Vaccines: The Week in Review

9 August 2010
Center for Vaccine Ethics & Policy
http://centerforvaccineethicsandpolicy.wordpress.com/
A program of
- Center for Bioethics, University of Pennsylvania
http://www.bioethics.upenn.edu/
- The Wistar Institute Vaccine Center
http://www.wistar.org/vaccinecenter/default.html
- Children’s Hospital of Philadelphia, Vaccine Education Center
http://www.chop.edu/consumer/jsp/microsite/microsite.jsp

This weekly summary targets news and events in the global vaccines field gathered
from key governmental, NGO and company announcements, key journals and
events. This summary provides support for ongoing initiatives of the Center for
Vaccine Ethics & Policy, and is not intended to be exhaustive in its coverage.
Vaccines: The Week in Review is now also posted in a blog format at
http://centerforvaccineethicsandpolicy.wordpress.com/. Each item is treated as an individual
post on the blog, allowing for more effective retrospective searching. Given email
system conventions and formats, you may find this alternative more effective. This
blog also allows for RSS feeds, etc.
Comments and suggestions should be directed to
David R. Curry, MS
Editor and
Executive Director
Center for Vaccine Ethics & Policy
david.r.curry@centerforvaccineethicsandpolicy.org

[Editor’s Note: Vaccines: The Week in Review will resume publication

on 30 August 2010 and will provide a summary of news,
announcements and journal activity covering the intervening period
from 9 August 2010]

The WHO continues to issue weekly updates and occasional briefing notes
on the H1N1 pandemic at
http://www.who.int/csr/disease/swineflu/en/index.html
Pandemic (H1N1) 2009 - update 112
Weekly update
6 August 2010
As of 1 August 2010, worldwide more than 214 countries and overseas
territories or communities have reported laboratory confirmed cases of
pandemic influenza H1N1 2009, including over 18449 deaths….
Situation update:
The overall situation remains largely unchanged since the last update.
Globally, pandemic influenza transmission remains most active in parts of
South Asia and in limited areas of tropical South and Central America. In the
temperate zone of the southern hemisphere, overall seasonal and pandemic
influenza activity remains low, except in South Africa, where peak wintertime
influenza transmission due to circulating seasonal influenza viruses (H3N2
and type B) might have recently occurred. Seasonal influenza viruses,
particularly H3N2 viruses, continue to circulate in parts of Central America,
East Africa, and Southeast Asia…
http://www.who.int/csr/don/2010_08_06/en/index.html

[Editor’s Note: We will occasionally include announcements by commercial

organizations that pertain to vaccine ethics and policy issues we are tracking,
such as strategies to enhance influenza vaccine uptake. We make no
endorsement of the strategy or assessment of its potential impact or
propriety.]
Walgreens Offering Flu Shot Gift Cards
Walgreens, describing itself as “the largest retail provider of flu prevention
services with more than 24,000 certified immunizers,” said it introduced the
flu shot gift card as “a way to help more Americans stay well throughout the
upcoming flu season by giving the gift of a flu shot.” Kermit R. Crawford,
Walgreens executive vice president of pharmacy, commented, “Whether you
have college kids going back to school or have friends, co-workers or family
members you want to protect this flu season, the flu shot gift card is a
thoughtful way to make it even easier for them to get a flu shot at Walgreens.
While millions of Americans are diligent about getting a flu shot every year,
gift cards may also help those who might not otherwise take the initiative to
get a flu shot. With these gift cards, you can help protect those closest to
you.”
http://www.businesswire.com/portal/site/home/permalink/?
ndmViewId=news_view&newsId=20100803006837&newsLang=en

The Pharmaceutical Research and Manufacturers of America

(PhRMA) issued the following statement today regarding efforts to
enhance transparency:
“PhRMA and its member companies have a longstanding commitment to
the ethical conduct of clinical trials and to increasing transparency by
reporting more information about clinical trials.
“We are always looking for ways to enhance our voluntary industry codes
and, to this end, supported a joint position statement in June with the
International Federation of Pharmaceutical Manufacturers & Associations to
enhance publication of clinical research. The joint statement calls for
publication of summaries of all Phase III clinical trials and all clinical trials of
significant medical importance in peer-reviewed journals.
“PhRMA’s commitment to enhanced transparency of clinical research is in
addition to our member companies’ unanimous support of PhRMA’s recently
revised Principles on Conduct of Clinical Trials and Communication of Clinical
Trial Results, which call for registration and online publication of summaries
of all clinical trials in patients for approved medicines. What’s more, PhRMA’s
Clinical Trial Principles also call for our member companies to disclose
summaries of all clinical trials in patients for investigational medicines whose
development programs have been discontinued.
“It is our hope that the additional transparency of PhRMA’s member
companies will benefit patients and healthcare professionals. PhRMA has also
supported continued development of the federal clinical trial database,
ClinicalTrials.gov.
“The study, published today by the ‘Annals of Internal Medicine,’
demonstrates one more way that patients and the public health can benefit
from increased transparency: The study would not have been possible
without the large volume of information about ongoing and completed
industry-sponsored clinical trials provided through ClinicalTrials.gov and
supported by PhRMA and its member companies.
“While our review of the study continues, it is important to note that the
authors acknowledge that industry-funded trials tended to be for later stages
in the lengthy drug development process. As the authors note, ‘Later-phase
trials may be more likely to have positive outcomes, because there is more
certainty about the drug’s efficacy and safety at this advanced stage in the
drug-development cycle.’
“Developing a new medicine is costly, time-consuming and the odds of
success are quite low. At the earliest stage of discovery, researchers closely
analyze up to 10,000 compounds of interest. By the time clinical tests occur
in humans, more than 10 years later, promising therapies have been
winnowed from the thousands to single digits.
“PhRMA companies lead the world in the search for new cures. Our member
companies invested an estimated $45.8 billion in 2009 alone to discover and
to develop new medicines.” (August 2, 2010)
http://www.phrma.org/news/news/phrma_statement_supporting_enhanced_tr
ansparency

The Weekly Epidemiological Record (WER) for 6 August 2010, vol.

85, 32 includes: Rabies vaccines: WHO position paper
http://www.who.int/wer/2010/wer8532.pdf

Journal Watch
[Editor’s Note]
Vaccines: The Week in Review continues its weekly scanning of key journals
to identify and cite articles, commentary and editorials, books reviews and
other content supporting our focus on vaccine ethics and policy. Journal
Watch is not intended to be exhaustive, but indicative of themes and
issues the Center is actively tracking. We selectively provide full text of
some editorial and comment articles that are specifically relevant to our
work. Successful access to some of the links provided may require
subscription or other access arrangement unique to the publisher. Our initial
scan list includes the journals below. If you would like to suggest other titles,
please write to David Curry at
david.r.curry@centerforvaccineethicsandpolicy.org

Clinical Infectious Diseases

1 September 2010 Volume 51, Number 5
http://www.journals.uchicago.edu/toc/cid/current
No relevant content]

Emerging Infectious Diseases

Volume 16, Number 8–August 2010
http://www.cdc.gov/ncidod/EID/index.htm
[Reviewed last week]

Human Vaccines
Volume 6, Issue 8 August 2010
http://www.landesbioscience.com/journals/vaccines/toc/volume/6/issue/8/
[Reviewed last week]

JAMA
Vol. 304 No. 5, pp. 497-596, August 4, 2010
http://jama.ama-assn.org/current.dtl
[No relevant content]

Journal of Infectious Diseases

1 September 2010 Volume 202, Number 5
http://www.journals.uchicago.edu/toc/jid/current
EDITORIAL COMMENTARY
Mumps Control Today
M. Patricia Quinlisk
Iowa Department of Public Health, Des Moines
Free: http://www.journals.uchicago.edu/doi/full/10.1086/655395
Viruses
Seroprevalence of Antibody to Mumps Virus in the US Population,
1999–2004
Preeta K. Kutty, Deanna M. Kruszon-Moran, Gustavo H. Dayan,
James P. Alexander, Nobia J. Williams, Philip E. Garcia, Carole J. Hickman,
Geraldine M. McQuillan, and William. J. Bellini
Abstract
Background. In 2006, the largest mumps outbreak in the United States in 20
years occurred. To understand prior mumps seroprevalence and factors
associated with the presence of antibody to mumps virus, data from the
1999–2004 National Health and Nutrition Examination Survey (NHANES) were
analyzed.
Methods. A mumps virus–specific enzyme immunoassay was used to
measure the seroprevalence of serum immunoglobulin G (IgG) antibody
among NHANES participants aged 6–49 years. Participants were grouped on
the basis of 10‐year birth cohorts, 95% confidence intervals (CIs) were
calculated using SUDAAN software, and logistic regression was used to
identify independent predictors.
Results. The overall age‐adjusted seroprevalence of IgG antibody to mumps
virus during 1999–2004 was 90.0% (95% CI, 88.8%–91.1%). Seroprevalence
was higher among US-born non-Hispanic blacks (96.4% [95% CI, 95.5%–
97.2%]) and non–US-born Mexican Americans (93.7% [95% CI, 92.0%–
95.2%]). Seroprevalence was significantly lower in the 1967–1976 birth
cohort (85.7% [95% CI, 83.5%–87.8%]). The variables sex, education, and
race/ethnicity/birthplace were independent predictors in at least 1 of the birth
cohorts.
Conclusions. The overall estimate of 90.0% is at the lower end of the
estimated population immunity (90%–92%) needed to achieve herd
immunity. Lower seroprevalence among groups suggest that they represent
populations at an increased risk. For mumps control, high vaccine coverage
and high population immunity must be achieved and maintained.

The Lancet
Aug 07, 2010 Volume 376 Number 9739 Pages 389 - 486
http://www.thelancet.com/journals/lancet/issue/current
[No relevant content]

The Lancet Infectious Disease

Aug 2010 Volume 10 Number 8 Pages 505 - 576
http://www.thelancet.com/journals/laninf/issue/current
[Reviewed last week]

Nature
Volume 466 Number 7307 pp667-788 5 August 2010
http://www.nature.com/nature/current_issue.html
[No relevant content]

Nature Medicine
August 2010, Volume 16 No 8
http://www.nature.com/nm/index.html
Technical Reports
Dissolving polymer microneedle patches for influenza vaccination
Sean P Sullivan, Dimitrios G Koutsonanos, Maria del Pilar Martin, Jeong Woo
Lee, Vladimir Zarnitsyn, Seong-O Choi, Niren Murthy, Richard W Compans,
Ioanna Skountzou & Mark R Prausnitz
Abstract
Influenza prophylaxis would benefit from a vaccination method enabling
simplified logistics and improved immunogenicity without the dangers posed
by hypodermic needles. Here we introduce dissolving microneedle patches
for influenza vaccination using a simple patch-based system that targets
delivery to skin's antigen-presenting cells. Microneedles were fabricated
using a biocompatible polymer encapsulating inactivated influenza virus
vaccine for insertion and dissolution in the skin within minutes. Microneedle
vaccination generated robust antibody and cellular immune responses in
mice that provided complete protection against lethal challenge. Compared
to conventional intramuscular injection, microneedle vaccination resulted in
more efficient lung virus clearance and enhanced cellular recall responses
after challenge. These results suggest that dissolving microneedle patches
can provide a new technology for simpler and safer vaccination with
improved immunogenicity that could facilitate increased vaccination
coverage.

New England Journal of Medicine

August 5, 2010 Vol. 363 No. 6
http://content.nejm.org/current.shtml
[No relevant content]

The Pediatric Infectious Disease Journal

August 2010 - Volume 29 - Issue 8
http://journals.lww.com/pidj/pages/currenttoc.aspx
[Reviewed last week]

Pediatrics
http://pediatrics.aappublications.org/current.shtml
August 2010 / VOLUME 126 / ISSUE 2
[No relevant content]

PLoS Medicine
(Accessed 9 August 2010)
http://medicine.plosjournals.org/perlserv/?request=browse&issn=1549-
1676&method=pubdate&search_fulltext=1&order=online_date&row_start=1
&limit=10&document_count=1533&ct=1&SESSID=aac96924d41874935d8e1
c2a2501181c#results
Ecology: A Prerequisite for Malaria Elimination and Eradication
Heather M. Ferguson, Anna Dornhaus, Arlyne Beeche, Christian Borgemeister,
Michael Gottlieb, Mir S. Mulla, John E. Gimnig, Durland Fish, Gerry F. Killeen
Policy Forum, published 03 Aug 2010
doi:10.1371/journal.pmed.1000303
Summary Points
- Existing front-line vector control measures, such as insecticide-treated nets
and residual sprays, cannot break the transmission cycle of Plasmodium
falciparum in the most intensely endemic parts of Africa and the Pacific
- The goal of malaria eradication will require urgent strategic investment into
understanding the ecology and evolution of the mosquito vectors that
transmit malaria
- Priority areas will include understanding aspects of the mosquito life cycle
beyond the blood feeding processes which directly mediate malaria
transmission
- Global commitment to malaria eradication necessitates a corresponding
long-term commitment to vector ecology
Assessing Strategy and Equity in the Elimination of Malaria
Naman K. Shah Essay, published 03 Aug 2010
doi:10.1371/journal.pmed.1000312
Summary Points
- Recent dialogue around malaria elimination is laden with implicit
assumptions.
- While the elimination of malaria may be both feasible and equitable in a few
areas, globally the control tools that successfully reduce malaria burden may
not be sufficient to interrupt transmission over long periods of time.
- A malaria elimination strategy may inadvertently increase inequity.

Science
6 August 2010 Vol 329, Issue 5992, Pages 597-712
http://www.sciencemag.org/current.dtl
[No relevant content]

Science Translational Medicine

4 August 2010 vol 2, issue 43
http://stm.sciencemag.org/content/current
[No relevant content]

Vaccine
Volume 28, Issue 35, Pages 5653-5756 (9 August 2010)
http://www.sciencedirect.com/science/journal/0264410X
[Reviewed earlier]