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Basic Information About Vaccines
Vaccines are widely considered to be one of mankind’s greatest life saving inventions, along with water purification, sanitation, antibiotics, and nitrogen fertilizers (that ensure an adequate food supply). To illustrate just how great a job vaccines have done combatting infections diseases, check out the video in The Vaccination Effect: 100 Million Cases of Contagious Disease Prevented. You might also want to take a look at The History of Vaccines website, an educational resource assembled by the College of Physicians of Philadelphia. The CDC has produced a nice video for parents explaining How Vaccines Work with their babies immune system. And vaccines aren’t just for kids. Adults need vaccinations too, as explained on this resource page from the WA State Department of Health.
Finally, if you want to see the power of vaccines in one graphic, look at van Panhuis et al Contagious Diseases in the United States from 1888 to the Present. N Engl J Med. 2013 Nov 28; 369(22): 2152–2158. doi: 10.1056/NEJMms1215400. Focus your attention on Figure 2, which beautifully illustrates how effective many vaccines have been in the U.S. over time. I’ve reproduced it here:
If you want to learn about how vaccines are designed, check out this article which details the various factors that go into making the decision about how to develop the vaccine. Here are some of the options:
1. Killed/inactivated - virulent organisms that have been deactivated in some way, such as chemical or heat treatment. Examples include polio and hepatitis A.
2. Toxoid – a purified toxic component that causes the disease that has been inactivated, often chemically or via the use of heat. Tetanus and botulism vaccines are good examples.
3. Live attenuated – live organisms that have been disabled in some manor (via gene mutation or deletion – be it naturally through passaging or by genetic/chemical engineering) that makes them none pathogenic, for example yellow fever, tuberculosis (TB), MMR and Salmonella typhimurium.
4. Protein subunit – purified proteins of a microorganism are used to generate a productive immune response, for example some influenza vaccines. New vaccines using recombinant expression of components in Escherichia coli are currently in development. Recombinant proteins that constitute a viral capsid protein make up the current HPV vaccine Gardasil 9.
5. DNA – insertion of DNA into vaccinated individuals that is capable of expressing a component of the infectious microorganism and inducing a productive immune response.
6. Conjugate carbohydrate – normally contains a carbohydrate expressed on the surface of a microorganism that is used to produce immunity, linked to an adjuvant like cholera toxin. Examples are the vaccines to prevent infection with Streptococcus pneumoniae.
The Hot Zone: The Terrifying True Story of the Origins of the Ebola Virus by Richard Preston (1995)
Vaccinated: One Man's Quest to Defeat the World's Deadliest Diseases by Paul A. Offit (2008)
Spillover: Animal Infections and the Next Human Pandemic by David Quammen (2012)
Polio: An American Story by David M. Oshinsky (2006)
The Cutter Incident: How America's First Polio Vaccine Led to the Growing Vaccine Crisis by Paul A. Offit (2007)
Vaccines: What Everyone Needs to Know by Kristen Feemster, MD (2017)
The Vaccine Race: Science, Politics, and the Human Costs of Defeating Disease by Meredith Wadman (2017)
Complete Idiot’s Guide to Vaccinations by Michael J. Smith, MD and Laurie Bouck (2009)
On the other side of the coin are books that illustrate the fallacious thinking of the anti-vaccine movement:
The Panic Virus: The True Story Behind the Vaccine-Autism Controversy by Seth Mnookin (2011)
There are also two other books I can recommend to learn more about the anti-vaccine movement. Both were written by Dr. Paul Offit, a very well known vaccine expert who led a successful effort to develop a vaccine against rotavirus (which can cause fatal diarrhea). This vaccine is saving the lives of hundreds of children across the world every day.
Deadly Choices: How the Anti-Vaccine Movement Threatens Us All (2012)
Bad Advice: Or Why Celebrities, Politicians, and Activists Aren’t Your Best Source of Health Information (2018)
In these books Dr. Offit explains why you shouldn’t be getting your healthcare advice from Gwyneth Paltrow and her ilk? He also explains why he seldom gets in front of the public to argue with anti-vaxxers. Check out Paul Offit’s latest book Bad Advice: Or Why Celebrities, Politicians, and Activists Aren’t Your Best Source of Health Information. This second book is a fast read and basically covers two ideas. About half of the book explains why much of the information available from people with no training in medicine or science is at best mostly worthless and at worst sometimes dangerous. He also gives some very good advice for scientists who are planning on engaging with the press to challenge this bad information. Much of this advice is based on his (few) professional career missteps and is meant to guide you to best handle (and hopefully avoid) lawsuits, death threats, biased debate moderators, and ineffective arguments from those you engage with.
Organizations That Study and Promote Vaccine Safety
Centers for Disease Control and Prevention (US)
Provides fact sheets with FAQ on various current vaccine safety topics, including HPV.
National Vaccine Program Office (US)
This website contains general information about vaccines and immunization-related activities ongoing at the U.S. federal level. This includes vaccine development, testing, licensing, production, procurement, and distribution.
Infectious Diseases Society of America (US)
Works to develop guidelines for doctors on the treating of infectious diseases. There is no specific focus on HPV.
Institute for Vaccine Safety (US)
This group was established in 1997 at Johns Hopkins University. It was put together to provide an independent assessment of vaccines and vaccine safety. It’s goal is to help educate physicians, the public and the media about key issues surrounding the safety of vaccines. Their HPV vaccine page can be found here.
Global Advisory Committee on Vaccine Safety (part of the World Health Organization, based in Geneva, Switzerland)
Established in 1999 to respond promptly, efficiently, and with scientific rigor to vaccine safety issues of potential global importance. Updates and news can be found on their Vaccine Safety Net Portal.
Global Vaccine Safety Initiative (part of the World Health Organization, based in Geneva, Switzerland)
In 2011, WHO and others developed a strategic document on vaccine safety called the Global Vaccine Safety Blueprint. This document sets out indicators that aim to ensure that all countries have at least a minimal capacity to ensure vaccine safety. The document contains a strategic plan for strengthening vaccine safety activities globally by building national capacity for vaccine safety in the world’s poorest countries. The Global Vaccine Safety Initiative acts to implement the Blueprint strategy.
HPV Prevention and Control Board (Belgium)
This board was created in 2015 with the aim to share relevant information on HPV with a broad array of stakeholders. It’s composed of a group of ‘core’ experts, who set the strategy and define its actions. The HPV Board is located at the Vaccine & Infectious Disease Institute (VAXINFECTIO) of the University of Antwerp.
The Vaccine Confidence Project (UK)
The project is housed within the London School of Hygiene & Tropical Medicine. According to their website, The purpose of the project is to monitor public confidence in immunization programs by building an information surveillance system for early detection of public concerns around vaccines; by applying a diagnostic tool to data collected to determine the risk level of public concerns in terms of their potential to disrupt vaccine programs; and, finally, to provide analysis and guidance for early response and engagement with the public to ensure sustained confidence in vaccines and immunization.
International Vaccine Institute (Korea)
Their mission is quite simple: Discover, develop and deliver safe, effective and affordable vaccines for global public health.
Vaccination Resources in WA State
Where I live, in Seattle, we have an “immunity community” that works to advocate for all vaccines, not just the HPV vaccine. The group, Vax Northwest, is a partnership of six organizations: BestStart Washington, the Washington Chapter of the American Academy of Pediatrics, Kaiser Permanente, Seattle Children’s Hospital, the Washington State Department of Health, and WithinReach (which both supports and staffs the partnership). Vaccines aren’t just for kids. Adults need vaccinations too, as explained on this resource page from the WA State Department of Health.
They also offer the following e-courses:
Vaccine Training for Medical Assistants
There Never Was An Age of Reason - Vaccine Hesitancy
You Are the Key to HPV Cancer Prevention