Category: Vaccine

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America is on the edge of a dangerous ‘vaccine tipping point’ says FDA- amid measles outbreak and record high – Daily Mail

January 18, 2024

By Alexa Lardieri U.S. Deputy Health Editor Dailymail.Com 22:13 17 Jan 2024, updated 22:40 17 Jan 2024

The United States is teetering on the edge of a life-threatening precipice as the number of unvaccinated people has reached a dangerously high level, putting people at risk for preventable deaths, health officials warn.

A new commentary, written by Food and Drug Administration Commissioner Dr Robert Califf andFDAvaccine regulator Dr Peter Marks, warned that vaccine rates are approaching the level at whichthere are not enough healthy vaccinated people to protect those who can't get their shots because they are vulnerable.

The commentary comes as four states are dealing with a measles outbreakand school vaccination rates plummet, with a record high number of families applying for vaccine exemptions.

The commentary said: 'The situation has now deteriorated to the point that population immunity against some vaccine-preventable infectious diseases is at risk, and thousands of excess deaths are likely to occur this season due to illnesses amenable to prevention or reduction in severity of illness with vaccines.'

The team said vaccination was 'one of the most highly effective public health interventions,' adding vaccines have saved millions of lives, undergo rigorous testing to ensure safety and efficacy and are continuously monitored via safety surveillance systems.

Effective vaccine campaigns have eradicated deadly diseases in the US like smallpox and polio.

Measles was similarly eliminated but cases of the disease among unvaccinated people who contract it overseas and return to the US have been on the rise.

This month, four states have reported measles outbreaks. Officials in Pennsylvania, Virginia, New Jersey and Delaware reported nine infections, eight among people who have never received the measles vaccine.

An additional 30 people are being monitored for the disease. Measles is one of the most contagious viral illnesses - several more times contagious than Covid.

The FDA officials wrote: 'Regrettably, pediatric vaccine hesitancy now has been responsible for several measles outbreaks in the US.'

Experts attribute the decline in vaccinations to widespread misinformation, complacency, vaccine mandates and vaccine fatigue.

Recent data from the Centers for Disease Control and Prevention shows a quarter million kindergartners are entering school without their recommended childhood vaccines - and the number of kids with vaccine exemptions has hit a high.

Additionally, for the 2022-2023 school year three percent of kindergartners had a vaccine exemption from one or more required vaccines - an increase from 2.6 percent during the 2021-2022 school year and the highest the US has ever recorded.

As the antivax movement has grown, so have the number of parents requesting vaccine exemptions for their children.

Each state has different guidelines for vaccine requirements and exemptions. While some require all vaccines for kindergarten admission, others may only require a handful at the time, postponing others to future grades.

When getting vaccine exemptions, there are two types: medical and non-medical and exemptions can be from one, multiple or all required childhood vaccines

Medical exemptions are allowed when a child has a medical condition that prevents them from receiving a vaccine. Non-medical exemptions include those based on religious or philosophical beliefs.

While rules differ state by state, in most cases, parents must receive documentation from a medical doctor stating a child should be exempt from vaccinations.

The exemptions are then reviewed and granted by the child's school.

Drs Califf and Marks highlight the flu, Covid-19 and respiratory syncytial virus vaccines as crucial in protecting people - as the US struggles with one of the worst winter cold seasons health workers have ever seen.

The officials say that vaccination against these three viruses is 'inadequate' and 'distressing,' especially among the elderly who are high risk of severe infection and death.

In the US, just one-third of senior care home residents were up to date with their Covid vaccine and just 10 percent had received a vaccine for RSV.

A higher share - 72 percent - had received their flu vaccine, as of a December 10 CDC report.

Older residents in nursing homes are at heightened risk of severe illness and death from any one of the three viruses due to their weakened immune systems.

During the 2021-2022 flu season, the death rate for people 65 years and older was around 7.4 per 100,000 population, compared to 0.1 per 100,000 people among those aged 18 to 49 years.

Drs Califf and Marks wrote in their commentary that it is difficult for people to take action when their own risk of a bad outcome is relatively low, even when possible consequences are high and the population-wide risk is severe.

Making a comparison to the argument for seatbelts, they wrote: 'In situations such as with seat belts, however, the discussion ultimately has led to almost uniform use, and vaccination use had similarly been almost uniformly accepted.

'The current reversal of vaccine acceptance has already resulted in hundreds of thousands of excess deaths from COVID-19 and concern about the re-emergence of previously conquered infectious diseases.'

Experts have partly attributed the decline of vaccination rates in the US to Covid-19.

While the Covid vaccine is not mandated in the US, it is believed to be a contributing factor in the rise of vaccine hesitancy.

Americas top infectious disease expert Dr Anthony Fauci admitted Covid vaccine policies were 'counterproductive' and turned vaccine skeptics off of vaccinations rather than gain their favor.

Last year, he told The New York Times: Man, I think, almost paradoxically, you had people who were on the fence about getting vaccinated thinking, why are they forcing me to do this?

More than a quarter million kindergartners are entering school without their recommended childhood vaccines

'And that sometimes-beautiful independent streak in our country becomes counterproductive. And you have that smoldering anti-science feeling, a divisiveness thats palpable politically in this country.'

And the FDA officials wrote in their commentary they found vaccine hesitancy for children has been found highest in clusters among middle- to high-income areas of parents with at least a college degree who preferred narratives seen on social media rather than evidence-based vaccine information provided by doctors.

Drs Califf and Marks said vaccine complacency has also driven unvaccinated numbers up: 'Unfortunately, with the success of pediatric vaccination campaigns to date, increasing numbers of people have become complacent and underestimate the actual risk of forgoing vaccination.'

To counter the rising antivax movement, the authors strongly urge healthcare professionals double their efforts to provide accurate and clear information regarding the benefits of vaccination.

They added: 'Such information is now needed because vaccines have been so successful in achieving their intended effects that many people no longer see the disturbing morbidity and mortality from infections amenable to vaccines.

'We believe that the best way to counter the current large volume of vaccine misinformation is to dilute it with large amounts of truthful, accessible scientific evidence.

'To reduce deaths, hospitalization, and the burden on families and the health care system, all those directly interacting with individuals in a health care setting, ranging from front office staff to retail pharmacists to primary care physicians, need to focus at every appropriate opportunity on helping to ensure that individuals have the necessary information to make informed choices regarding vaccination, considering the benefits and risks.

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America is on the edge of a dangerous 'vaccine tipping point' says FDA- amid measles outbreak and record high - Daily Mail

Long Island Midwife Gave Kids Pellets, Not Vaccinations – Newser

January 18, 2024

A midwife from Long Island has been hit with a $300,000 fine, accused by the New York State Department of Health of writing up false vaccination records for hundreds of children. News 12 Long Island reports that the inoculation scheme run by Jeanette Breen began in 2019, via her Baldwin Midwifery, with Breen giving kids oral homeopathic pellets instead of vaccines, then filling out paperwork indicating her young patients had been vaccinated. The New York Times notes the pellets didn't have the green light from either the federal government or New York state to be used as a vaccination of any sort, even though Breen offered them to fend off a variety of diseases, including measles, mumps, polio, and flu.

Breen is also accused by the state DOH of claiming she gave a booster for tetanus, diptheria, and whooping cough more than 400 times, but actually didn't, per Newsday. The COVID vaccine was apparently not part of the scheme, which started after New York state nixed religious exemptions for vaccinations following a measles outbreak. The children involved mainly hailed from Long Island, but there were also kids under Breen's care from New York City and as far away as Erie County, in Western New York. An NYU bioethics instructor says the fact that Breen worked with children all over the state points to an underground word-of-mouth system in the anti-vax community, often through closed social-media groups.

"People don't show up from 300 schools out of the blue," Arthur Caplan notes. He adds that alternative treatments like the ones Breen offered aren't always safethey can cause allergic reactions, for oneand that unvaccinated children can put other people around them at risk. "Misrepresenting or falsifying vaccine records puts lives in jeopardy and undermines the system that exists to protect public health," state Health Commissioner Dr. James McDonald says in a statement.

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"Ms. Breen has provided excellent midwifery services for many years to many families," her attorney says, per Newsday, adding that his client is cooperating with the state DOH and "intends to comply" with any parameters it sets for her. Breen is said to have already paid $150,000 of the fine, and the state has agreed to waive the rest if she meets certain conditions, including not administering any vaccines. As for the kids who were "vaccinated" by Breen, their records have been voided and they must now receive proper vaccinations before they can return to school, per the state DOH. More here on Breen's past, which includes a previous two-year stayed suspension for "failing to maintain accurate patient records." (Read more Long Island stories.)

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Long Island Midwife Gave Kids Pellets, Not Vaccinations - Newser

NY midwife who gave kids homeopathic pellets instead of vaccines fined $300K for falsifying records – The San Diego Union-Tribune

January 18, 2024

NEW YORK

A New York midwife who gave nearly 1,500 children homeopathic pellets instead of required vaccinations has been fined $300,000, the states health department announced this week.

Jeanette Breen, who operates Baldwin Midwifery on Long Island, administered the pellets as an alternative to vaccinations and then falsified their immunization records, the agency said Wednesday.

The scheme, which goes back least to the 2019-2020 school year, involved families throughout the state, but the majority reside on suburban Long Island. In 2019, New York ended a religious exemption to vaccine requirements for schoolchildren.

The health department said immunization records of the children who received the falsified records have been voided, and their families must now prove the students are up-to-date with their required shots or at least in the process of getting them before they can return to school.

Misrepresenting or falsifying vaccine records puts lives in jeopardy and undermines the system that exists to protect public health, State Health Commissioner James McDonald said in a statement.

Breen, a state-licensed healthcare provider, supplied patients with the Real Immunity Homeoprophylaxis Program, a series of oral pellets that are marketed as an alternative to vaccination but are not recognized or approved by state or federal regulators as valid immunizations, according to the health department.

She administered 12,449 of the fake immunizations to roughly 1,500 school-aged patients before submitting information to the states immunization database claiming the children had received their required vaccinations against measles, mumps, rubella, polio, chickenpox, diphtheria, tetanus, pertussis, hepatitis B and a host of other diseases, the department said.

Breens lawyer said Thursday that his client cooperated with investigators, paid her fine and intends to comply with all other requirements of her agreement with health officials.

Suffice it to say, Ms. Breen has provided excellent midwifery services for many years to many families, especially on Long Island. She is now toward the end of her career, David Eskew wrote in an emailed statement. From her perspective, this matter is over, done with, and closed and she is now moving on with her life.

As part of the settlement, Breen has paid $150,000 of the $300,000 penalty, with the remainder suspended contingent upon her complying with state health laws and never again administering any immunization that must be reported to the state, according to the health department. Shes also permanently banned from accessing the states immunization records system.

Erin Clary, a health department spokesperson, said Thursday that while parents and legal guardians had sought out and paid Breen for her services, they werent the focus of the agencys investigation.

State health officials say theyre now in the process of notifying hundreds of affected school districts.

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NY midwife who gave kids homeopathic pellets instead of vaccines fined $300K for falsifying records - The San Diego Union-Tribune

A NY midwife gave kids homeopathic pellets instead of vaccines. Then she faked their records – Press of Atlantic City

January 18, 2024

NEW YORK A New York midwife who gave nearly 1,500 children homeopathic pellets instead of required vaccinations has been fined $300,000, the state's health department announced this week.

Jeanette Breen, who operates Baldwin Midwifery on Long Island, administered the pellets as an alternative to vaccinations and then falsified their immunization records, the agency said Wednesday.

A doctor makes homeopathic pills to treat COVID-19 onMarch 12, 2020, in New Delhi, India, though there is no evidence the alternative medicines work.

The scheme, which goes back least to the 2019-2020 school year, involved families throughout the state, but the majority reside on suburban Long Island. In 2019, New York ended a religious exemption to vaccine requirements for schoolchildren.

The health department said immunization records of the children who received the falsified records have been voided, and their families must now prove the students are up-to-date with their required shots or at least in the process of getting them before they can return to school.

Misrepresenting or falsifying vaccine records puts lives in jeopardy and undermines the system that exists to protect public health, State Health Commissioner James McDonald said in a statement.

Breen, a state-licensed health care provider, supplied patients with the Real Immunity Homeoprophylaxis Program, a series of oral pellets that are marketed as an alternative to vaccination but are not recognized or approved by state or federal regulators as valid immunizations, according to the health department.

She administered 12,449 of the fake immunizations to roughly 1,500 school-aged patients before submitting information to the state's immunization database claiming the children had received their required vaccinations against measles, mumps, rubella, polio, chickenpox, diphtheria, tetanus, pertussis, hepatitis B and a host of other diseases, the department said.

Breen's lawyer said Thursday that his client cooperated with investigators, paid her fine and intends to comply with all other requirements of her agreement with health officials.

Suffice it to say, Ms. Breen has provided excellent midwifery services for many years to many families, especially on Long Island. She is now toward the end of her career, David Eskew wrote in an emailed statement. From her perspective, this matter is over, done with, and closed and she is now moving on with her life.

As part of the settlement, Breen has paid $150,000 of the $300,000 penalty, with the remainder suspended contingent upon her complying with state health laws and never again administering any immunization that must be reported to the state, according to the health department. She's also permanently banned from accessing the state's immunization records system.

Erin Clary, a health department spokesperson, said Thursday that while parents and legal guardians had sought out and paid Breen for her services, they weren't the focus of the agencys investigation.

State health officials say they're now in the process of notifying hundreds of affected school districts.

In 2023, a helicopter carrying Ukraines interior minister crashed into a kindergarten in a foggy residential suburb of Kyiv, killing him and about a dozen other people, including a child on the ground.

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A NY midwife gave kids homeopathic pellets instead of vaccines. Then she faked their records - Press of Atlantic City

$300K Fine for Midwife Who Gave Kids Homeopathic Pellets Instead of Vaccines – Medpage Today

January 18, 2024

A New York midwife who gave nearly 1,500 children homeopathic pellets instead of required vaccinations has been fined $300,000, the state's health department announced this week.

Jeanette Breen, who operates Baldwin Midwifery on Long Island, administered the pellets as an alternative to vaccinations and then falsified their immunization records, the agency said Wednesday.

The scheme, which goes back at least to the 2019-2020 school year, involved families throughout the state, but the majority reside on suburban Long Island. In 2019, New York ended a religious exemption to vaccine requirements for schoolchildren.

The health department said immunization records of the children who received the falsified records have been voided, and their families must now prove the students are up-to-date with their required shots or at least in the process of getting them before they can return to school.

"Misrepresenting or falsifying vaccine records puts lives in jeopardy and undermines the system that exists to protect public health," State Health Commissioner James McDonald, MD, MPH, said in a statement.

Breen, a state-licensed healthcare provider, supplied patients with the "Real Immunity Homeoprophylaxis Program," a series of oral pellets that are marketed as an alternative to vaccination but are not recognized or approved by state or federal regulators as valid immunizations, according to the health department.

She administered 12,449 of the fake immunizations to roughly 1,500 school-age patients before submitting information to the state's immunization database claiming the children had received their required vaccinations against measles, mumps, rubella, polio, chickenpox, diphtheria, tetanus, pertussis, hepatitis B, and a host of other diseases, the department said.

Breen's lawyer said Thursday that his client cooperated with investigators, paid her fine, and intends to comply with all other requirements of her agreement with health officials.

"Suffice it to say, Ms. Breen has provided excellent midwifery services for many years to many families, especially on Long Island. She is now toward the end of her career," David Eskew wrote in an emailed statement. "From her perspective, this matter is over, done with, and closed and she is now moving on with her life."

As part of the settlement, Breen has paid $150,000 of the $300,000 penalty, with the remainder suspended contingent upon her complying with state health laws and never again administering any immunization that must be reported to the state, according to the health department. She's also permanently banned from accessing the state's immunization records system.

Erin Clary, a health department spokesperson, said Thursday that while parents and legal guardians had sought out and paid Breen for her services, they weren't the focus of the agency's investigation.

State health officials say they're now in the process of notifying hundreds of affected school districts.

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$300K Fine for Midwife Who Gave Kids Homeopathic Pellets Instead of Vaccines - Medpage Today

Rat study alleged to link COVID-19 vaccines to autism cannot be generalized to humans and contains important … – Health Feedback

January 18, 2024

Autism COVID-19 Vaccine

Published on: 18 Jan 2024 | Editor: Flora Teoh

Health Feedback is a non-partisan, non-profit organization dedicated to science education. Our reviews are crowdsourced directly from a community of scientists with relevant expertise. We strive to explain whether and why information is or is not consistent with the science and to help readers know which news to trust. Please get in touch if you have any comment or think there is an important claim or article that would need to be reviewed.

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Rat study alleged to link COVID-19 vaccines to autism cannot be generalized to humans and contains important ... - Health Feedback

Measles Cases in Several States: What’s Going On? – Medpage Today

January 18, 2024

Several recent measles outbreaks have public health officials concerned -- and are drawing attention to rising childhood vaccine exemptions and renewing calls for increased measles awareness.

Philadelphia's health department confirmed nine cases of the illness as of Tuesday, which spread at local health facilities and a daycare. At least three of the infections were in unvaccinated children, according to ABC News.

As of January 12, two counties in Washington state noted "3 lab-confirmed and 3 [epidemiologically]-linked measles cases have been identified among unvaccinated adults." Delaware identified 20-30 people who were exposed to measles at the Nemours Children's Hospital a few days earlier.

Camden County, New Jersey confirmed a measles case on January 13, and around the same time, Virginia health officials flagged a case in someone who may have exposed people at Dulles International Airport and Ronald Reagan Washington National Airport.

In Missouri, too, the public health department posted an alert about a confirmed measles case.

Is It Normal to See This Many Measles Cases?

Katelyn Jetelina, MPH, PhD, epidemiologist and author of the "Your Local Epidemiologist" newsletter, calls the recent measles outbreaks a potential symptom of "collective amnesia" in a recent newsletter, writing, "As generations age, the memory of mid-20th-century diseases like measles fade. ... Some don't know why this disease is bad or if this vaccine is safe. This is understandable."

Walter Orenstein, MD, DSc, from Emory University School of Medicine, echoed this sentiment in a call with MedPage Today. "Measles itself is not a trivial illness -- in a sense, vaccines can be victims of their own success," he said.

Though measles cases crop up every year, U.S. cases have ticked up in recent decades, according to CDC data cited by Jetelina. Worldwide cases have increased, too, according to provisional data from the World Health Organization. "Measles is coming back, and with that there's more chance of importation into the United States," Orenstein added.

Why Are We Seeing More Measles Cases?

Experts told MedPage Today that this year's cases may partially stem from fallout from COVID-19. Routine vaccination went down during the worst of the pandemic, and international travel is up since then.

Vaccine hesitancy, another leftover from the pandemic era, is also playing a role, Jetelina and others noted. In the 2022-2023 school year, nonmedical vaccine exemptions for kindergarteners increased in 41 states, according to the CDC. Health misinformation persists, and experts cited concerns about eroding trust in established health systems.

"The ones that are getting measles are those that are simply not vaccinated, for whatever reason, whether it's mistrust of the public healthcare system, [or] maybe they're having eroding confidence in their healthcare providers," Steven Schweon, RN, MPH, MSN, a member of the Emerging Infectious Diseases task force for the Association for Professionals in Infection Control and Epidemiology, told MedPage Today. "They may believe misinformation that's out there, as opposed to credible information."

What Are the Risks of Measles Infection?

Though most recover from measles, children are particularly susceptible to it. The disease can become serious, with complications including hearing loss, pneumonia, encephalitis, and even death.

Schweon said to look out for the "Three C's" of measles: "Conjunctivitis, coryza -- running eyes, runny nose -- and a cough."

"The very early symptoms of measles can mimic the flu," Schweon added. "But after several days with measles, they develop that typical rash, which is key for the diagnosis of measles."

Measles is also highly infectious. "Measles, in essence, is really the most contagious of the vaccine-preventable diseases," Orenstein said, such that someone with measles could infect 12-18 other people in a totally susceptible population, on average.

Schweon agreed, saying that measles is "much more infectious to people than COVID or the flu, for instance," and added, "There's long-term nervous system consequences of getting measles disease, and death."

Measles can actually alter immune memory, wiping out preexisting antibodies in the body and making it harder to fight future pathogens, experts told MedPage Today.

"It's easier to prevent an infection than it is to treat one," Schweon said.

What Can Healthcare Providers Do About Measles?

According to Schweon, healthcare providers should ask if patients have been vaccinated, and vaccinate without hesitation, if possible.

"Healthcare providers should be asking [patients] about their vaccine history, if they are up to speed with their vaccines," Schweon said, "and if their patients aren't sure, depending on the vaccine and why, it's a great opportunity to vaccinate them right there in the office."

Public health departments in a number of the states with confirmed cases are offering measles vaccines, including the Black Doctors COVID19 Consortium, which held a vaccination event with free measles vaccines and testing on Monday at the Dr. Ala Stanford Center for Health Equity in Philadelphia.

When it comes to vaccine hesitancy, Orenstein said the priority should be to build trust and overcome concerns about vaccination.

"It's important to try and explain that getting the measles vaccine is your protection -- and protects them from diseases -- that will prevent hospitalizations, pneumonia, ear infections and even encephalitis or brain damage," he said. "So we need to get that message across, and we need to find the right messengers."

Schweon cited a measles outbreak in 1990-1991 -- where 486 were infected and six children died -- in a largely unvaccinated religious community. "I think about those pediatric deaths from 1991," Schweon said. "And the children did not have a voice in that decision not to vaccinate them -- that clearly was a parent's preference."

Sophie Putka is an enterprise and investigative writer for MedPage Today. Her work has appeared in the Wall Street Journal, Discover, Business Insider, Inverse, Cannabis Wire, and more. She joined MedPage Today in August of 2021. Follow

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Measles Cases in Several States: What's Going On? - Medpage Today

Vaccine Innovation Continued in 2023 with Several Important Approvals – Drug Topics

January 18, 2024

Vaccinations are one of the most important public health efforts for preventing serious illness, avoiding hospitalizations and saving lives. During the COVID-19 pandemic, vaccine technology made a huge leap forward with the introduction of messenger RNA (mRNA) vaccines. COVID-19 vaccines developed by BioNTech/Pfizer and Moderna use mRNA instead of weakened viruses or virus fragments to teach the bodys immune system how to respond when presented with an infection.

Innovation in the vaccine area continues. In 2023, the FDA approved six vaccines, including several important firsts. (See list below.)

In the area of respiratory diseases, the first two vaccines for respiratory syncytial virus (RSV) were approved for older adults and a separate vaccine was approved to prevent RSV infections in infants. RSV is a common respiratory virus that usually causes mild, cold-like symptoms, but it can lead to serious respiratory illness and increased hospitalizations. It results in 14,000 deaths annually among those over the age 65 and about 58,000 hospitalizations of infant younger than 1, according to the National Institute of Allergy and Infectious Disease. GSKs Arexvy, approved for adults in early May 2023, is an adjuvanted vaccine, which means it contains an ingredient to increase immune response. The second adult vaccine was approved a few weeks later. Pfizers Abrysvo is a bivalent RSV prefusion F (preF) vaccine that is composed of two preF proteins selected to optimize protection against RSV A and B strains.The FDA also approved Abrysvo to prevent RSV in infants.

Separately, the FDA approved Sanofi and AstraZenecas Beyfortus (nirsevimab-alip), which prevents RSV in newborns and infants. Beyfortus is the first monoclonal antibody to protect infants through their first RSV season. Although designed to prevent disease like a vaccine, it is not a vaccine because it does not stimulate the immune system.

The FDA also granted accelerated approval in November 2023 to Ixchiq, the first vaccine to prevent the mosquito-borne virus chikungunya. It was approved for use in adults aged 18 years and older. Infection with chikungunya virus can lead to severe disease and prolonged health problems, particularly for older adults and individuals with underlying medical conditions.

It is administered as a single dose injected intramuscularly. The manufacturer, Valneva, has begun a phase 2 trial of the vaccine in children one to seven years of age. Once available, the phase 2 pediatric data are intended to support a phase 3 pivotal study in children to extend the label. A clinical study in adolescents is also ongoing in Brazil.

This year the FDA could approve additional vaccines, including the first self-administered flu vaccine. AstraZenecas has submitted a supplemental biologics license application (sBLA) for a self-administered option for FluMist Quadrivalent, which is a needle-free nasal spray. Researchers said this would provide another option for flu vaccination and potentially increase access and use of flu vaccine,The FDA has set a Prescription Drug User Fee Act (PDUFA) date for a regulatory decision during the first quarter of 2024. If approved, Astra Zeneca has said it to be available for the 2024-2025 flu season.

Regulators are also currently reviewing Mercks BLA for a pneumococcal conjugate vaccine specifically designed to help prevent invasive pneumococcal disease and pneumococcal pneumonia in adults. The vaccine was developed using the serotypes responsible for about 80% of pneumococcal disease in those over the age of 65. The PDUFDA action date is June 17, 2024.

Even though advances have been made in the area of vaccines, the question remains whether people in the United States and elsewhere will accept and get these vaccines. Vaccine hesitancy, which ranges from misgiving to outright resistance, took hold during the COVID-19 pandemic because of misinformation about the COVID-19 vaccines, and it has shown staying power. The proportion of U.S. adults who have received COVID-19 vaccines, flu and RSV remains low, according to recent data from the Centers for Disease Control and Prevention. Just 21.4% of adults over the age of 18 have received the COVD-19 vaccine, while 41.5% have gotten a flu vaccine.

Vaccine hesitancy is not just about COVID-19 vaccines. Cases of measles have surged in the Washington, D.C., area, Pennsylvania, New Jersey, Delaware and Washington state, partly because children have not been vaccinated.

In a recent study, researchers from University of Colorado School of Medicine found while the COVID-19 pandemic did not overall impact parent vaccine hesitancy, some misinformation about COVID-19 may be impacting parental trust in childhood vaccines.

In a survey by researchers from University of Michigan School of Public Health found that some parents (12%) believe that childhood vaccines are less important compared with before the pandemic and that some (13%) believe that childhood vaccines are less effective now. They also found that negative beliefs about childhood vaccines were clustered in places with low COVID-19 vaccination rates.

In a another study, researchers from University of Colorado School of Medicine found that misinformation about COVID-19 may be impacting parental trust in childhood vaccines.

Vaccine Approvals in 2023

This article originally appeared on Managed Healthcare Executive.

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Vaccine Innovation Continued in 2023 with Several Important Approvals - Drug Topics

TB: How prior exposure to bacteria changes the lung’s innate immune response and what it might mean for vaccines – Medical Xpress

January 18, 2024

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Tuberculosis, caused by the bacterium Mycobacterium tuberculosis (Mtb) kills upwards of 1.6 million people a year, making it one of the leading causes of death by an infectious agent worldwideand that number is only growing larger.

How, exactly, Mtb evades the immune system isn't yet known, but a collaborative team of researchers from the University of Massachusetts Amherst and Seattle Children's Research Institute recently discovered something surprising: prior exposure to a genus of bacteria called Mycobacterium seems to remodel the first-line defenders in the body's immune system.

Furthermore, how those cells are remodeled depends on exactly how the body is exposed. These results, published in PLOS Pathogens, suggest that a more integrated treatment approach that targets all aspects of the immune response could be a more effective strategy in the fight against tuberculosis.

"We breathe in thousands of liters of air every day," says Alissa Rothchild, assistant professor in the Veterinary and Animal Sciences Department at UMass Amherst and the paper's senior author. "This essential process makes us incredibly vulnerable to inhalation of all sorts of potentially infectious pathogens that our immune systems have to respond to."

Systems, plural. When we think of immunity, we typically think of the adaptive immune system, which is when prior exposure to a pathogensay, a weakened version of chickenpoxteaches the immune system what to guard against. Vaccination is the most common tool that we use to teach our adaptive immune systems what to look out for.

While the adaptive immune system is the major focus of most vaccine research (think protective antibodies induced by COVID-19 vaccines), it is not the body's first responderthat would be the innate immune system and its ranks of macrophages. The macrophages are the first-line defenders in the tissues that recognize and destroy pathogens and also call for backup. One way they do this by turning on different inflammatory programs that can change the tissue environment.

In the case of the lungs, these macrophages are called alveolar macrophages (AMs). They live in the lung's alveoli, the tiny air sacs where oxygen passes into the bloodstreambut, as Rothchild has shown in a previous paper, AMs don't mount a robust immune response when they're initially infected by Mtb.

This lack of response seems to be a chink in the body's armor that Mtb exploits to such devastating effect. "Mtb takes advantage of the immune response," says Rothchild, "and when they infect an AM, they can replicate inside of it for a week or longer. They effectively turn the AM into a Trojan Horse in which the bacteria can hide from the body's defenses."

"But what if we could change this first step in the chain of infection?" Rothchild continues. "What if the AMs responded more effectively to Mtb? How could we change the body's innate immune response? Studies over the last 10 years or so have demonstrated that the innate immune system is capable of undergoing long-term changes, but we are only beginning to understand the underlying mechanisms behind them."

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To test conditions where the innate immune response might be remodeled, Dat Mai, a research associate at Seattle Children's Research Institute and the first author of the paper, Rothchild and their colleagues designed an experiment using two different mouse models.

The first model used the BCG vaccination, one of the world's most widely distributed vaccines and the only vaccine used for tuberculosis. In the second model, the researchers induced a contained Mtb infection, which they previously showed protects against subsequent infections in a form of concomitant immunity.

Weeks after exposure, the researchers challenged the mice with aerosolized Mtb and infected macrophages were taken from each mouse model for RNA sequencing. There were striking differences in the RNA from each set of models.

While both sets of AMs showed a stronger pro-inflammatory response to Mtb than AMs from unexposed mice, the BCG-vaccinated AMs strongly turned on one type of inflammatory program, driven by interferons, while the AMs from the contained Mtb infection turned on a qualitatively different inflammatory program.

Other experiments showed that the different exposure scenarios changed the AMs themselves, and that some of these changes seem to be dependent on the greater lung environment.

"What this tells us," says Rothchild, "is that there's a great deal of plasticity in the macrophage response, and that there's potential to therapeutically harness this plasticity so that we can remodel the innate immune system to fight tuberculosis."

This research is part of a much bigger, global, cross-species effort to comprehensively understand the immune responses to eliminate tuberculosis, called IMPAc-TB, for Immune Mechanisms of Protection Against Mycobacterium Tuberculosis.

Dr. Kevin Urdahl, professor of pediatrics at Seattle Children's Research Institute, lead PI for this IMPAc-TB consortium, and one of the paper's co-authors, says that "the overall goal of the program is to elucidate how the immune system effectively controls or eradicates the bacteria that causes tuberculosis so that effective vaccines can be developed."

"This is an important part of the larger IMPAc-TB program because we will be assessing the responses of human alveolar macrophages recovered from individuals who have recently been exposed to Mycobacterium tuberculosis in a TB endemic region. The findings of Rothchild's team will help us interpret and understand the results we obtain from the human cells."

More information: Exposure to Mycobacterium remodels alveolar macrophages and the early innate response to Mycobacterium tuberculosis infection, PLoS Pathogens (2024). DOI: 10.1371/journal.ppat.1011871. journals.plos.org/plospathogen journal.ppat.1011871

Journal information: PLoS Pathogens

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TB: How prior exposure to bacteria changes the lung's innate immune response and what it might mean for vaccines - Medical Xpress

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