, Dubé says. Attitudes are often deeply ingrained."
• Dr. Peter Hotez, latest vaccine pitchman, clueless on vaccine-autism science (J.B. Handley, Jr., Healthcare in America, 2-2-17). A dissenting essay, from a man whose son is autistic, and who questions the arguments of Offit, a vaccine developer.
• The forgotten history of autism (TED talk by Steve Silberman, March 2015. Available in 31 subtitle languages and an interactive transcript--click on transcript and it will appear on the screen). An Austrian doctor by the name of Hans Asperger published a pioneering paper in 1944. Because it was buried in time, autism has been shrouded in misunderstanding ever since--because of one dishonest scientist's interpretation of an apparent spike in autism cases. In 1975, 1 in 5,000 kids was estimated to have it. Today, 1 in 68 is on the autism spectrum. What caused this steep rise? Steve Silberman points to “a perfect storm of autism awareness” — a pair of psychologists with an accepting view, an unexpected pop culture moment (a movie called "Rainman"), and a new clinical test. An important overview that sheds important light on a controversy that is causing deaths all over the world and that provides hope, enabling autistic people and their families to finally get the support and services they deserved.
• Study Addresses ‘Too Many Too Soon?’ Vaccine Concerns (Autism Speaks, 3-29-13)
• On Vaccines and Autism: An Open Letter to Larry Wilmore (David Kyle Johnson, Psychology Today, 1-29-15) The Nightly Show's Larry Wilmore knows vaccines are safe...If you have an anti-vaccination advocate (i.e., anti-vaxer) on your panel, include someone who has the skills or knowledge to debunk her claims.
• How My Daughter Taught Me that Vaccines Do Not Cause Autism (Juniper Russo, Voices for Vaccines)
• Penn and Teller on Vaccines (video) Measles in Disneyland should be a wake-up call for the anti-vaccine movement. Will it? Magicians Penn and Teller do their part and show us why anti-vaccination is nonsense. (Warning: explicit language.)
• Mercury, Vaccines, and Autism: One Controversy, Three Histories (Jeffrey P. Baker, Am J Public Health. 2008 February) The controversy regarding the once widely used mercury-containing preservative thimerosal in childhood vaccines has raised many historical questions that have not been adequately explored. Why was this preservative incorporated in the first place? Was there any real evidence that it caused harm? And how did thimerosal become linked in the public mind to the “autism epidemic”?
• Vaccines for measles, mumps and rubella in children (Vittorio Demicheli et al., Cochrane Database of Systematic Reviews, 2-15-12)
Remember, vaccinations are about developing herd immunity to protect those who cannot be vaccinated. In many of these diseases, the patient is contagious before showing recognizable symptoms, so it isn't just a question of keeping at home the child who is sick. Vaccination isn't just about your child. It's about the kid with cancer down the street, the neighbor who had an organ transplant, and other kids who have a pregnant mom or newborn at home, and so on. (Hat tip to Erin Archer Kelser, Germ Nurse a writer who is a registered nurse, certified in infection control)
Vaccine resistance and vaccine undercoverage
Poverty, poor health care coverage, anti-vaxxers, a fraudulent report on autism, and an active law firm
• Resistance to Public Health, No Longer Fringe, Gains Foothold in G.O.P. Politics (Sheryl Gay Stolberg, NY Times, 10-9-24) The merger of the Robert F. Kennedy Jr. and Donald J. Trump campaigns puts the so-called medical freedom movement on the cusp of real power in Washington, with a new slogan: “Make America Healthy Again.”
"Resistance to public health, relegated to the fringes of the American right and left before Covid vaccine mandates became a cultural flashpoint and a symbol of government overreach, now has a firm foothold in Republican politics — and a chance to wield real power in Washington. Mr. Trump and Mr. Kennedy support “Make America Healthy Again.”
"More than just rebranded anti-vaccination activism, the movement marries fierce resistance to public health measures like vaccine mandates; deep suspicion of pharmaceutical companies and federal regulatory agencies; and an embrace of alternative medicine and natural foods. Those foods include “raw,” or unpasteurized, milk, which is being promoted by right-wing commentators and which the Centers for Disease Control and Prevention deems dangerous. Mr. Kennedy has said he drinks it."
• Health Care and the 2024 Elections (KFF Health News, 10-17-24) As misinformation and disinformation proliferate, one area of concern is the “malleable middle”: people who are uncertain of whom or what to trust and therefore especially susceptible to misleading or downright false information. Could a second Trump administration embed misinformation in federal policy? The push to soften or even eliminate school vaccination mandates shows the public health consequences of falsehood creep.
• Needle Pain Is a Big Problem for Kids. One California Doctor Has a Plan. (April Dembosky, KQED and KFF Health News, 3-20-24) The pain and trauma from repeated needle sticks leads some kids to hold on to needle phobia into adulthood. Research shows the biggest source of pain for children in the health care system is needles. Stefan Friedrichsdorf, a specialist at the University of California-San Francisco’s Stad Center for Pediatric Pain, outlined simple steps that clinicians and parents can follow:
"Apply an over-the-counter lidocaine, which is a numbing cream, 30 minutes before a shot.
Breastfeed babies, or give them a pacifier dipped in sugar water, to comfort them while they’re getting a shot.
Use distractions like teddy bears, pinwheels, or bubbles to divert attention away from the needle.
Don’t pin kids down on an exam table. Parents should hold children in their laps instead."
• How the Anti-Vaccine Movement Pits Parental Rights Against Public Health (Amy Maxmen, KFF Health News and NBC News, 3-12-24) Gayle Borne has fostered more than 300 children in Springfield, Tennessee. She’s cared for kids who have rarely seen a doctor — kids so neglected that they cannot speak. Such children are now even more vulnerable because of a law Tennessee passed last year that requires the direct consent of birth parents or legal guardians for every routine childhood vaccination. Foster parents, social workers, and other caregivers cannot provide permission.
"Tennessee’s law has also stymied grandmothers and other caregivers who accompany children to routine appointments when parents are at work, in drug and alcohol rehabilitation clinics, or otherwise unavailable. The law claims to “give parents back the right to make medical decisions for their children.”
"Framed in the rhetoric of choice and consent, it is one of more than a dozen recent and pending pieces of legislation nationwide that pit parental freedom against community and children’s health. In actuality, they create obstacles to vaccination, the foundation of pediatric care."
• Grassroots Work Leads to Vaccination Success in Georgia Refugee Community (Alander Rocha, KFF Health News and WABE Atlanta Public Radio, 8-22-22) "Public health officials and resettlement groups across the U.S. have used such community strategies to encourage newly arrived refugees and other vulnerable people to get vaccinated against covid. And in places like Clarkston, health officials say these kinds of grassroots efforts are working. The metro Atlanta city — the hub of refugee resettlement in Georgia — has a higher vaccination rate than its county or state.
"Refugees generally have been disproportionately affected by covid. Those newly resettled may experience living situations or employment conditions that increase their risk of contracting the virus. Some refugees enter the country with underlying medical conditions that increase their risk of developing severe illness, according to the Centers for Disease Control and Prevention. And in multigenerational households, protecting older family members in cramped housing arrangements can be difficult."
• Trump Leads, and His Party Follows, on Vaccine Skepticism (Darius Tahir, KFF Health News, 10-6-24) A number of Republican voters now identify as vaccine skeptics
• The Rise of the Anti-Vaccine Movement
---Our new poll shows just how much GOP voters have diverged from everyone else on vaccines (Steven Shepard, Politico, 9-23-23) Vaccine skepticism has found a home in the post-pandemic GOP. And it’s not just related to the Covid shot. A significant number of Republicans question the safety of vaccines and say Americans shouldn’t be encouraged to get them. Before 2020, polls showed little overall difference along partisan lines on issues related to vaccination, such as whether students should be inoculated against measles to attend public schools. But since Covid, Republican voters have diverged from everyone else.
---What can Trump do about vaccines? More than you might think. (Megan Messerly, Politico,6-8-24) His new anti-vaccine persona could have far-reaching consequences if he’s elected to a second stint as president with far-reaching administrative powers. The former Covid-19 vaccine booster is now the nation’s most high-profile critic of immunization mandates.
---Trump says he won't give 'one penny' to schools with vaccine mandate (video, Politico, 5-19-24)
---Anti-vaxxers are now a modern political force (Jessica Piper, Politico, 9-24-23) “Covid vaccines have been the foot in the door for the more general anti-vaccine movement. The once-fringe movement is now seeing an influx in cash after the Covid pandemic. Depressed vaccination rates have led to more deaths from Covid-19, and have the potential to enable the return of potentially fatal childhood diseases such as measles. “Increasingly there’s less and less difference between old school and new school anti-vaxxers,” Gorski said. “New anti-vaxxers are lapping up the same old conspiracy theories and pseudoscience.”
---Ron DeSantis has a problem: Covid vaccine skepticism isn’t moving GOP voters The Florida governor rode the vaccine skepticism wave to remarkable heights, but voters are moving on from the pandemic.
• Resistance to vaccine mandates is building. A powerful network is helping. (Isaac Stanley-Becker, Washington Post, 5-26-21) A New York firm has filed suit or sent letters to employers in several states as part of an effort spearheaded by one of the largest anti-vaccination groups in the country.
• The Influence of the Anti-Vaccine Movement (Isaac Chotiner, New Yorker, 12-18-2020) "So clearly it’s that Wakefield paper that was the trigger. But what gave it momentum, though, I think, was the political alliances and links. And again, under this banner of health freedom, we’re seeing that stuff expand this year. Because while it was very focussed on vaccines —which, by the way, started bringing people like Rush Limbaugh and Alex Jones into it—in 2020 it glommed on to the protest against masks and social distancing. So what was an anti-vaccine movement then morphed into a full-on anti-science movement. Chotiner quotes Dr. Peter Hotez, author of Preventing the Next Pandemic: Vaccine Diplomacy in a Time of Anti-Science, to be published in March 2021.
• Inside the Mind of an Anti-vaxxer (Olga Khazan, The Atlantic, 10-16-2020) The majority of Americans will need to take the coming COVID-19 vaccine. Here’s how to persuade those who won’t want to. 'Vaccine advocates should recognize that the vaccine-hesitant, like most people, want to be heard, not mocked. “It is not crazy to wonder about all these unpronounceable, scary-sounding ingredients that are in vaccines,” O’Meara told me. Their concerns should be addressed without implying, Oh, you’re just some nutball, crazy anti-vaxxer.'
• The Denialist Playbook (Sean B. Carroll, Scientific American, 11-8-2020) On vaccines, evolution, and more, rejection of science has followed a familiar pattern. In 1955, when Salk's polio vaccine first became available, chiropractors actively opposed the vaccination campaign that followed, despite clear evidence of its effectiveness. The purpose of the denialism playbook is to advance rhetorical arguments that give the appearance of legitimate debate when there is none. Carroll describes the predictable tactics of those clinging to an untenable position (in this case, creationism and science denial).
• How the Anti-Vaccine Community Is Responding to Covid-19 (Katharine Gammon, Undark, 4-16-2020) So far, the responses from major players wear down a familiar path of conspiratorial thinking and government mistrust.
• ‘It’s like you injected adrenaline into them’: Facebook’s vaccine misinformation problem faces a new test with Covid-19 (Erin Brodwin, STAT, 7-28-2020) 'Among the pages spreading falsehoods, the researchers identified one prominent category: people who sell or profit off of vaccine misinformation. These “anti-vaccination entrepreneurs” — who collectively garnered a total following of 28 million people — saw their followers grow by 854,000 between May and June. Zeroing in on groups, the researchers identified 64 that regularly shared vaccine misinformation, with a collective following of 1 million that has also kept growing.'
• A Vaccine Reality Check (Sarah Zhang, The Atlantic, 7-24-2020) The good news is that experts think there will be a COVID-19 vaccine. The virus that causes COVID-19 does not seem to be an outlier like HIV. But biologically, a vaccine against the COVID-19 virus is unlikely to offer complete protection. Logistically, manufacturers will have to make hundreds of millions of doses while relying, perhaps, on technology never before used in vaccines and competing for basic supplies such as glass vials. The Centers for Disease Control and Prevention, which has led vaccine distribution efforts in the past, has been strikingly absent in discussions so far—a worrying sign that the leadership failures that have characterized the American pandemic could also hamper this process. To complicate it all, 20 percent of Americans already say they will refuse to get a COVID-19 vaccine, and with another 31 percent unsure, reaching herd immunity could be that much more difficult.
• Research fraud catalyzed the anti-vaccination movement. Let’s not repeat history. (Julia Belluz, Vox, 3-5-19) How Andrew Wakefield’s shoddy science fueled autism-vaccine fears that major studies keep debunking. See also Researchers have ditched the autism-vaccine hypothesis. Here’s what they think actually causes autism. (Julia Belluz, Vox, 4-2-18)
• Fraud Behind the MMR Scare (Immunization Action Coalition) BMJ Calls Wakefield's Study Linking MMR Vaccine to Autism 'Fraudulent.' In a special series of articles (linked to here) published in 2011 by the British Medical Journal, Brian Deer exposes the data behind claims that launched a worldwide scare over the measles, mumps, and rubella vaccine, and reveals how the appearance of a link with autism was manufactured at a London medical school. In an accompanying editorial, Fiona Godlee and colleagues say that Andrew Wakefield's article linking MMR vaccine and autism was based not on bad science but on a deliberate fraud.
• Anti-Vaxxers Are Terrified the Government Will ‘Enforce’ a Vaccine for Coronavirus (Anna Merlan, Vice, 2-25-2020) Anti-vax groups on social media are claiming that the spread of the disease will lead to mandatory vaccinations and 'unlimited surveillance.' We should be so lucky as to get a vaccine sooner than projected.
• An anti-vaxxer message about coronavirus: Anthony Fauci sets stage for mandatory -- lucrative! -- vaccine (Cheryl K. Chumley, Washington Times, 4-8-2020) Ms. Chumley fact-checks: Vaccines are not moneymakers, and the Gates Foundation exists to spend money on public goods, not to make a profit. I agree with the fellow who suggests "Let the government make the vaccine and distribute it for free." (As is done for elders with flu vaccine.)
• My 6-Year-Old Son Died. Then the Anti-vaxxers Found Out. (Billy Ball, The Atlantic, 3-28-23) Opponents of COVID vaccines terrorize grieving families on social media. "I know that Twitter, Facebook, and other networks amplify bad information; that their algorithms feed on anger and division; that anonymity and distance bring out the worst in some people online. And yet I had never anticipated that anyone would mock and terrorize a grieving parent."
• Psychology research: Vaccine skeptics actually think differently than other people (Texas Tech University news release, 4-10-2020) Results show people with vaccine skepticism overestimate the likelihood of all kinds of negative events, especially those that are rare.
• A Rural Doctor Gave Her All. Then Her Heart Broke. (Oliver Whang, NY Times, 9-19-22) 'Physicians suffer one of the highest burnout rates among professionals. Dr. Kimberly Becher, one of two family practitioners in Clay County, West Virginia, learned the hard way. In Clay County, there is no public transportation, no stoplight, no hospital. Most residents live in a food desert. And as one of only two family doctors in the county, Dr. Becher has an all-encompassing job....She began to run more, sometimes twice a day, for hours at a time, “raging down the road.” She was mad about the widespread distrust of vaccines; mad about teachers who went to school even after testing positive for the virus; mad about the endemic food insecurity, the county’s lack of affordable transportation, the high rate of fatty liver disease.'
• Anti-vaccine myths are being promoted by social media bots and Russian trolls, study finds (Andrew Griffith, Independent UK, 4-23-18) Malicious characters look to use arguments to divide the American public and exploit them. "In the study, researchers examined thousands of tweets sent between July 2014 and September 2017. It found many tweets that were posted by the same bots thought to have been used to influence the 2016 election, as well as marketing and malware bots. That gives the impression that the US public are arguing over the ethics and safety of vaccines, when opinion is actually far less divided."
• The Message of Measles (Nick Paumgarten, New Yorker, 8-26-19) As public-health officials confront the largest outbreak in the U.S. in decades, they’ve been fighting as much against dangerous ideas as they have against the disease. "In 1966, [a] bill passed, 150–2, making New York the first state to have a vaccination law with a religious exemption. By the beginning of this year, forty-six other states had a version of such a provision; it has proved to be an exploitable lever for people who, for reasons that typically have nothing to do with religion, are opposed to vaccination. They are widely, and disdainfully, known as anti-vaxxers." ..."Because of the success of the anti-vaccination movement, measles cases have since turned up in twenty-nine other states, but New York has had by far the most cases: 1,046 as of last week, out of a national total of 1,203. This has threatened to wind back decades of success in the containment of the disease since the first measles vaccines were introduced, in 1963..."... The outbreak began in the Rockland County village of New Square, an enclave of roughly eighty-five hundred Hasidim founded in 1954, on an old dairy farm...Much of the story is about how the measles got there.
• See also Why Measles Is a Quintessential Political Issue of Our Time (Masha Gessen, New Yorker, 3-2-19) "Vaccination is a basic political issue, because it is the subject of community agreement. When a high-enough percentage of community members are immunized, a disease can be effectively vanquished. In epidemiological terms, this is known as “herd immunity,” which cannot be maintained below a certain threshold. When enough people reject the community agreement, they endanger the rest. Willfully unvaccinated adults and children can spread diseases to those who cannot be vaccinated or haven’t been vaccinated, such as infants and people with a compromised immune system; these vulnerable populations would probably be safe in conditions of herd immunity. Vaccination and the refusal to vaccinate are political acts: individual decisions that affect others and the very ability of people to inhabit common spaces."
• Amid a Measles Outbreak, an Ultra-Orthodox Nurse Fights Vaccination Fears in Her Community (Amanda Schaffer, New Yorker, 1-25-19)
• New York’s Orthodox Jewish community is battling measles outbreaks. Vaccine deniers are to blame. (Julia Belluz, Vox, 11-9-18) Rockland County and New York City have declared emergencies because of the outbreaks.
• Why the Washington measles outbreak is mostly affecting one specific group (Julia Belluz, Vox, 3-20-19) The CDC says 75 percent of recent measles cases are linked to tight-knit communities (including Orthodox Jewish communities in New York, a Somali-American community in Minnesota, immigrants from Russia and the former Soviet Union in Clark County, Washington, Amish in Ohio, . The groups themselves have a lot in common. "They’re cohesive and conservative. They appear to trust each other more than outsiders. They also speak the same languages and read or watch the same news."
• Measles and the Limits of Facts (James Hamblin, The Atlantic, 4-26-19) At its core, the resurgence of the once-defeated disease in the U.S. is a failure of communication. "Research suggests that the reason informed people fall into conspiracy-theory mind-sets often has less to do with a lack of information than with social and emotional alignment. Facts are necessary, but not at all sufficient...The work of global inoculation requires first rebuilding a social contract, which means meeting people on the platforms where they now get their information, in the ways they now consume it."
• The Other Reasons Kids Aren't Getting Vaccinations: Poverty and Health Care Access (Selena Simmons-Duffin, All Things Considered, NPR, 5-20-19) Sometimes the reasons kids are not up-to-date on their vaccines has more to do with poverty and access to health care than a parent's vaccine hesitancy. Patients often miss vaccinations because of struggles in their parents' lives. The reasons include: "transportation, couldn't get off work, didn't have insurance and didn't know that they could come in without insurance." Data from the CDC shows the connection between poverty and vaccination rates bears out nationally: in 2017 only 75% of uninsured children age 19 to 35 months had gotten at least one dose of MMR, the vaccine for measles, compared with 94% of privately insured children, and 90% of those on Medicaid. Vaccines for Children (a federally funded program) provides free vaccines to children who are uninsured or on Medicaid, but vaccination rates before kindergarten can be very low and it can be challenging for doctors to piece together vaccination histories for children whose families move a lot, or where health coverage is inadequate, concludes a CDC study.
• The Anti-anti-vax-vaccine (podcast, America Dissected with Abdul El-Sayed, 9-30-19. 36 minutes.) We almost eradicated measles in the U.S., but anti-vaxxers had to go and ruin it for everyone. WTF? Dr. Abdul El-Sayed walks us through the history and science of vaccines and the growing anti-vax movement. We meet the people affected, like Ethan Lindenberger, an 18-year-old who defied his anti-vax mom to get vaccinated.
• The Anti-Anti-Vax Vaccine Dr. Abdul El-Sayed walks us through the history and science of vaccines and the growing anti-vax movement. We meet the people affected, like Ethan Lindenberger, an 18-year-old who defied his anti-vax mom to get vaccinated. A 36-minute listen to podcast on America Dissected.
• Why Aren't Parents Getting Their Children Vaccinated? (David Greene talks to Jennifer Reich, author of Calling the Shots: Why Parents Reject Vaccines, on Morning Edition, NPR, 4-29-19) "Now, it's worth reminding you that we do vaccines in a way that has been shown to be scientifically the most efficacious and the safest and also the easiest to distribute at a national level. But for parents who really prioritize each child in their family as an individual, they don't accept this kind of logic."
• Values and vaccines (Maggie Koerth-Baker, Aeon) Parents who reject vaccination are making a rational choice – they prefer to put their children above the public good. Is vaccination a social obligation or a personal decision? Anti-vaccination may be rational but is it reasonable? Scientists personally think the trade-off between the small risks of side effects and the big benefit of herd immunity is a fair one, but it it’s easy to forget that our perspective on the trade-off is a belief, and not a provable fact. Scientists try to fight with facts, assuming the public just doesn’t know what’s going on, while the public gets angrier because it’s not being listened to. An interesting, thought-provoking essay.
• The Real-Life Conversion of a Former Anti-Vaxxer (John M. Glionna, KHN, 8-5-19) Amid the contentious dispute over immunization requirements for children, Kelley Watson Snyder stands out: She has been both a recalcitrant skeptic and an ardent proponent of childhood vaccines. Once you're in the anti-vaxx loop it's hard to get out of it; the search algorithms lead you to more of what you were seeing already. "Because when you’re in that anti-vax mindset, you spend all these hours on the internet, reading studies. I’ve come to realize that a Google search isn’t really research. Most times, you’re not reading an entire study, but only the abstract....I’m always happy to share real solid scientific evidence with people who want to do their critical thinking for themselves. I’m hoping people come around. I did. But we can’t force anybody. We just want to protect everyone else."
• Measles, Mumps, Rubella Vaccination and Autism: A Nationwide Cohort Study (Anders Hviid, Jørgen Vinsløv Hansen, Morten Frisch, Mads Melbye, Annals of Internal Medicine, 4-16-19) A cohort study of 657,461 children born in Denmark over 11 years with one-year follow-up study. "In conclusion, our study does not support that MMR vaccination increases the risk for autism, triggers autism in susceptible children, or is associated with clustering of autism cases after vaccination."
• Despite Measles Warnings, Anti-Vaccine Rally Draws Hundreds of Ultra-Orthodox Jews (Kimiko de Freytas-Tamura, NY Times, 5-14-19) A “vaccine symposium” in Rockland County was denounced by health authorities and some ultra-Orthodox rabbis, who said the speakers were spreading dangerous propaganda.
• Article linking autism to vaccination was fraudulent. Fiona Godlee, editor in chief, Jane Smith, deputy editor, and Harvey Marcovitch, associate editor, British Medical Journal 5 Jan 2011. A 1998 Lancet paper, chiefly by Andrew Wakefield, implied a link between the measles, mumps, and rubella (MMR) vaccine and a “new syndrome” of autism and bowel disease. Clear evidence of falsification of data in that article should now close the door on this damaging vaccine scare, write BMJ's top editors. In a seven-part series, journalist Brian Deer shows the extent of Wakefield's fraud and how it was perpetrated. Others have criticized this series for being overhyped.
• It’s not all about autism: The emerging landscape of anti-vaccination sentiment on Facebook (Beth L. Hoffman, et al., Science Direct, 3-21-19) Social media outlets may facilitate anti-vaccination connections and organization by facilitating the diffusion of centuries old arguments and techniques. Arguments against vaccination are diverse but remain consistent within sub-groups of individuals. It would be valuable for health professionals to leverage social networks to deliver more effective, targeted messages to different constituencies.
• Fake news and distrust of science could lead to global epidemics (Heidi Larson and Peter Piot, Wired UK, 1-9-18) "Vaccines are one of the most important scientific inventions of all time, preventing millions of cases of disease every year and helping to consign once-deadly outbreaks to history. Yet these vital public-health tools are under threat from growing public mistrust in immunisation and the rise of so-called "fake news" drowning out expert voices. This "anti-vax" sentiment and pushback against scientific evidence threatens public health around the world, from measles outbreaks in the US and across Europe, prompting stricter vaccination laws, to persisting polio in Pakistan and Afghanistan. If this trend continues, 2018 could see a devastating resurgence of deadly diseases previously on the brink of eradication....These are disruptions that set back, rather than advance, scientific progress. Examples range from the 2017 WhatsApp and Facebook anti-vaccination campaigns in South India, which sparked fear and refusal of the measles rubella vaccine - some linked to now debunked autism anxieties around the MMR vaccine nearly 20 years ago in the UK - to similar social-media-propagated false rumours provoking vaccine refusals, measles outbreaks and diphtheria deaths in Malaysia. As a result of declining immunisation levels, between 2016-2017 Europe experienced 35 deaths due to measles, a disease that was nearly wiped out. All of those deaths were preventable."
• ‘He is wrong’: Robert F. Kennedy Jr.’s family calls him out for anti-vaccine conspiracy theories (Kayla Epstein, WaPo, 5-8-19) On Wednesday, Kennedy’s siblings Kathleen Kennedy Townsend and former congressman Joseph P. Kennedy II (D-Mass.), as well as niece Maeve Kennedy McKean, published an article in Politico Magazine accusing him of being “complicit” in a misinformation campaign. “Robert F. Kennedy Jr. … is part of this campaign to attack the institutions committed to reducing the tragedy of preventable infectious diseases,” they wrote. “He has helped to spread dangerous misinformation over social media and is complicit in sowing distrust of the science behind vaccines.” The Politico article: RFK Jr. Is Our Brother and Uncle. He’s Tragically Wrong About Vaccines. (5-8-19)
• The enduring appeal of conspiracy theories (Melissa Hogenboom, BBC, 1-24-18) In certain pockets of America, measles diagnoses have been spreading at previously unprecedented rates. Less than a decade earlier, measles had been largely eliminated in the US. The gradual resurgence can, researchers say, be directly attributed to people who were not vaccinated.
• Russian Trolls Used Vaccine Debate to Sow Discord, Study Finds (Donald G. McNeil Jr., NY Times, 8-23-18) By impersonating both sides in the vaccine debate, Russian trolls and bot accounts wanted only to raise the level of hostility, researchers concluded. See also How Russia Sows Confusion in the U.S. Vaccine Debate (Katherine Kirk, Foreign Policy, 4-9-19) Russian disinformation activities, which have tried to amplify and intensify the debate between pro-vaccine and anti-vaccine activists, have contributed to the illusion of a growing anti-vaxxer movement while also sowing distrust among Americans. After combing through nearly 2 million tweets recorded between 2014 and 2017, the researchers found that Russian troll accounts were significantly more likely to tweet about vaccination than general Twitter users. They had turned to vaccines as a wedge issue in an effort to ramp up social discord, erode trust in public health institutions, and exacerbate fear and division in the United States.
• Anti-vaccine activists spark a state’s worst measles outbreak in decades (Lena H. Sun. WaPo, 5-5-17) The young mother started getting advice early on from friends in the close-knit Somali immigrant community here. Don’t let your children get the vaccine for measles, mumps and rubella — it causes autism, they said. Suaado Salah listened. And this spring, her 3-year-old boy and 18-month-old girl contracted measles in Minnesota’s largest outbreak of the highly infectious and potentially deadly disease in nearly three decades.
• Misinformation lingers in memory: Failure of three pro-vaccination strategies ( Sara Pluviano, Caroline Watt, and Sergio Della Sala, PLOS One, 7-27-17) Beliefs in the autism/vaccines link and in vaccines' side effects, along with intention to vaccinate a future child, were evaluated after three vaccine-promotion strategies were test, and the results reveal possible backfire effects. Existing strategies to correct vaccine misinformation are ineffective and often backfire, resulting in the unintended opposite effect, reinforcing ill-founded beliefs about vaccination and reducing intentions to vaccinate.
• The Vaccine War (Frontline, PBS, 4-27-10) Public health scientists and clinicians tout vaccines as one of the greatest achievements of modern medicine. But for many ordinary Americans vaccines have become controversial. Young parents are concerned at the sheer number of shots — some 26 inoculations for 14 different diseases by age 6 — and follow alternative vaccination schedules. Other parents go further. In communities like Ashland, Oregon, up to one-third of parents are choosing not to vaccinate their kids at all. This is the vaccine war: On one side sits scientific medicine and the public health establishment; on the other a populist coalition of parents, celebrities, politicians and activists.
• Distributors of Anti-Vax Film Are Trying to Keep an Autistic Rights Advocate From Criticizing It (Anna Merlan, Jezebel, 7-27-16). "Vaxxed is the anti-vaccination film made by Andrew Wakefield" and is shown "to breathless audiences who see Wakefield as a personal savior and believe the government is engaged in a vast coverup of the fictional autism-MMR link." Fiona O’Leary, an Irish mother of five, a woman with Aspergers syndrome and the founder of an organization called Autistic Rights Together, says the film “is spreading misinformation and harm.” "She’s also promoting a longshot petition addressed to Texas Attorney General Ken Paxton. It reads, in part: VACCINES DO NOT CAUSE AUTISM! VACCINES SAVE LIVES!"
• How the case against the MMR vaccine was fixed (British Medical Journal)
• The problems with the BMJ’s Wakefield-fraud story by Seth Mnookin
• The Panic Virus: The True Story Behind the Vaccine-Autism Controversy by Seth Mnookin. Booklist review: "Over the last three decades, the incidence of autism spectrum disorder, better known simply as autism, has risen dramatically in the U.S., from approximately 1 in 1,000 children to 1 in 110, arousing widespread concern among parents and psychiatrists alike. A few of the many potential possible culprits scientists have targeted are faulty genes and thimerosal, a mercury-laced preservative in vaccines. Former Newsweek senior journalist Mnookin focuses his masterful investigative skills primarily on the latter, highly controversial possibility, illustrating how the current, misguided anti-vaccine movement can be blamed almost equally on panic-driven parents, sensation-hungry media, and PR-challenged health authorities. In making his case, Mnookin covers a wide swathe of medical history, from polio outbreaks to the scare tactics of fringe British researcher Andrew Wakefield, who first forged the dubious vaccine-autism link. While Mnookin dismantles this link convincingly, his argument that multivaccine cocktails have been proven safe is ultimately less persuasive. Still, he’s an able, engaging wordsmith, and this cautionary tale about misinformed medical alarmism is thoroughly compelling." --Carl Hays, Booklist.
• Vaccines and autism (links to several articles)
• On Vaccines and Autism: An Open Letter to Larry Wilmore (David Kyle Johnson, Psychology Today, 1-29-15) The Nightly Show's Larry Wilmore knows vaccines are safe...If you have an anti-vaccination advocate (i.e., anti-vaxer) on your panel, include someone who has the skills or knowledge to debunk her claims.
• How My Daughter Taught Me that Vaccines Do Not Cause Autism (Juniper Russo, Voices for Vaccines)
• Anti-Vaxxers Are Using Twitter to Manipulate a Vaccine Bill (Renee DiResta, Wired, June 2015) One small, vocal group can have a disproportionate impact on public sentiment and legislation. Welcome to Anti-Vax Twitter.
• Penn and Teller on Vaccines (video) Measles in Disneyland should be a wake-up call for the anti-vaccine movement. Will it? Magicians Penn and Teller do their part and show us why anti-vaccination is nonsense. (Warning: explicit language.)
• My parents didn’t tell me they skipped my vaccines. Then I got sick. (Josh Nerius, Opinion, Washington Post, 4-25-19) My sore throat and fever kept getting worse. I developed a rash. Then I collapsed....I contracted the disease as an adult in good health, and it landed me in the hospital. To this day, I still feel its effects. Years after people seem to recover, measles can suppress the immune system, effectively creating an “immune amnesia” that leaves them more vulnerable to other infections. When someone close to me gets the sniffles, I end up coughing for weeks. Worry about panencephalitis — in which virus lingering in the brain triggers a deadly immune response — also weighs on me."
• Mercury, Vaccines, and Autism: One Controversy, Three Histories (Jeffrey P. Baker, Am J Public Health. 2008 February) The controversy regarding the once widely used mercury-containing preservative thimerosal in childhood vaccines has raised many historical questions that have not been adequately explored. Why was this preservative incorporated in the first place? Was there any real evidence that it caused harm? And how did thimerosal become linked in the public mind to the “autism epidemic”?
• Seriously flawed’ study linking behavioral problems to Gardasil has been retracted (Rachel Feltman, WaPo,2-25-16) Retraction Watch reports that a paper published online in the journal Vaccine last month and temporarily removed weeks later has now officially been retracted.
• Anti-vaxxers have been raising money with GoFundMe. The site just put a stop to it. (Lindsey Bever, WaPo, 3-22-19) GoFundMe has joined a growing list of social media companies cracking down on anti-vaccination propaganda to help stop the spread of misinformation. The increased effort from tech giants, such as Facebook, Pinterest and YouTube, comes amid a relentless anti-vaccine movement, talk about “chickenpox parties” and concerns over measles outbreaks across the country. It also comes as the American Medical Association, the nation’s most prominent doctors’ organization, has urged social media platforms to ensure users have access to accurate information on vaccines. Amazon confirmed this week that it, too, had taken action, pulling books from its online marketplace that tout bogus information about autism and vaccines.
The anti-vaccine movement has been sustained, in part, from fraudulent research from 1998 that purported to show a link between autism and a preservative used in vaccines — despite the fact that it has been discredited and despite the fact that numerous other studies have provided conclusive evidence that vaccinations do not cause autism. Art Caplan, a bioethics professor and head of the division of medical ethics at New York University School of Medicine, previously said that these companies cannot allow themselves to be “vehicles for misinformation contagion.”
"You can certainly post things that oppose vaccination — individuals can speak their minds. But when you have websites that are presenting false information, debunked information or, similarly, books that tout phony cures, I think there is a role for somebody in censorship,” said Caplan, who co-wrote a 2017 paper on “The overlooked dangers of anti-vaccination groups’ social media presence.” Caplan said it is important for companies to exclude such misinformation “because the power of social media, particularly in the vaccine space, is so strong that it’s leading to fear of vaccines, which is leading to epidemics, which is putting people at risk.”
Other problems in the vaccine world
• Journalists could change the way we think about vaccines in one powerful way (Annabelle Timsit, Quartz, 4-29-19) Stop with the photos of babies and children crying! “Photos have a tremendous impact on our cognitive [and] emotional impressions,” says Tara Haelle, a freelance science journalist and author of Vaccination Investigation: The History and Science of Vaccines ("an excellent introduction to a complicated and timely topic"). Lauren Whaley, a multimedia journalist affiliated with the Center for Health Journalism at USC Annenberg,was asked by a reader why she wouldn’t rather “promote the advantages of immunizing children and stop the traditional use of medieval style photos that continue to scare people away.” After some soul-searching, realizing that she was choosing alarmist photos to illustrate stories about vaccines. Whaley agreed. most people retweet articles they’ve never read. Usually "it’s because the headline confirmed an inherent bias they had about an issue, or the photo was sensational enough to compel them to share it with their network."
• Freezing, shortages among global vaccine challenges (Center for Infectious Disease Research and Policy, CIDRAP, 3-30-17) A special supplement to the journal Vaccine published yesterday aims to measure the biggest challenges to global vaccine campaigns today, noting that vaccine stockouts—or complete unavailability of vaccines—occur at least monthly, while 19% to 38% of vaccines worldwide are subjected to improper refrigeration practices. Outmoded delivery systems could compromise the efficacy of vaccines, says Benjamin Schreiber, a senior health advisor with UNICEF. "Often a supply arrives in a capital city and has to travel hundreds of miles before it gets to the correct clinic or health center," Schreiber said in an interview. "We know a vaccine has to be kept stable at 2 to 8 degrees [Celsius, or 36°F to 46°F], but our data show that's not happening at least 20% of the time." Freezing is a problem that affects vaccines in both high- and low-income countries. Researchers also found that vaccine stockouts, or instances of running out of vaccine supplies, are a startlingly frequent occurrence in many parts of the world. One in every three WHO member-states experienced at least one stockout of at least one vaccine for at least 1 month each year. And 38% of nations in sub-Saharan Africa reported national-level stockouts annually.
• Adult vaccination saves lives. Why do so few adults get vaccinated? (Sangini S. Sheth, STAT, 11-15-19) 'Hospitals identify vaccines as “ambulatory care,” ambulatory care offices provide adult vaccines with great variability or identify them as “pharmacy care,” and pharmacy administration of a broad spectrum of vaccines remains tenuous. Where can an adult reliably go to access essential preventive health? It is long past time that the U.S. invests in a modern-day immunization infrastructure. This would leverage advanced information technology for identifying children and adults needing vaccination and consolidate vaccination history across locations and delivery systems; create innovative ways to finance and supply vaccines; and use proven preventive health delivery programs to minimize missed opportunities to immunize individuals of all ages against vaccine-preventable diseases."
• Percentage of young U.S. children who don’t receive any vaccines has quadrupled since 2001 (Lena H. Sun, WaPo, 10-11-18) "The vast majority of parents across the country vaccinate their children and follow recommended schedules for this basic preventive practice. But the recent upswing in vaccine skepticism and outright refusal to vaccinate has spawned communities of under-vaccinated children who are more susceptible to disease and pose health risks to the broader public....Measles is an extremely contagious respiratory infection caused by a virus. Once common in the United States, it was eliminated nationally in 2000, but has made a comeback, mostly because of the growing number of people who refuse to vaccinate their children or delay those vaccinations, experts say.
• Can a new Lyme disease vaccine overcome a history of distrust and failure? (Brittany Flaherty, STAT, 8-22-19) As the threat of Lyme disease grows and fears surrounding it spread faster than the ticks that carry the infection, researchers are developing two vaccine or vaccine-like approaches to prevent this increasingly problematic disease. But don’t expect to get one soon. They are at least three to five years away from clinical use, according to their developers. That may seem like a long time to wait, especially since there are several Lyme disease vaccines available for dogs. But it’s taken researchers almost two decades to get this close — for the second time.
• Our Dogs Can Get Lyme Vaccines And We (Still) Can't. When Might We? (David Scales, WBUR, CommonHealth, 7-21-17) We "used to have a vaccine for Lyme, called LYMErix, but it was pulled from the market. Now, the only family member who can get a Lyme vaccine is your dog....Despite a good safety record in clinical trials, some people experienced what they thought were side effects and sued SmithKline Beecham, the manufacturer....While the official line is that poor sales led the vaccine's maker to pull it, most experts think the specter of lawsuits was a key factor. Though an FDA panel ultimately found no link between the vaccine and arthritis, SmithKline settled lawsuits making that claim. And by then, the vaccine was already dead....It will be years before a new Lyme vaccine could make it through FDA trials." See also The History of the Lyme Disease Vaccine on a website called The History of Vaccines (an educational resource of the College of Physicians of Philadelphia).
• Years Before Heading Offshore, Herpes Researcher Experimented On People In U.S. (Marisa Taylor, Kaiser Health News, 11-21-17) Three years before launching an offshore herpes vaccine trial, an American researcher vaccinated patients in U.S. hotel rooms in brazen violation of U.S. law, a Kaiser Health News investigation has found. Southern Illinois University associate professor William Halford administered the shots himself at a Holiday Inn Express and a Crowne Plaza Hotel that were a 15-minute drive from the researcher’s SIU lab. Halford injected at least eight herpes patients on four separate occasions in the summer and fall of 2013 with a virus that he created, according to emails from seven participants and interviews with one participant. Offshore Human Testing of Vaccine Ignites Debate in U.S. (Rebecca Gibian, Real Clear Life, 8-21-17) An American university and a group of wealthy libertarians, including tech billionaire and Trump adviser Peter Thiel, are backing the offshore testing of an experimental herpes vaccine. Their actions defy U.S. safety protections for human trials, reports Kaiser Health News. With the debate over vaccination safety raging in the US, American researchers are increasingly going offshore (and away from current FDA regulations) to conduct clinical trials. Meanwhile, researchers at several universities and private research centers have been working on two different herpes vaccines under FDA and IRB oversight, one which is expected to undergo final trials by 2018. It will then be submitted to the FDA for approval.
• Offshore Human Testing of Herpes Vaccine Stokes Debate Over U.S. Safety Rules (Marissa Taylor, KHN, 8-28-17) Defying U.S. safety protections for human trials, an American university and a group of wealthy libertarians, including a prominent Donald Trump supporter, are backing the offshore testing of an experimental herpes vaccine. The American businessmen, including Trump adviser Peter Thiel, invested $7 million in the ongoing vaccine research, according to the U.S. company behind it. Southern Illinois University also trumpeted the research and the study’s lead researcher, even though he did not rely on traditional U.S. safety oversight in the first trial, held on the Caribbean island of St. Kitts....The push behind the vaccine is as much political as medical. President Trump has vowed to speed up the FDA’s approval of some medicines. FDA Commissioner Scott Gottlieb, who had deep financial ties to the pharmaceutical industry, slammed the FDA before his confirmation for over-prioritizing consumer protection to the detriment of medical innovations.
• Participants In Rogue Herpes Vaccine Research Take Legal Action (Marisa Taylor, Kaiser Health Network, 3-13-18) Three people injected with an unauthorized herpes vaccine by a Southern Illinois University researcher have filed suit against his company, demanding compensation for alleged adverse side effects from the experiments. SIU professor William Halford, who died in June, had injected Americans with his experimental herpes vaccine in St. Kitts and Nevis in 2016 and in Illinois hotel rooms in 2013 without safety oversight that is routinely performed by the Food and Drug Administration or an institutional review board.
Vaccine information for medical professionals
• The Vaccine Times
• Vaccines News (Science Daily)
• The History of Vaccines (an educational resource, from the College of Physicians of Philadelphia).
• COVID conspiracies, flu facts and respiratory realness: The journalists’ guide to debunking health misinformation (Poynter fack-checking)
• ACIP Cliff Notes: : Feb 29 (RSV) (Katelyn Jetelina and Andrea Tamayo, Your Local Epidemiologist, 2-29-24) Today was the second day of ACIP (CDC's Advisory Committee on Immunization Practices). YLE tuned in for the discussion on adult RSV vaccines. This was the first-ever respiratory virus season where we had RSV vaccines for older adults, pregnant people, and babies. This was a huge step in the right direction. However, we had one big, unanswered question among older adults: Is there a “true” safety signal, and if so, do the vaccine’s benefits still outweigh the risks? CDC provided a helpful analysis. Bottom line: "RSV vaccines for older adults are a good call, as the benefits exceed the risks. If you haven’t gotten your vaccine (and are eligible), really consider it next season and talk with your clinical care provider."
---ACIP Vaccine Recommendations and Guidelines (CDC)
---Archived ACIP Recommendations
---Posts on ACIP and vaccinations (Katelyn Jetelina, Your Local Epidemiologist)
• CDC Yellow Book: Health Information for International Travel The US government’s most current travel health guidelines, including pretravel vaccine recommendations, destination-specific health advice, and easy-to-reference maps, tables, and charts.
• Vaccine Considerations for the High-Risk Traveler (Ashley Lyles, MedPage Today, 11-2-18)
• WHO says use of sole dengue vaccine should be curtailed (Helen Branswell, STAT, 12-22-17) The World Health Organization says use of the world’s only licensed dengue vaccine should be restricted because of concerns it increases the risk of severe disease in people who have never previously had dengue. See FAQs: Updated Questions and Answers related to the dengue vaccine Dengvaxia® and its use (World Health Organization, 12-22-17)
• Concerns over one dengue vaccine raise alarms over others in development (Helen Branswell, STAT+, 2-2-18) Requires subscription to read.
• Vaccine Shortage Complicates Efforts To Quell Hepatitis A Outbreaks (Stephanie O'Neill, Kaiser Health News, 11-14-17) San Diego County, battling a deadly outbreak of hepatitis A, is postponing an outreach campaign to provide the second of two inoculations against the contagious liver disease until a national shortage of the vaccine is resolved, the county’s chief public health officer said. “Our goal is to get that vaccine in as many arms as possible for that first dose...”
• Another Way For Anti-Vaxxers to Skip Shots for Schoolkids: A Doctor’s Note (Ana B. Ibarra and Barbara Feder Ostrov, California Healthline, 9-5-17) Dr. Tara Zandvliet was inundated with calls and emails from parents last year, after California passed a law nixing personal beliefs as an exemption from school vaccinations. Suddenly, many parents sought exemptions for medical reasons. Someone even faked two medical exemption forms purportedly written by the San Diego pediatrician, copying a legitimate document she’d provided for a patient and writing in the names of students she’d never treated, she said. She learned of the forgeries only when the school called for verification. For families seeking exemptions without a health reason, perhaps because they’re misinformed or philosophically opposed to vaccines, Zandvliet takes the opportunity to educate them. Sometimes, she succeeds in getting reluctant parents to partially vaccinate their children, or to spread out vaccines over a longer period than the U.S. Centers for Disease Control and Prevention recommends. Not vaccinating all children could undercut the collective protection against contagious diseases that the state law seeks to bolster.
• How Do You Change an Anti-Vaccine Parent's Mind? Scare the Crap Out of Them (Tara Haelle, Forbes, 8-4-15) From that article: Zachary Horne, at the University of Illinois at Urbana-Champaign, and his colleagues proposed that “parents’ decisions to accept or refuse vaccinations for their children should depend on not only the risks associated with vaccinating, but also the risks of not vaccinating.” They point out that “it is often easier to replace an existing belief with an alternative belief rather than attempting to directly counter it.” In other words, don’t debunk. Tell another story.
In this study, "a random third of them were provided with three pieces of information, all from the CDC website: a mom’s description of her child contracting measles, three warnings about the dangers of not vaccinating and then three photos – a child with measles, a child with mumps and a baby with rubella. A second group received CDC website information summarizing the research showing that vaccines and autism are not linked. The third group, a control/comparison group, simply read two paragraphs about the costs and benefits of feeding birds....in this new study, when the participants answered more questions about vaccines after reviewing the materials, those who read the mother’s account and saw the images did shift their attitudes.
“Fear is an incredibly powerful motivator, and the anti-vaccine crowd has done a fabulous job of capitalizing on that knowledge,” Tannenbaum said. “We shouldn’t ignore that information when the fact of the matter is, there are already quite a few truly frightening motivators that fall on the side of encouraging vaccination. There’s nothing comforting and relaxing about real-life photographs of rubella.”
• Mumps outbreaks are spiking — and raising questions about vaccine effectiveness (Helen Branswell, STAT, 3-29-17) Large and lengthy mumps outbreaks have been reported in multiple places across the US over the past couple of years and, worryingly, often among people who have been vaccinated against the disease. The reason for the resurgence is a mystery. The vaccine’s problems could be a double-edged sword — eroding the confidence of vaccine believers while shoring up the resolve of vaccine opponents.The most common symptoms are facial swelling, flu-like aches, and fever. The mumps virus is transmitted in saliva, and a number of factors affect how well it spreads. Living conditions where a lot of people share a space, drink from the same glass, share food, set people up for getting the mumps.
• As more parents refuse vaccines, more doctors cut ties with families (Rebecca Plevin, Southern California Public Radio, 8-31-16) California is the third state in the nation – after Mississippi and West Virginia – to ban vaccine exemptions based on personal or religious beliefs. The most common concern of anti-vaccine parents in 2013 was that vaccines are unnecessary, according to a survey of pediatricians.. The authors of the report suggest this is because most parents of young children have little or no experience with vaccine-preventable diseases.
• Countering antivaccination attitudes ( Zachary Hornea, Derek Powellb, John E. Hummela, and Keith J. Holyoakb, Proceedings of the National Academy of Sciences, 6-11-15) "Myths about the safety of vaccinations have led to a decline in vaccination rates and the reemergence of measles in the United States, calling for effective provaccine messages to curb this dangerous trend. Prior research on vaccine attitude change suggests that it is difficult to persuade vaccination skeptics and that direct attempts to do so can even backfire. Here, we successfully countered people’s antivaccination attitudes by making them appreciate the consequences of failing to vaccinate their children (using information provided by the Centers for Disease Control and Prevention). This intervention outperformed another that aimed to undermine widespread vaccination myths."
• Physician Communication With Vaccine-Hesitant Parents: the Start, Not the End, of the Story (Julie Leask and Paul Kinnersley, Pediatrics, 5-26-15) Physicians should aim for both parental satisfaction and a positive decision to vaccinate.19 Researchers must continue to develop conceptually clear, evidence-informed, and practically implementable approaches to parental vaccine hesitancy, and agencies need to commit to supporting the evidence base. Billions of dollars fund the research and development of vaccines to ensure their efficacy and safety. There needs to be a proportional commitment to the “R&D” of vaccine acceptance because vaccines are only effective if people willingly take them up.
• Working with vaccine-hesitant parents (Noni E MacDonald, Jane C Finlay, Canadian Paediatric Society, 5-3-13). How can health care providers more effectively engage vaccine-hesitant parents in a decision-making partnership? What follows are five important steps in this process.
1. Understand the specific vaccine concerns of the parent: Use motivational interviewing, ie, questions that are client-centred, semidirective and aimed at changing behavior.
2. Stay on message and use clear language to present evidence of vaccine benefits and risks fairly and accurately.
3. Inform parents about the rigour of the vaccine safety system.
4. Address the issues of pain with immunization.
5. Do not dismiss children from your practice because parents refuse to immunize.
In summary, dealing with vaccine-hesitant parents requires knowledge and skill. Health care professionals must understand parents’ specific concerns and take time to foster trust. This means presenting the evidence in a way that parents can understand it and showing compassion for the child. Taking the time to do these things well can mean the difference between a child being immunized or not.
• Effective Messages in Vaccine Promotion: A Randomized Trial (Brendan Nyhan, Jason Reifler, Sean Richey, Gary L. Freed, Pediatrics, Feb. 2014) Refuting claims of an MMR/autism link successfully reduced misperceptions that vaccines cause autism but nonetheless decreased intent to vaccinate among parents who had the least favorable vaccine attitudes. In addition, images of sick children increased expressed belief in a vaccine/autism link and a dramatic narrative about an infant in danger increased self-reported belief in serious vaccine side effects. (In short, as Felice Freyer puts it, information and images only caused parents who were doubtful to dig in their heels.)
Conclusions: Current public health communications about vaccines may not be effective. For some parents, they may actually increase misperceptions or reduce vaccination intention. Attempts to increase concerns about communicable diseases or correct false claims about vaccines may be especially likely to be counterproductive
• There’s a surprisingly simple way to convince vaccine skeptics to reconsider (Carolyn Y. Johnson, Wonkblog, WaPo, 8-3-15) "Here is a depressing fact about facts: In the face of beliefs, they often have little power....A new study found that while it may be tempting to lecture someone that they're just wrong about vaccines and autism, it may be more powerful to simply tell and show them exactly what it's like when a child gets sick from a disease that could have been prevented....In a study published Monday in the Proceedings of the National Academy of Sciences, psychology researchers have found that a more effective way to persuade parents to change their attitudes about vaccinations is not to tell them they're wrong; It's to introduce new facts.[Parents were more likely to change their minds when given] "a parent's description of what it was like to have a child with measles, warnings about the importance of vaccination, and photos of a child covered with measles and rubella rashes, or a young boy's face horribly swollen by mumps. 'What’s going on with anti-vaccination parents, we think, is because they haven’t seen kids with measles and mumps, those consequences aren’t that real to them. And the other consequence, the purported link between vaccination and autism, is.'
• How to address vaccine hesitancy: New AAP report says dismissal a last resort (Ruben J. Rucoba, American Academy of Pediatrics, 8-29-16). In a new clinical report co-authored by Dr. Jesse M. Hackell, the Academy has officially acknowledged for the first time that dismissal of a patient is an option in certain circumstances for patient families who categorically refuse vaccines. This story links to several related stories. Drs. Edwards and Hackell emphasize that dismissal should be undertaken only if these conditions are met:
The pediatrician has exhausted all means of education with the family.
The family has been made aware of the office policy concerning dismissal of non-vaccinators.
The geographic area is not in short supply of pediatric providers.
The practice continues to provide health care until the family finds another provider (usually 30 days).