Northern Hemisphere Influenza Season
The composition of trivalent virus vaccines for use in the 2017â2018 Northern Hemisphere influenza season recommended by the Advisory Committee on Immunization Practices on August 25, 2017, was:
- an A/Michigan/45/2015 pdm09âlike virus
- an A/Hong Kong/4801/2014 -like virus
- a B/Brisbane/60/2008âlike virus
In addition to these components, quadrivalent vaccines will also include a B/Phuket/3073/2013âlike virus .
In California, some emergency systems were strained by a spike in H3N2 flu cases. In addition, some areas experienced local shortages of oseltamivir. The severity of the flu season seemed somewhat comparable to the 2009â10 swine flu outbreak. A February 2018 CDC interim report estimated the vaccine effectiveness to be 25% against H3N2, 67% against H1N1, and 42% against influenza B.
Education And Medical Training
Jenner went to school in Wotton-under-Edge and Cirencester. During this time he was inoculated for smallpox, which had a lifelong effect upon his general health. At the age of 14 he was apprenticed for seven years to Mr Daniel Ludlow, a surgeon of Chipping Sodbury, where he gained most of the experience needed to become a surgeon himself.
In 1770 he moved to St. George’s Hospital in London, to complete his medical training under the great surgeon and experimentalist John Hunter. Hunter quickly recognised Edward’s abilities at dissection and investigation, as well as his understanding of plant and animal anatomy. The two men were to remain lifelong friends and correspondents.
In 1772 at the age of 23, Edward Jenner returned to Berkeley and established himself as the local practitioner and surgeon. Although in later years he established medical practices in London and Cheltenham, Jenner remained essentially a resident of Berkeley for the rest of his life.
Trial And Authorization Status
Phase I trials test primarily for safety and preliminary dosing in a few dozen healthy subjects, while Phase II trials following success in Phase I evaluate immunogenicity, dose levels and adverse effects of the candidate vaccine, typically in hundreds of people. A Phase III trial consists of preliminary safety and immunogenicity testing, is typically randomized, placebo-controlled, while determining more precise, effective doses. Phase III trials typically involve more participants at multiple sites, include a control group, and test effectiveness of the vaccine to prevent the disease , while monitoring for adverse effects at the optimal dose. Definition of vaccine safety, efficacy, and clinical endpoints in a Phase III trial may vary between the trials of different companies, such as defining the degree of side effects, infection or amount of transmission, and whether the vaccine prevents moderate or severe COVID19 infection.
A clinical trial design in progress may be modified as an “adaptive design” if accumulating data in the trial provide early insights about positive or negative efficacy of the treatment. Adaptive designs within ongoing Phase IIIII clinical trials on candidate vaccines may shorten trial durations and use fewer subjects, possibly expediting decisions for early termination or success, avoiding duplication of research efforts, and enhancing coordination of design changes for the Solidarity trial across its international locations.
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The Spread Of Variolation
In Europe, where the medical profession was relatively organized, the new methods of variolation became known quickly among physicians. Since there was also a demand for protection against smallpox, physicians soon began the variolation procedure on a massive scale. Although 2% to 3% of variolated persons died from the disease, became the source of another epidemic, or suffered from diseases transmitted by the procedure itself, variolation rapidly gained popularity among both aristocratic and common people in Europe. The case-fatality rate associated with variolation was 10 times lower than that associated with naturally occurring smallpox. In the 1750s more European princes died of smallpox, giving further impetus for the use of variolation . Among those variolated were Empress Marie-Therese of Austria and her children and grandchildren, Frederick II of Prussia, King Louis XVI of France and his children, and Catherine II of Russia and her son. King Frederick II of Prussia also inoculated all his soldiers. In fact, variolation was widely practiced in Europe until Jenner’s discovery.
In 1757, an 8-year-old boy was inoculated with smallpox in Gloucester he was one of thousands of children inoculated that year in England. The procedure was effective, as the boy developed a mild case of smallpox and was subsequently immune to the disease. His name was Edward Jenner.
The Origins Of Vaccination
Edward Jenner , a physician from Gloucestershire in England, is widely regarded as the father of vaccination . However, the origins of vaccination lie further back in time and also further afield. In fact, at the time Jenner reported his famous story about inoculating young James Phipps with cowpox and then demonstrating immunity to smallpox, the procedure of variolation , by which pus is taken from a smallpox blister and introduced into a scratch in the skin of an uninfected person to confer protection, was already well established.
Variolation had been popularized in Europe by the writer and poet Lady Mary Wortley Montagu, best known for her letters from the Ottoman Empire. As wife of the British ambassador to Turkey, she had first witnessed variolation in Constantinople in 1717, which she mentioned in her famous letter to a friend. The following year, her son was variolated in Turkey, and her daughter received variolation in England in 1721. The procedure was initially met with much resistance so much so that the first experimental variolation in England was carried out on condemned prisoners, who were promised freedom if they survived . Nevertheless, the procedure was not without danger and subsequent prominent English variolators devised different techniques to improve variolation, before it was replaced by the much safer cowpox vaccination as described by Jenner.
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Is It True Were Covid
It may seem vaccines were developed quickly, but researchers around the world have been working hard to develop vaccines from the start of the pandemic. They were able to speed up development thanks to the collaboration between them, scientists, manufacturers and distributors. Find out more below.
- Listen
List Of Authorized And Approved Vaccines
National regulatory authorities have granted emergency use authorizations for fifteen vaccines. Six of those have been approved for emergency or full use by at least one WHO-recognized stringent regulatory authority. Biologic License Applications for the PfizerBioNTech and Moderna COVID19 vaccines have been submitted to the US Food and Drug Administration .
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Plants As Bioreactors For Vaccine Production
The idea of vaccine production via transgenic plants was identified as early as 2003. Plants such as tobacco, potato, tomato, and banana can have genes inserted that cause them to produce vaccines usable for humans. In 2005, bananas were developed that produce a human vaccine against hepatitis B. Another example is the expression of a fusion protein in alfalfa transgenic plants for the selective directioning to antigen presenting cells, therefore increasing vaccine potency against Bovine Viral Diarrhea Virus .
Opposition Within The Medical Profession
Jenner’s newly proven technique for protecting people from smallpox did not catch on as he anticipated. One reason was a practical one. Cowpox did not occur widely and doctors who wanted to test the new process had to obtain cowpox matter from Edward Jenner. In an age when infection was not understood, cowpox samples often became contaminated with smallpox itself because those handling it worked in smallpox hospitals or carried out variolation. This led to claims that cowpox was no safer than smallpox inoculation. There were also many surgeons who did not want Jenner to succeed. They were the variolators whose large incomes were threatened by Jenner’s safer and more effective cowpox treatment.
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Last Cases Of Smallpox
In late 1975, three-year-old Rahima Banu from Bangladesh was the last person in the world to have naturally acquired variola major. She was also the last person in Asia to have active smallpox. She was isolated at home with house guards posted 24 hours a day until she was no longer infectious. A house-to-house vaccination campaign within a 1.5-mile radius of her home began immediately. A member of the Smallpox Eradication Program team visited every house, public meeting area, school, and healer within 5 miles to ensure the illness did not spread. They also offered a reward to anyone who reported a smallpox case.
Ali Maow Maalin was the last person to have naturally acquired smallpox caused by variola minor. Maalin was a hospital cook in Merca, Somalia. On October 12, 1977, he rode with two smallpox patients in a vehicle from the hospital to the local smallpox office. On October 22, he developed a fever. At first healthcare workers diagnosed him with malaria, and then chickenpox. The smallpox eradication staff then correctly diagnosed him with smallpox on October 30. Maalin was isolated and made a full recovery. Maalin died of malaria on July 22, 2013, while working in the polio eradication campaign.
The Schedule From 2011 To Present
Annual updates to both the childhood and adult immunization schedules offer guidance to healthcare providers in the form of new recommendations, changes to existing recommendations, or clarifications to assist with interpretation of the schedule in certain circumstances. The schedules are reviewed by committees of experts from the Centers for Disease Control and Prevention, the American Academy of Pediatrics, and the American Academy of Family Physicians.
Important changes to the schedule:
- New vaccines: meningococcal serogroup B vaccine
- Additional recommendations for existing vaccines: HPV , intranasal influenza vaccine
- Discontinuation of vaccine: intranasal influenza vaccine
2020 | Recommended Vaccines
* Given in combination as DTaP** Given in combination as MMR
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Jenner Did All This Without Knowing What He Was Dealing With
Dividing forces, the expedition travelled through the Caribbean, South and Central America and eventually crossed the Pacific to reach the Philippines. Within 20 years of its discovery, Jenners vaccine was already saving millions of lives. Soon, smallpox vaccination was common practice around the world. It was completely eradicated in 1979.
Personally, it gives me hope for the Covid-19 vaccine, says Najera. Now we have 200 years of knowledge of viruses and the immune system but Jenner did all this without knowing what he was dealing with.
Jenners up there as one of my top scientific heroes, says Gower. His determination and innovation changed the world and saved countless millions of lives and continues to save lives.
Richard Hollingham is a science and space journalist, feature writer for BBC Future and the author of Blood and Guts, A History of Surgery.
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The Long History Of Mrna Vaccines
Messenger RNA, or mRNA, was discovered in the early 1960s research into how mRNA could be delivered into cells was developed in the 1970s. So, why did it take until the global COVID-19 pandemic of 2020 for the first mRNA vaccine to be brought to market?
In this explainer, Chris Beyrer talks us through mRNA vaccines history, development, and breakthroughs.
Theres a big gap between when the first mRNA flu vaccine was tested in mice in the 1990s and when the first mRNA vaccines for rabies were tested in humans in 2013. What was happening in the interim?
The early years of mRNA research were marked by a lot of enthusiasm for the technology but some difficult technical challenges that took a great deal of innovation to overcome.
The biggest challenge was that mRNA would be taken up by the body and quickly degraded before it could deliver its messagethe RNA transcriptand be read into proteins in the cells.
The solution to this problem came from advances in nanotechnology: the development of fatty droplets that wrapped the mRNA like a bubble, which allowed entry into the cells. Once inside the cell, the mRNA message could be translated into proteins, like the spike protein of SARS-CoV-2, and the immune system would then be primed to recognize the foreign protein.
So, what happened once they figured out this technology?
Then COVID-19 hit what happened then?
Whats next?
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Vaccine Efficacy And Effectiveness
Vaccine efficacy and effectiveness are measures that compare the rates of disease between vaccinated and unvaccinated people. Efficacy is measured in controlled clinical trials, whereas effectiveness is measured once the vaccine is approved for use in the general population. From these we can identify the proportion of vaccinated people we would expect to be protected by the vaccine.
Herd immunity is an important mechanism by which the larger community is protected. For some diseases, if enough people are immune then transmission of the disease is reduced or eliminated. This is particularly so for diseases such as rubella and pneumococcal disease. High vaccine coverage must be maintained in order to prevent the disease re-entering the population.
No vaccine is 100% effective, a small percentage of people are not protected after vaccination and for others the protection may wane over time. Also, some people are unable to be vaccinated due to certain conditions such as immune suppression. Maintaining immunity in those around these people protects them from disease.
Early Smallpox Vaccine Is Tested
Edward Jenner, an English country doctor from Gloucestershire, administers the worlds first vaccination as a preventive treatment for smallpox, a disease that had killed millions of people over the centuries.
While still a medical student, Jenner noticed that milkmaids who had contracted a disease called cowpox, which caused blistering on cows udders, did not catch smallpox. Unlike smallpox, which caused severe skin eruptions and dangerous fevers in humans, cowpox led to few ill symptoms in these women.
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On May 14, 1796, Jenner took fluid from a cowpox blister and scratched it into the skin of James Phipps, an eight-year-old boy. A single blister rose up on the spot, but James soon recovered. On July 1, Jenner inoculated the boy again, this time with smallpox matter, and no disease developed. The vaccine was a success. Doctors all over Europe soon adopted Jenners innovative technique, leading to a drastic decline in new sufferers of the devastating disease.
In the 19th and 20th centuries, scientists following Jenners model developed new vaccines to fight numerous deadly diseases, including polio, whooping cough, measles, tetanus, yellow fever, typhus, and hepatitis B and many others. More sophisticated smallpox vaccines were also developed and by 1970 international vaccination programs, such as those undertaken by the World Health Organization, had eliminated smallpox worldwide.
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Europe’s Who Incident Manager Explains Rise In Covid Cases
Scientists Ugur Sahin and Ozlem Tureci have dedicated their lives to the field of oncology and infectious diseases, and spent years pioneering personalized immunotherapy treatments for cancer.
Salks Journey To Inventing The Polio Vaccine
In 1947, Salk was appointed to work with the University of Pittsburgh, School of Medicine. Still, in the same station, the National Foundation of Infantile Paralysis sponsored a program that focused on determining how many viruses of polio existed in a body. Salk took advantage of this opportunity and decided to research further on developing a polio vaccine. Together with a few of his colleagues, Salk kept researching on the project for a continuous period of seven years. In 1955, he came up with a vaccine that became the first successful polio vaccine. A field trial was set to test the Salks vaccine. The testing involved 20,000 medical physicians and practitioners, 64,000 school staff, and over 1.8 million school children. The field test was largely successful. On April 12, 1955, it was announced to the public that a polio vaccine had been successfully developed.
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Vaccines For Adolescents: A New Generation Of Vaccines
Adolescents, like adults, were recommended to get tetanus boosters every 10 years most requiring their first booster dose around age 11. Other than this, however, most adolescents did not require additional vaccines unless they missed one in childhood. By 2005, vaccines specifically recommended for adolescents were only recommended for sub-groups based on where they lived or medical conditions that they had. However, a new group of vaccines became available in the latter part of the decade.
- New vaccines: Tdap, 2005, meningococcal conjugate , HPV , meningococcal serogroup B vaccine
- Additional recommendations for existing vaccines: HPV , intranasal influenza vaccine
- New versions of existing vaccines: HPV
- Discontinuation of vaccine: intranasal influenza vaccine
2000
Pneumococcus
Who Endorses Use Of Worlds First Malaria Vaccine In Africa
World Health Organizations director general hails historic day in fight against parasitic disease
The World Health Organization has recommended the widespread rollout of the first malaria vaccine, in a move experts hope could save tens of thousands of childrens lives each year across Africa.
Hailing an historic day, the WHOs director general, Dr Tedros Adhanom Ghebreyesus, said that after a successful pilot programme in three African countries the RTS,S vaccine should be made available more widely.
I started my career as a malaria researcher, and I longed for the day that we would have an effective vaccine against this ancient and terrible disease. And today is that day, an historic day. Today, the WHO is recommending the broad use of the worlds first malaria vaccine, Tedros said at a press conference in Geneva.
The RTS,S vaccine, also known as Mosquirix, was developed by the British pharmaceutical company GlaxoSmithKline , and has been administered to more than 800,000 children in Ghana, Kenya and Malawi since the pilot programme began in 2019.
The vaccine, which went through lengthy clinical trials, has limited efficacy, preventing 39% of malaria cases and 29% of severe malaria cases among small children in Africa over four years of trials.
However, in August a study led by the London School of Hygiene & Tropical Medicine found that when young children were given both the RTS,S and antimalarial drugs there was a 70% reduction in hospitalisation or death.
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