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Is This Season’s Flu More Severe Than Usual or Just Highly Active?

January 13, 2018 10 comments

At this point in the flu season people often wonder if all the media hype is part of an orchestrated effort to panic people about flu, or if it is really signaling serious concern.

There are lots of flu stories in the news these days.  From reports of  74 Californian’s who’ve died from flu – five times the number seen at this point last year – to 13 school districts in TX closing due to the high number of flu cases among students, we’re left to wonder….

Is this year’s flu season more severe than usual or just highly active at the moment?

A recent CDC media briefing has helped clarify the following concerns regarding the latest flu activity in the U.S.: 

Right now, flu is widespread everywhere.  

One of the most notable differences between this season and others is in relation to the geographic spread of flu. This is the first time over the course of 13 years of surveillance data that the entire nation is experiencing widespread flu at the exact same time, as can be noted by the color of CDC’s flu surveillance map below.

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One of the ways the CDC tracks influenza activity is to record the number of lab confirmed cases of flu and hospitalizations by week. What they’ve noted is a very rapid increase in the number of people seeing their healthcare providers for flu diagnosis, along with a rapid rise in the numbers of people being hospitalized with lab confirmed flu. For instance, this week’s surveillance data indicates that there’s been 22.7 hospitalizations per 100,000 people in the U.S., which is up considerably from the 13.7 number recorded last week.

So far this season, influenza A (H3N2), has been the most prevalent strain in circulation. Unfortunately, historically it is often the strain linked to more severe illness, especially among children and older individuals above the age of 65. Interestingly enough, the current flu surveillance observations seem to be in line with two more previous H3N2 dominant seasons; the 2014-2015 and 2012-2013 seasons.WHOPHL02_small

Additionally the hospitalizations so far this season seem to be in line with other H3N2 predominant seasons, with the highest rates among those over the age of 65, those between 50-64, and children under 5 years of age.

Flu can cause mild disease in some, but severe disease and death in others.

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Sadly, there have been as many as 30 pediatric deaths so far this season. While children are at great risk, there are plenty of reports of otherwise healthy adults who have been hospitalized or died from flu this season.

Peak season may have started early, but there are many more weeks to go.

Speaking to the media on behalf of the CDC on Friday, Dr.  Jernigan explained,

“If we look at the timing of the season, even if we have hit the top of the curve or the peak of the seasonal activity, it still means we have a lot more flu to go.”

He went on to suggest that there will likely be at least 11 to 13 more weeks of elevated influenza activity this season, before activity begins to subside. Even though it can take about two weeks for protection from vaccination to set in, Dr. Jernigan explained that we still have a lot of flu season to get through and that vaccination efforts should continue as long as influenza viruses are circulating.

While we are seeing a lot of H3N2 circulating now, we are also seeing H1N1 show up in states that have already had H3N2 activity. And we know that B viruses also tend to show up later in the season. Each of these strains are covered in the vaccine, so flu vaccination now can still help to prevent, or lessen the severity of flu throughout the remainder of the season.

Vaccination is our best defense.  

While flu vaccination is far from perfect, it remains our best defense. Not only can it help prevent flu, but it can also help lessen the severity of symptoms if a vaccinated person does end up getting infected.  This can reduce the chances of an individual being hospitalized or dying from flu.

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In fact, a recent study showed that influenza vaccination reduced the risk of flu-associated death by 65% among healthy children and by 51% among children with underlying high-risk medical conditions. Another study indicated that many older adults benefit from repeated flu vaccination. When getting vaccinated in both the current and previous seasons, the study found flu vaccination was 74% effective in preventing ICU admissions in older individuals and 70% effective in preventing deaths among older adults.

Manufacturers are reporting that they’ve shipped more than 151 million doses of flu vaccine this season, so there shouldn’t be a problem finding a flu vaccine in your area.  Simply refer to the flu vaccine finder for assistance.

We won’t know preliminary flu vaccine effectiveness until February.  

Read more…

Free Online Course Explains Cells, Immunity and Vaccines

January 4, 2018 1 comment
by Rich Greenaway, Director of Program Operations and Special Projects, Every Child By Two

Often times, the concerns people have about vaccines can be addressed through a better understanding of science.  It begins with a more comprehensive explanation of how the cells in our body work, how viruses can infect us, how our bodies fight off infections, and how vaccines help in that process.

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Fortunately, you don’t have to devote your life to being a doctor or scientist to benefit from an improved understanding of immunology.  While many people strive to better educate themselves on these topics, the challenge is in finding educational resources that are not only accessible to the general public, but are also scientifically accurate and comprehensible for non-scientists.

Now Dr. Jonathan M. Gershoni, a Professor of Molecular Immunology and Virology at Tel Aviv University, has stepped in to help.  

After spending thirty years investigating the immune response towards viruses such as HIV, HCV and SARS CoV, Dr. Gershoni is now offering a free course entitled, Viruses & How to Beat Them: Cells, Immunity, Vaccines.

 

Designed for the general public, the course is offered at no charge, but can also be taken for continuing education credits for a small fee ($49).  The online lectures are offered in English in a video format that is easy to understand. Additional learning materials and a glossary of terms are also available for each section.

The entire course consists of seven lessons which are then subdivided into six to ten sub-lessons, each concluding with a quiz.  Although the course became available in December, new participants can view any of the lectures at their own pace.  Lesson 7 may be of particular interest since it deals specifically with vaccines and how they work.  While the time one invests in this course may vary, it is expected that the course can be completed by committing two to three hours per week over an eight-week period.

At a time when immunization misinformation remains prevalent on the internet, and continues to interfere with the public’s ability to recognize the value of vaccines as a primary means of disease prevention, this class and others from reputable individuals and organizations, can further our mission to ensure that everyone is making well-informed decisions regarding vaccines.

Consider the comments Dr. Jonathan M. Gershoni has received from various experts on what they think about vaccines:

We encourage you to register for the course, share your thoughts about the course if you are taking it, and encourage others to further educate themselves about immunology and virology by signing up today.  Simply click here to get started.

Most Popular Posts of 2017 Address Flu, Vaccine Safety, Disease Outbreaks and Maternal Vaccines

December 27, 2017 Leave a comment

As we look back at the success of the Shot of Prevention blog this past year, we’re especially grateful to our blog readers, contributors and subscribers.

Whether you’ve shared a post, shared your story, or shared your expertise, we recognize that our growth and success would not have been possible without your support. Thanks to you, our posts are helping people to make important immunization decisions for themselves and their families.

In these final days of 2017, we hope that you will revisit the top ten posts from the past year and share them with others in your social networks.  

1)  3 Things I’ve Learned Since Losing My Son To Flu

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It’s been eight years since Serese Marotta of Families Fighting Flu lost her five-year-old son, Joseph, to the flu. She’s not the same person she was eight years ago. Today, she sees things through a different lens as a bereaved parent. Losing a child is devastating, but she feels a responsibility to pass on some of the lessons she’s learned through her personal tragedy, which she does in her article here.

 

2)  10 Things Parents Who Don’t Vaccinate Their Kids Should Know

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In some cases, children who have suffered with a preventable disease were unvaccinated.  This could be the result of parents who did not have access to certain vaccines, parents who willfully refused a particular vaccine, or it could because they were too young to be fully vaccinated. After Riley Hughes passed away in the arms of his parents when he was just 32 days old, his parents made it their mission to educate people about the dangers of whooping cough, and promote the need for vaccination. In a plea to parents who still choose not to vaccinate, Riley’s mom posted the following list of “things to know” here.

 

3)  Even With All Our Modern Medicine I Watched My Sister Die From Flu

lizaLiza was healthy and only 49 years old when she contracted flu. She sought medical care early. She was cared for at a good hospital in a major city.  She had no other infections. And she was unvaccinated. To say that her death was a surprise to her brother is an understatement.  And yet her brother, Dr. Michael Northrop is a pediatric intensive care physician. His story traces the clinical course of Liza’s illness, and expresses the grief he felt as he helplessly watched his sister  succumbs to an illness that even modern medicine can’t always save us from. To read his story, click here.

 

4) Take It From This Mom, The Flu Is No Joke

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After her four-year old daughter is rushed to the emergency room, she writes a warning to others.  “The words just the flu need to be eradicated from our lexicon. Because this? This is the flu. There’s no ‘just’ about this. It was terrifying. It was the most helpless I’ve ever felt as a mommy. And it was potentially deadly.  All because I was too busy to get our flu shots.” Read the full story here.

 

5) Flu Vaccine Benefits Go Beyond Effectiveness of One Strain

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Amid speculation about how effective the flu vaccine will be this year, Dr. LJ Tan addresses some of the public’s most prominent concerns. He starts with a basic explanation of flu and flu vaccines, discusses the factors that play into vaccine effectiveness, and addresses rumors about this year’s flu vaccines. To gain a better understanding, read more here.

 

6) How My Sister Helped Save My Daughter From Whooping Cough

As a Medical Director responsible for Community Health and Prevention at Intermountain Healthcare in Salt Lake City, Utah, Tamara Sheffield is a huge advocate for SOTI_Pertussis_FBimmunizations. She is especially appreciative of maternal immunizations, which she considers one of today’s most promising new preventive health strategies. But her reasons go beyond her professional understanding of how maternal flu and Tdap vaccines pass on protective antibodies to newborns. Her surprising story ends with a twist involving her own daughter who nearly died from whooping cough when she was just three weeks old. Read it here.

 

7) Multiple Vaccine Oversight Committees Ensure Our Public Safety

While 2017 brought a lot of uncertainty about health services in this country, Dr. Dorit Reiss, Professor of Law at the University of California Hastings College of Law, explains 178_NFID_Vaccine_Safety_infograms_2_FINALwhy the public should remain confident in vaccine safety. In this post she reviews the specific ways in which vaccine safety is regulated in the U.S., and the oversight committees that monitor vaccines pre and post licensure. Her scrutiny explains that it would be hard to hide a problem if one existed, and that when problems do occur, they are quickly discovered and addressed. To learn more about vaccine safety oversight, read the full post here.

 

8) Why Should Vaccinated Individuals Worry About Measles Outbreaks

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With various measles outbreaks reported across the U.S. and the world in 2017, it’s important to understand why vaccinated individuals should be concerned. Many people mistakenly think that vaccinated individuals are not at risk during outbreaks. However, when it comes to infectious diseases like measles, one person’s decision not to vaccinate can negatively impact the health of others and this post explains how.

 

9) Five Things I’ve Learned About Vaccines Through 21 Years of Parenting

HowHerdImmunityWorksWe’ve all received plenty of unsolicited advice about how to care for our children. However, when making health decision for our families we should rely on evidence based research and credible information from reputable sources. In this post, I share five of the most important things I’ve learned about vaccines through my journey as a parent and immunization blogger. Spoiler alert: it begins with science and it ends with action.

 

10) Five Things Expectant Parents Need to Know About Vaccines in Pregnancy

SOTI-PregnancyCoverFBWhile well-meaning friends and family will provide a constant stream of advice on what to do and what to avoid while pregnant, all this information can be overwhelming. Expectant couples should rely on credible medical sources such as the CDC, the American College of Obstetricians and Gynecologists (ACOG), and the American College of Nurse Midwives. This blog post reviews the 5 things these trusted organizations say about the flu and Tdap vaccines routinely recommended during pregnancy. Learn more here.

 

We hope you have found our content to be engaging and informative.  We have exciting changes planned for Shot of Prevention in 2018 in hopes of engaging even more people in these important immunization conversations in the years to come.  

If you have suggestions for topics you would like us to address in 2018, or you would like to contribute a guest post for publication, please email shotofprevention@gmail.com.

Also, if you want to receive important immunization news and join in our online discussions, be sure to “Like” our Vaccinate Your Family Facebook page, follow our @ShotofPrev Twitter feed and subscribe to Shot of Prevention by clicking the link on the top right of this page.

Thanks again for your continued support and best wishes for a happy and healthy new year!

Flu Vaccine Benefits Go Beyond Effectiveness of One Strain

December 11, 2017 2 comments
LJ TanGuest post by Litjen (LJ) Tan, MS, PhD; co-chair and co-founder of the National Adult and Influenza Immunization Summit.

 

There seems to be a lot of speculation recently about how effective the influenza (flu) vaccine will be at preventing cases of influenza this season.

We have heard suggestions that the vaccine may only be 10% effective against flu this year, that there may be mismatches in the vaccine compared to the influenza strains that are circulating, and thus, that the vaccine is not worth getting.

To address these concerns I will start with a basic explanation of flu and flu vaccines, and then discuss the factors that play into vaccine effectiveness.

First, let me say that influenza is a serious respiratory infection that is responsible for about 30% of all the respiratory infections during the winter season. When I say serious, I mean that flu can keep you down for a week or more, and you will feel completely miserable. Additionally, each year thousands of people of all ages die from flu in the U.S.; it can be very dangerous. So, that office colleague who said that he was out with the flu yesterday very likely did not have influenza. Not fully understanding the dangers of flu is why some people fail to see the value of flu prevention.  

Flu is caused by multiple strains of influenza viruses that circulate during the winter season; specifically, we have influenza type A (with the H3N2 and H1N1 strains) and influenza type B (there are two type B strains that can circulate and currently 90% appear to be the Yamagata lineage, but since it is still so early in the season and sample sizes are small, this data point may not be statistically significant). Because these strains of flu viruses can switch every season in terms of dominance, and can also mutate, manufacturers need to develop a new influenza vaccine every year and people need to be re-vaccinated each year.

To be clear, the vaccine development process is the same every year, it is just that the starting, or “seed”, vaccine virus that we immunize against has to be identified before it can be used to develop our country’s annual vaccines.

When that seed virus is identified, it is then amplified (or passaged) to develop more seed virus. Then that seed virus is further amplified to create the large quantities of vaccine virus that we ultimately need to prepare an adequate supply of vaccines to protect our population. That amplification of the seed virus, and the making of large amounts of vaccine virus, can occur in eggs, which is the more traditional way, or it can also occur in cell cultures. So there needs to be four seed viruses developed and amplified to create influenza vaccines – an H3N2 seed, an H1N1 seed, and the two B seed viruses.

So why do we keep hearing people say that this year’s flu vaccine may only be 10% effective? Where did that suggestion come from?

When we say that a flu vaccine is 10% effective, what we usually mean is that it was effective in preventing 10% of cases of influenza in those who were vaccinated. This 10% number that you may have heard is actually a data point from Australia, and it’s not against all strains of flu, but specifically against the H3N2 strain that dominated the southern hemisphere this past flu season. If you look at the Australian data for all influenza, the vaccine effectiveness goes up to 33%. Agreed, that’s not great for Australians (although, it’s still better than no protection), but is looking at the Australian data truly reflective of what might happen in the US?

It’s unlikely, and here’s why. Read more…

Vaccine Hesitancy Often Tied to Moral Foundations of Liberty and Purity

December 5, 2017 Leave a comment

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We often try to overcome vaccine hesitancy with education, hoping that the scientific evidence will be enough to change people’s minds.  The hope is that if we can just provide people with the facts about the dangers of diseases, and the benefits of vaccines, than they will be encouraged to vaccinate.  But research shows that it’s not that easy, and this may not even be the right approach.

Today, Washington Post reporter, Lena Sun, published an article that explains that vaccine hesitancy is not just an issue of education.  Recent behavioral research suggests that there is often a moral difference between people who accept vaccines and people who refuse them.  The point is that people don’t make decisions based solely on fact.  Rather, parents who are most reluctant to vaccinate appear to be strongly concerned with two powerful moral values that influence their attitudes and judgments: individual liberty and purity.

In this framework, liberty is associated with belief in personal responsibility, freedom, property rights and resistance to state involvement in citizens’ lives, while concerns about purity focus on boundaries and protection from contamination.

One new study out of Emory University, published recently in Nature Human Behaviour, used a social psychology theory known as Moral Foundations Theory to determine the underlying moral values most strongly associated with vaccine-hesitant parents. They assessed the parents’ level of vaccination hesitancy and explored how important different moral values were to them when deciding if something was right or wrong. Their findings correspond with the reasons many vaccine-hesitant parents give for delaying or refusing some vaccines.

Another group of researchers out of Loyola University in Chicago were able to validate these finding, but then went one step further.  They found that purity and liberty values also seem to influence the belief in false or misleading statements that often appear on websites that adamantly oppose vaccines.

In another study recently published in the Personality and Social Psychology Bulletin, researchers at the University of Amsterdam and University of Kent explored science skepticism as it relates to various issues such as climate change, vaccination and genetic modification in food.  They determined that “religiosity”, as well as concerns about moral purity, were also a common predictor of vaccine skepticism.

The insight that we get from this type of behavioral research can certainly help us better understand those who are vaccine hesitant.  If we can take the moral foundation concerns and incorporate them into our messaging, we may be able to persuade parents that vaccines do fulfill their desire to maintain both liberty and purity.

As an example, to address the purity concerns, one suggested intervention may be to explain that vaccinating is a way of  boosting a child’s natural defenses against disease and keeping the child “pure of infections”.  Whereas a liberty-oriented message might suggest that vaccines can help parents to take personal control of a child’s health so that they are free to live a happy and healthy life.

While such messaging has yet to be tested, these studies, and others like this, are critical to helping us develop more effective communication, and should be a consideration for all of us who engage with vaccine hesitant parents in the doctor’s office, on the internet or at the playground.

 

How One Man is Credited With Saving 8 Million Lives a Year  

November 17, 2017 Leave a comment

Saving 8 million lives a year may seem like a stretch, but not for Dr. Maurice Hilleman.

Hilleman_scope2Hailed as one of the world’s greatest scientists, Dr. Hilleman helped develop 9 of the 14 routinely recommended vaccines in the U.S. And in 1957, he was the first person to successfully predict an influenza pandemic when he read of an outbreak occurring in Hong Kong. This led him to develop a vaccine for the U.S. that likely saved hundreds of thousands of lives. His life spanned one of the most productive periods in vaccine innovation, and since Dr. Hilleman was right in the middle of it, his life story is truly inspiring.  Fortunately for science enthusiasts, it is now the focus of a new vaccine-related documentary, HILLEMAN: A Perilous Quest to Save the World’s Children.

Developed as part of the Vaccine Makers Project, produced by Medical History Pictures and sponsored by the Vaccine Education Center at Children’s Hospital of Philadelphia (CHOP), the film includes exclusive interviews with Dr. Hilleman and his peers, rare archival footage, and 3-D animations.

The film is meant to not only introduce Dr. Hilleman and his amazing accomplishments, but to also describe the incredible scientific discovery and effort required to create safe and effective vaccines.

Over the last several months, the film has been shown by institutions such as the Smithsonian’s National Museum of American History, the National Foundation for Infectious Diseases, and the Bill & Melinda Gates Foundation. HILLEMAN has also been featured at immunization coalition conferences and national professional meetings, including the American Academy of Pediatrics, National Association of School Nurses, National Science Teachers Association, and National Association of Biology Teachers.

To complement the film, the Vaccine Makers Project has developed comprehensive educational materials for elementary, middle, high school and college students. 

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Educators are encouraged to utilize this flexible curriculum in whole or part to support learning objectives related to infectious diseases, the immune system, and how humans fight disease through technologies such as vaccines.

The Vaccine Makers Project has also collaborated with Families Fighting Flu (FFF) to present an eight-minute excerpt of HILLEMAN: A Perilous Quest to Save the World’s Children to remind families of the importance of annual influenza vaccines. Families Fighting Flu has made the film a central component of its fall awareness efforts. According to Serese Marotta, Chief Operating Officer of Families Fighting Flu,

“Every year, we remind families of the importance of influenza vaccination, often with members of our organization sharing their own personal experiences. This year, we hope that by sharing the film clip along with our personal stories, even more families will be compelled to prioritize influenza vaccination for themselves.”

Visit the Vaccine Makers Project to view a list of upcoming film screenings, gain access to the free educational materials, or to make an inquiry about the project.

For more information about influenza, visit the Vaccine Education Center at Children’s Hospital of Philadelphia for an in-depth look at the flu vaccine and an influenza fact sheet.  And visit the Families Fighting Flu website to read stories of families who have been adversely affected by flu, view flu facts and download the Community Toolkit and other educational materials

Scientists Travel to Remote Village in Search of Clues to Monkeypox Virus

November 4, 2017 Leave a comment

In this day of globalization, outbreaks of infectious diseases that begin in remote villages in far away countries can reach major cities on any continent in a matter of days.  To complicate matters, animal-borne infectious diseases that jump to humans are on the rise and there is still so much we don’t know about these diseases.

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“Understanding the virus and how it spreads during an outbreak is key to stopping it and protecting people from the deadly disease.” Lena H. Sun, The Washington Post

As an example, reports of monkeypox, a rare but fatal disease, have been on the rise since late last year. Monkeypox is a cousin to the deadly smallpox virus which initially infects people through contact with wild animals (though not necessarily monkeys) which is then spread from person to person. The disease produces a fever and a rash that often turns into painful lesions. Even though most people have never heard of monkeypox, the U.S. government has included it on their list of pathogens with the greatest potential to threaten human health.  

The concern with monkeypox is that there is still so much we don’t know about the disease. However, what we do know is that there is no cure and it is deadly in 1 out of 10 of its victims. 

So, while some parents in the U.S. have spent the year fighting for their right to exempt their children from school-required vaccines, human cases of monkeypox have been reported in Liberia, Sierra Leone, Congo Republic, the Central African Republic and, most recently, Nigeria.

But that doesn’t mean monkeypox isn’t a threat to the U.S.  In fact, according to the Washington Post, the U.S. “experienced a monkeypox outbreak in 2003 when an exotic pet dealer imported 800 animals from Africa, including giant pouched rats, dormice and rope squirrels”, some of which were believed to be infected with monkeypox. While the animals were in a facility in Illinois, some of them infected prairie dogs that were later sold as pets and 47 people in six Midwestern states were sickened.

As of January, the Congo Republic of Africa has been experiencing an outbreak of monkeypox that has since spread to at least 88 suspected cases throughout the country, with 6 documented deaths so far.  Out of concern for this outbreak, the Congolese government recently invited researchers from the Centers for Disease Control and Prevention (CDC) to their country to help track the disease and train local scientists.

As American scientists traveled deep into the Congo rain forest to a village at the epicenter of the outbreak, a Washington Post reporter and photographer had the rare opportunity to accompany them. Their amazing journey, and the fascinating work that the scientists did there, is featured in a special Washington Post story entitled CHASING A KILLER.

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The article chronicles the trip from Atlanta to the Congo Republic, and details the specific efforts made to sample the animal population and bring those samples back to Atlanta for analysis. Not only does the story unfold like a novel, but the photography captures the primitive conditions and the importance of this continuing work.

Hopefully, readers will appreciate the ongoing efforts that are being made to not only improve global health, but to protect our public health here in America.