Vaccines: The Week in Review – 31 August 2013

Vaccines: The Week in Review is a weekly digest — summarizing news, events, announcements, peer-reviewed articles and research in the global vaccine ethics and policy space. Content is aggregated from key governmental, NGO, international organization and industry sources, key peer-reviewed journals, and other media channels. This summary proceeds from the broad base of themes and issues monitored by the Center for Vaccine Ethics & Policy in its work: it is not intended to be exhaustive in its coverage. You are viewing the blog version of our weekly digest, typically comprised of between 30 and 40 posts below all dated “29 June 2013″
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David R. Curry, MS
Executive Director
Center for Vaccine Ethics and Policy
a program of the
– Division of Medical Ethics, NYU Medical School
– The Wistar Institute Vaccine Center
– Children’s Hospital of Philadelphia Vaccine Education Center
Associate Faculty, Division of Medical Ethics, NYU Medical School

GPEI – Update: Polio this week – As of 28 August 2013

Update: Polio this week – As of 28 August 2013
Global Polio Eradication Initiative
Full report:
[Editor’s extract and bolded text]

:: The outbreak of wild poliovirus type 1 (WPV1) in the Horn of Africa, which affects Somalia, Kenya and Ethiopia, has spread into two new states of Somalia.
:: In Israel, the number of sewage samples which have tested positive for WPV1 has reached 85; one sewage sample collected in West Bank and Gaza has tested positive for WPV1.

:: One new case of WPV was reported in the past week, a WPV1 from FR Bannu in the Federally Administered Tribal Areas, with onset of paralysis on 27 July. This is the most recent case in the country and brings the total number of WPV1 cases for 2013 to 25.
:: The total number of cVDPV2 cases for 2013 remains 12.

Chad, Cameroon and Central African Republic
:: In Cameroon, one new cVDPV2 case was reported in the past week, bringing the total number of cVDPV2 cases for 2013 to three. This new case had onset of paralysis on 19 July (from Extreme-Nord).
:: Central African Republic (CAR) continues to be at serious risk of re-infection due to proximity with Chad, ongoing insecurity and humanitarian crises, and destruction of health infrastructure. :: To minimize the risk and consequences of potential re-infection, two subnational immunization campaigns were conducted in June and July. A SNID is planned for September and a NID for October.

Horn of Africa
:: 20 new WPV1 cases were reported in the past week in Somalia and one in Kenya. The total number of WPV1 cases for 2013 is 142 (128 from Somalia, 13 from Kenya, 1 from Ethiopia). The most recent WPV1 case in the region had onset of paralysis on 30 July (from Somalia).
:: The outbreak is spreading geographically in Somalia, with two new states reporting cases: Galgadud and Gedo. Anticipation of this spread has driven intense vaccination activities across the country, in an effort to raise immunity.

Israel and West Bank and Gaza
:: WPV1 has been detected in 85 sewage samples from 27 sampling sites in Israel, collected from 3 February to 18 August 2013. Initially restricted to southern Israel, WPV1 has now also been detected in environmental sampling sites elsewhere in Israel, indicating transmission throughout the country. A sampling site in Tulkarem in the West Bank has also reported a positive sample, collected on 30 June. No case of paralytic polio has been reported in either Israel or the West Bank and Gaza.
:: To interrupt WPV1 transmission, a supplementary immunization activity (SIA) with bivalent oral polio vaccine (OPV) targeting children up to the age of nine years was initiated in the southern district of Israel during the week of 5 August; since August 18, the SIA was expanded to all of Israel. The objective of the SIA with OPV is to boost intestinal immunity in children vaccinated with IPV only in order to rapidly interrupt wild poliovirus transmission.
:: Following the positive sample from Tulkarem, subsequent samples in the West Bank and Gaza have all tested negative. Discussions have begun for a vaccination response to the positive sample in the West Bank.

West Africa
:: One new cVDPV2 was reported in the past week from Niger’s Diffa province, with onset of paralysis on 11 July. Niger has not reported a case of cVDPV since 2011. Genetic sequencing has shown that the virus is related to those seen in Cameroon, Chad and (Borno) Nigeria.

WHO: Global Alert and Response (GAR) – Disease Outbreak News MERS=CoV at 30 August 2013

WHO: Global Alert and Response (GAR) – Disease Outbreak News

Disease outbreak news
Middle East respiratory syndrome coronavirus (MERS-CoV) – update
   30 August 2013 – WHO has been informed of an additional four laboratory-confirmed cases of Middle East respiratory syndrome coronavirus (MERS-CoV) infection in Saudi Arabia.

The first patient is a 55-year-old man with an underlying medical condition from Medina who became ill on 17 August 2013 and is currently hospitalised.

The second patient is a 38-year-old man with an underlying medical condition from Hafar al-Batin who became ill on 8 August 2013 and died on 17 August 2013.

The third and the fourth cases are family contacts of the second patient. Both the cases, a 16-year-old boy and a seven year-old girl, tested positive for the MERS-CoV virus. They are both healthy and do not have any symptoms of illness.

Globally, from September 2012 to date, WHO has been informed of a total of 108 laboratory-confirmed cases of infection with MERS-CoV, including 50 deaths.

Based on the current situation and available information, WHO encourages all Member States to continue their surveillance for severe acute respiratory infections (SARI) and to carefully review any unusual patterns.

Health care providers are advised to maintain vigilance. Recent travellers returning from the Middle East who develop SARI should be tested for MERS-CoV as advised in the current surveillance recommendations…

CDC – National and State Vaccination Coverage Among Adolescents Aged 13–17 Years — United States, 2012

CDC/MMWR Watch [to 31 August 2013]

August 30, 2013 / Vol. 62 / No. 34
National and State Vaccination Coverage Among Adolescents Aged 13–17 Years — United States, 2012
At ages 11 through 12 years, the Advisory Committee on Immunization Practices (ACIP) recommends that preteens receive 1 dose of tetanus, diphtheria, and acellular pertussis (Tdap) vaccine, 1 dose of meningococcal conjugate (MenACWY) vaccine,* and 3 doses of human papillomavirus (HPV) vaccine (13). ACIP recommends administration of all age-appropriate vaccines during a single visit (4). ACIP also recommends that pre-teens and older adolescents receive an annual influenza vaccine as well as any overdue vaccines (e.g., varicella) (1). To monitor vaccination coverage among persons aged 13–17 years,† CDC analyzed data from the National Immunization Survey–Teen (NIS-Teen). This report highlights findings of that analysis.

From 2011 to 2012, coverage increased for ≥1 Tdap vaccine dose§ (from 78.2% to 84.6%), ≥1 MenACWY vaccine dose (from 70.5% to 74.0%) and, among males, ≥1 HPV vaccine dose (from 8.3% to 20.8%). Among females, vaccination coverage estimates for each HPV vaccine series dose were similar in 2012 compared with 2011. Coverage varied substantially among states.

Regarding Healthy People 2020 targets for adolescents (5), 36 states achieved targets for Tdap, 12 for MenACWY, and nine for varicella vaccine coverage. Large and increasing coverage differences between Tdap and other vaccines recommended for adolescents indicate that substantial missed opportunities remain for vaccinating teens, especially against HPV infection    (6).

Health-care providers should administer recommended HPV and meningococcal vaccinations to boys and girls during the same visits when Tdap vaccine is given. In addition, whether for health problems or well-checks, providers, parents, and adolescents should use every health-care visit as an opportunity to review adolescents’ immunization histories and ensure that every adolescent is fully vaccinated.

Statement from PATH: Cervical cancer demonstration project in India

Statement from PATH: Cervical cancer demonstration project in India
30 August 2013
Today, the Indian Parliament’s Standing Committee on Health and Family Welfare released a report critical of a cervical cancer vaccine demonstration project conducted in India from 2009 to 2010 through a collaboration among PATH, the Indian Council of Medical Research (ICMR), and the state governments of Andhra Pradesh and Gujarat.

PATH welcomes public discussion about the role of vaccines in preventing life-threatening diseases such as cervical cancer, and we thank the committee members for their time and effort in reviewing this matter. We support the adoption of reasonable measures to further strengthen and clarify protections for individuals participating in research projects. However, we are troubled by the report’s inaccurate characterization of this important work.

…The demonstration project in India was part of a four-country project to explore suitable vaccine delivery strategies and help provide evidence for national health authorities to make informed decisions about the potential benefits and challenges of introducing vaccines against human papillomavirus (HPV), the primary cause of cervical cancer.

…The ICMR, India’s highest medical research authority, reviewed and approved the protocol for this project, including its design and methodology. At the time of its review, the ICMR determined the project was a post-licensure observational study and not a clinical trial. The project did not seek to evaluate the efficacy or long-term safety of the vaccines, which had already undergone clinical evaluation in India and had been licensed and approved by the Drugs Controller General of India.

The ICMR’s view was crucial, as it established the approval processes and protocols for the work that followed. PATH designed the project protocols in compliance with the ICMR’s instructions and fully complied with the ICMR’s requirements regarding the necessary approval processes and the requirements of state governments regarding consent processes.

We believe that by following the guidance provided by the ICMR, as well as two state governments and three ethical review committees, we designed a project that met or exceeded the country’s existing regulatory standards for demonstration projects while providing the greatest health benefit to Indian women…

–       Full PATH statement:
–       Standing Committee Report: [no link provided in PATH statement; no web version apparent after google search]

Global Fund said it appoints Paul Tuxford as CIO; Jason Clark as Head of Controlling and Program Finance

  The Global Fund said it appointed Paul Tuxford as Chief Information Officer and Jason Clark as Head of Controlling and Program Finance. Mr. Tuxford was most recently at  Credit Suisse where he was Director, Chief Operating Officer – Corporate Services Technology. Before joining Credit Suisse, he worked for Quintiles, a pharmaceutical research company, as Director, Global IT Business Solutions. Mr. Clark joins the Global Fund from RWE AG, one of Europe’s largest electricity and gas companies, where he has acted as Director, Finance and Controlling for the last 10 years, leading a team of about 300 people. Both positions will report to Daniel Camus, Chief Financial Officer.