Cytomegalovirus (CMV) Vaccine 1

Cytomegalovirus (CMV) Vaccine: What will it take?

Roxanne Morris

College Composition II – CM220-07na

Professor Gabriel A. Smith

 Cytomegalovirus (CMV) Vaccine 2

A young girl of seventeen waits nervously in a doctor’s office with her mother. She is

pregnant. The worst of the news, however, is not that she will be a teen mom. It is that the baby

she carries will be severely disabled by a virus she has never even heard of. The doctor walks in

silently with a grave look on his face. “Young lady…,” the doctor says. ”I don’t know how to put

this to you gently so I will just say it. You are pregnant and the pregnancy should be terminated

immediately.” The young girl caught the words square on her shoulders as the color drained from

her cold face. “Let’s go for a walk,” says the doctor. Room by room he parades her by many

severely handicapped and disfigured children, some of whom were unable to even lift their own

heads. The young girl slowly began to realize why she had been referred to a high risk Ob/Gyn.

“No.,” whispered the horrified teenager as she turned to face the ominous doctor, “I would die

for this child.” To which the doctor replies flatly, “Think carefully young lady. You might.” The

baby in this story is now a beautiful ten year old girl, a sister, a daughter, and her name is Amber

Elizabeth.

Amber was permanently disabled by a virus called Cytomegalovirus, also referred to as

CMV. Amber was born full term after a very complicated pregnancy. Six months of bed rest and

constant medication did little to protect the baby from the damage being done by the congenital

CMV infection. Amber was born with hydrocephalus (also known as water on the brain) for

which she required brain surgery to place a shunt just 3 days after her birth. This shunt has been

infected and/or revised 16 times. Cerebral Palsy, brought on by the infection, prevented Amber

from walking until she was almost three years old. The damage to her brain caused her

permanent hearing loss and a quite violent seizure disorder. She remained in the hospital for the

first two years of her life and many after that. This virus may have been avoided had there been a

vaccine. To this day ten years later there is no effective vaccine to eradicate the “world’s leading
 Cytomegalovirus (CMV) Vaccine 3

cause of long-term medical conditions and disabilities in children”[ CITATION Cennd \l 1033 ].

It would be a senseless tragedy for another woman to stand before a doctor with shards of her

reality crashing down at her feet. The human suffering and heartbreak this virus brings to

families all over America and across the world has got to cease. There needs to be a vaccine.

Many experts agree that the vaccine will not likely enter the development stage without the

support of government agencies [ CITATION Stand \l 1033 ]. United States government

agencies must offer public funding support for the development of a CMV vaccine to protect the

nation from a CMV epidemic.

Although CMV is a quickly spreading and devastating virus, there is not much awareness

among the American public. Cytomegalovirus is a disease that causes permanent disability in 1

of 750 children born each year. The virus is spread through contact with urine, saliva, blood, and

semen. The catch is that it is most common in young children. Much like the Varicella virus

(Chicken Pox), CMV is considered mostly a childhood disease. Although the virus can be spread

through sexual contact, the spread is most often due to contact with the urine or saliva of young

children. If a woman who has never been infected by the virus has a primary (first) infection

during pregnancy, there is a 33% chance of passing the infection to the infant. Among the

children born with a congenital CMV infection, there is a 1 in 5 chance of them developing

permanent disabilities or hearing loss [ CITATION Nat06 \l 1033 ]. Many mothers will not learn

of this virus, or how to avoid infection, until after it has permanently disabled their new born

baby. According to a figure from the Center for Disease Control and Prevention (CDC) website,

CMV has the least percentage of awareness among women of all the conditions that can affect

children with only 22% of women having ever heard of it (Fig. 1). It is astounding to think that

so few women are educated about this virus when a reported 5,500 children are born each year
 Cytomegalovirus (CMV) Vaccine 4

with permanent disability due to CMV infection (Fig. 2). CMV actually affects more children

than any other widely known cause of disability, such as Fetal Alcohol Syndrome, Down

syndrome (Trisomy 21), or Spina Bifida. With so many children affected by the virus each year,

the virus has earned itself the title of the “Disabilities Virus.” The virus can only be passed to a

fetus if the mother has contracted it for the first time during pregnancy. Once the woman has

been exposed to the virus she carries the antibodies for the rest of her life and it no longer poses a

threat to future pregnancies, so the infection goes untested and undiscovered[ CITATION Ist98 \l

1033 ]. In fact, the National Vaccine Advisory Committee states that Congenital CMV disease is

not reportable to the CDC, although estimates say it impacts thousands of children born each

year. The Institute of Medicine considers CMV at the top priority in vaccine development due to

the costs and years of suffering that would be avoided by a successful vaccine [ CITATION

Stand \l 1033 ]. With no way to accurately report CMV there is no demand for the vaccine.

The only way to create a demand for this vaccine is to raise public awareness. This is

where support from government agencies is vital. Entities such as the Centers for Disease

Control and Prevention (CDC), the Health and Human Services Commission, and the American

Medical Association have an obligation to the public to educate them on potential health hazards

they may be encountering day by day. When someone goes into a Doctor’s office, one of the first

things they will see is a table or wall full of pamphlets on different viruses and medications.

Literature on this virus and ways to prevent it should be in the waiting rooms of every OB/GYN

and pediatrics office in America. Another form of public awareness to consider is public service

announcements. Most people have seen late night public service announcements, and may

possibly be able to quote a few because they work. The media is a great way to spread the word

in the information age. A great way to spread awareness among the medical community would
 Cytomegalovirus (CMV) Vaccine 5

be to hold a forum to discuss the many symptoms that can manifest during a symptomatic CMV

infection. Medical professionals from every discipline could discuss means of treatment for the

symptoms associated with the virus. Much of the public awareness efforts for CMV are being

made by the mothers of CMV children. Organizations such as the Brendan B. McGinnis

Foundation and Stop CMV: The CMV Action Network are comprised of primarily parents,

family, friends, and medical professionals personally affected by CMV. Thanks to the internet,

families all over the world are getting connected to share their knowledge of the disease and

possible therapeutic treatments. With public awareness and more accurate reporting the demand

for a vaccine will be undeniable. As stated before development of the vaccine will not likely

occur without the support of government agencies. Public funding by agencies like the Centers

for Disease Control and Prevention, Department of Health and Human Services, and American

Medical Association are necessary to launch a public awareness campaign on a global scale.

Unfortunately, support by these government agencies depends heavily on the vaccine’s

development being proven cost effective.

The actual figures associated with CMV not only prove the development of a vaccine to

be cost effective, but also show the enormous spectrum of human suffering that could be avoided

in thousands of children around the world. In 2003, the National Vaccine Advisory Committee

estimated the economic burden associated with CMV to cost the US health care system around

$1.86 billion annually, with a cost per child of more than $300,000. With these numbers it is

astounding that the government offers very little support to the vaccine’s development.

Especially when taking into consideration that the estimated cost of a child with Rubella was

merely $200,000 a year before a vaccine was created, $100,000 a year less than CMV

[ CITATION Stand \l 1033 ]. Thus, the impact of congenital CMV infection is profound
 Cytomegalovirus (CMV) Vaccine 6

economically and in human suffering. Amber received 42 doses of Gancyclovir to treat the

effects of the virus after birth. The price of each dose was estimated to be around $40,000 dollars

a dose by the Infectious Disease doctor over her case. By these estimates the therapeutic antiviral

drugs she took for 8 weeks was over $320,000 of public funds spent just to combat hearing loss.

Still, many government agencies see the vaccine’s development as not cost effective. What is it

really worth to save an unborn baby from a lifetime of disability and pain?

Although disability is a devastating diagnosis for any child there are also many children

out there that lose the battle with CMV. Many CMV babies are stillborn and many more die at a

very early age from complications associated with the virus. Many children pass away in their

sleep after being tucked in at night by their Mommy and Daddy. Children sometimes endure

years of pain and surgery only to lose their battle to a post operative infection. Babies are the

most precious and fragile of God’s children and CMV babies are the most precious and fragile of

all babies. CMV babies are sometimes deaf, blind, unable to walk, and unable to communicate.

Worse still are the children that must be fed by tubes to get nutrition. CMV babies that are

affected by lung disorders are hooked to ventilators and can aspirate their own saliva. This

usually leads to a case of fatal pneumonia. Parents have all kinds of hopes and dreams for their

unborn children. The dream that they will someday teach their baby to catch a ball or ride a bike

often becomes nothing more than haunting regrets. The longing to hear their child say “I love

you!” must be pushed aside to focus on the basic needs of a chronically ill child. It is said that

parents have this natural urge to protect their children at all costs, but when CMV has taken hold

of a child there is nothing you can do to protect them.

Ten years after beginning the battle with this lifelong illness, Amber is still struggling

with learning to overcome her disabilities. Amber has undergone 16 brain surgeries for
 Cytomegalovirus (CMV) Vaccine 7

hydrocephalus, a symptom of congenital CMV infection. She takes 300 mg of seizure

medication a day to maintain her epilepsy. Her Cerebral Palsy affects her only in the slightest

ways, prohibiting her from being potty trained and impeding her lower extremity dexterity. She

is deaf as well. Amber will never be able to call for her mommy or say, “I love you.” There is

nothing anyone can do to repair the damage this virus has done to her, but there is something that

can be done to honor her struggle. The government and the public can come together to educate

the world on the virus that causes permanent disability for approximately 1 in every 750 children

born in the United States[ CITATION Nat06 \l 1033 ]. What is the price of protecting babies

from a deadly virus? Is money really worth more than the relief of human suffering? To learn

more about Cytomegalovirus and Amber’s struggle visit www.cmvmom.com.

 Cytomegalovirus (CMV) Vaccine 8

 
Figure 1. CDC Data & Statistics | Feature: Cytomegalovirus (CMV) Disease: The Congenital Disease Mothers Don’t Know About
http://www.cdc.gov/Features/dsCytomegalovirus/
Screen clipping taken: 7/28/2010, 9:16 PM
 

Figure 2. CDC Data & Statistics | Feature: Cytomegalovirus (CMV) Disease: The Congenital Disease Mothers Don’t Know About
http://www.cdc.gov/Features/dsCytomegalovirus/
Screen clipping taken: 7/28/2010, 9:15 PM
 Cytomegalovirus (CMV) Vaccine 9

References
National Center for Immunization and Respiratory Diseases. (2006, Februaury 06).

Cytomegalovirus. Retrieved July 11, 2010, from Center for Disease Control and

Prevention: http://www.cdc.gov/cmv/facts.htm

Arvin, A. M., Fast, P., Myers, M., Plotkin, S., & Rabinovich, R. (2000, October). The National

Vaccine Advisory Committee (NVAC). Retrieved July 28, 2010, from U.S. Department of

Health and Human Services: http://www.hhs.gov/nvpo/nvac/vaccines21cer.html

Arvin, A. M., Fast, P., Myers, M., Plotkin, S., & Rabinovich, R. (2003). The National Vaccine

Advisory Committee (NVAC). Retrieved July 28, 2010, from U.S. Department of Health

and Human Services: http://www.hhs.gov/nvpo/nvac/vaccines21cer.html

Center for Disease Control. (n.d.). Cytomegalovirus (CMV) Disease: The Congenital Disease

Mothers Don’t Know About. Retrieved August 05, 2010, from www.cdc.gov:

http://www.cdc.gov/Features/dsCytomegalovirus/

Istas, A. (1998). What everyone should know about CMV. Retrieved July 28, 2010, from

National CMV disease Registry:

http://www.bcm.edu/web/pediatrics/documents/CMV_Brochure_eng.pdf