Category: Vaccine

Danjuma Adda is the past president of the World Hepatitis Alliance and a fellow with the Aspen Voices Fellowship. He is the founder of Appreciate You Organization in Nigeria, which works to improve access to hepatitis testing and increase awareness about the disease. Ida is also living with HBV.

Chronic HBV infection remains a significant global health challenge, leading to approximately 1.1 million deaths in 2022, primarily from cirrhosis and hepatocellular carcinoma, according to WHO. In 2022, an estimated 254 million people worldwide were living with HBV, with the highest prevalence in the African and Western Pacific regions, where 65% of these cases are found.

There has not been any significant improvement in the diagnosis and treatment of hepatitis B. The prevalence of hepatitis B is alarming, with the disease claiming over 270,000 lives annually in Africa. The rate of diagnosis is dire; only about 3% of hepatitis cases are diagnosed, and merely 2% of those diagnosed receive treatment.

The primary transmission routes of HBV are from mother to child at birth and through horizontal household contact. Despite the severity of the disease, there has been notable progress in preventing perinatal HBV transmission through universal infant vaccination programs. The administration of a hepatitis B vaccine within 24 hours of birth has been shown to be 90-95% effective in preventing the infection and has significantly reduced the incidence among children. However, global coverage of this birth-dose vaccination is still low at 45%, and even lower in the WHO African region at 18%.

The WHO recommends that newborns should receive the HBV vaccine within 24 hours of birth, or as early as possible. This is a critical measure to prevent new infections and it's important to remember that this is a cancer-preventing vaccine. To ensure all babies are vaccinated, we need to strengthen immunization systems so that these vaccines are readily available, especially in delivery rooms, not just outside where access can be limited after business hours or on weekends. It's crucial that the vaccines are accessible exactly where and when the babies are born.

For those already living with HBV, treatments such as tenofovir or entecavir have been highly effective in slowing the progression of liver disease and reducing the incidence of liver cancer, improving long-term survival rates. A substantial gap in diagnosis and treatment persists only 13% of those with HBV were diagnosed in 2022, and a mere 3% received treatment.

To ensure all babies are vaccinated, we need to strengthen immunization systems so that these vaccines are readily available, especially in delivery rooms, not just outside where access can be limited after business hours or on weekends. It's crucial that the vaccines are accessible exactly where and when the babies are born.

Achieving the WHO's elimination goals, which aim for 90% testing coverage and 80% treatment coverage, will require a significant overhaul of the current approaches to diagnosing and treating HBV. This includes simplifying treatment criteria, diagnostic methods, and care pathways to enhance access to vital testing and treatment services.

Reference

Easterbrook P, Luhmann N, Bajis, et. al. WHO 2024 Hepatitis B Guidelines: An Opportunity to Transform Care. The Lancet. Published April 10, 2024. Accessed April 12, 2024. DOI: https://doi.org/10.1016/S2468-1253(24)00089-X

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Hepatitis B Virus (HBV) Bridges Gap Between Policy and Implementation in Vaccine Coverage - Contagionlive.com

An experimental approach to treating pancreatic cancer with the messenger RNA (mRNA)-based therapeutic cancer vaccine candidate autogene cevumeran continues to show potential to stimulate an immune response that may reduce the risk of the disease returning after surgery.

New results from a phase 1 clinical trial show that the cancer vaccine candidate activated immune cells that persisted in the body up to three years after treatment in certain patients. In addition, a vaccine-induced immune response correlated with reduced risk of the cancer coming back.

The latest data from the phase 1 trial show that we are on the right track. This investigational mRNA vaccine can trigger T cells the cells that mobilize anti-tumor immune responses that may recognize pancreatic cancers as foreign, says Memorial Sloan Kettering Cancer Center (MSK) pancreatic cancer surgeon-scientist Vinod Balachandran, MD. Moreover, we continue to detect vaccine-stimulated T cells at substantial frequencies in patients blood up to three years after vaccination.

Autogene cevumeran (BNT122, RO7198457) was developed through a collaboration between BioNTech, an immunotherapy company, and Genentech, a member of the Roche Group. Dr. Balachandran, who led the phase 1 trial, presented the latest results at the American Association for Cancer Research Annual Meeting in San Diego.

Pancreatic cancer is one of the deadliest cancers, and even with surgery, only about 12% of patients are alive five years after diagnosis. Chemotherapy, radiation, targeted therapy, and current immunotherapies are also largely ineffective against pancreatic cancer, so new therapies are urgently needed for patients who face this disease.

The investigational mRNA cancer vaccines were custom-made for every participant in the phase 1 clinical trial based on the mutational profile of each individual tumor. The cancer vaccines teach T cells to recognize proteins called neoantigens that are found exclusively in each patients pancreatic tumor. In this way, these vaccines alert the immune system that the cancer cells are foreign. The goal of this approach is to train the body to protect itself against cancer cells.

Initial results from the phase 1 trial, reported May 2023 in Nature, showed the vaccine was well tolerated and that it activated immune cells in half of treated patients. The latest results are based on following patients for a median of three years after the investigational treatment. The team was able to track vaccine-induced T cells with the help of computational biologist Benjamin Greenbaum, PhD.

Our findings thus far show that this vaccine candidate can induce a lasting immune response up to three years in some patients, explains Dr. Balachandran, a member of the Human Oncology and Pathogenesis Program and the David M. Rubenstein Center for Pancreatic Cancer Research at MSK. As these are critical features of an effective cancer vaccine, the results continue to support the approach of using customized mRNA vaccines to target neoantigens in each patients tumor.

The investigator-initiated, single-center trial involved studying 16 MSK patients who received autogene cevumeran,along with an immunotherapy drug called atezolizumab and a chemotherapy regimen called mFOLFIRINOX. At the three-year median follow-up:

A phase 2 clinical trial (NCT05968326), sponsored by Genentech in collaboration with BioNTech, will evaluate the efficacy and safety of autogene cevumeran in a larger patient group. The new study, which began in July 2023, will enroll approximately 260 patients at various sites around the world, including MSK.

Given the positive data from our phase 1 trial, we are excited to evaluate individualized mRNA cancer vaccine candidates in more pancreatic cancer patients, Dr. Balachandran says.

The phase 2 trial will study whether the mRNA approach works better than the current standard treatment. Patients will be randomly split into two groups:

The trial is open to people with newly diagnosed pancreatic cancer eligible for surgery, who have not had other treatment (such as chemotherapy, immunotherapy, or radiation therapy) and who fit other specific criteria.

Here, Dr. Balachandran explains how this new approach has been developed to treat one of the deadliest cancers. It all began with discoveries in his lab about pancreatic cancer and a global collaboration with Genentech and BioNTech in the middle of the COVID-19 pandemic.

There has been great interest in using immunotherapy for pancreatic cancer because nothing else has worked very well. We thought immunotherapy held promise because of research we began about eight years ago. A small subset of patients with pancreatic cancer manage to beat the odds and survive after their tumor is removed. We looked at the tumors taken from these select patients and saw that the tumors had an especially large number of immune cells in them, especially T cells. Something in the tumor cells seemed to be sending out a signal that alerted the T cells and drew them in.

We later found that these signals were proteins called neoantigens that T cells recognize as foreign, triggering the immune system attack. When tumor cells divide, they accumulate these neoantigens, which are caused by genetic mutations. In most people with pancreatic cancer, these neoantigens are not detected by immune cells, so the immune system does not perceive the tumor cells as threats. But in our study, we saw that neoantigens in the long-term pancreatic cancer survivors were different they did not escape notice. They, in effect, uncloaked the tumors to T cells, causing the T cells to recognize them.

We found that T cells recognizing these neoantigens circulated in the blood of these rare patients for up to 12 years after the pancreatic tumors had been removed by surgery. The T cells had memory of the neoantigens as a threat.

My colleagues and I published our findings about immune protection in long-term pancreatic cancer survivors in Nature in November 2017. While working on this, we were also looking for ways to deliver neoantigens to patients as vaccines. We were particularly interested in mRNA vaccines, a technology that we thought was quite promising. The vaccines use mRNA, a piece of genetic code, to teach cells in your body to make a protein that will trigger an immune response.

Coincidentally, at this time, BioNTech co-founder and CEO Uur ahin, MD, emailed us that he had read our paper and was interested in our ideas. He and his team were working with Genentech on individualized neoantigen-based mRNA immunotherapies. In late 2017, we flew to Mainz, Germany, where BioNTech is based. We discussed the potential of therapeutic mRNA cancer vaccines for pancreatic cancer as well as the possible use of the mRNA platform they have developed.

Designing a cancer vaccine tailored to an individual is complex. Because cancers arise from our own cells, it is much harder for the immune system to distinguish proteins in cancer cells as foreign compared with proteins in pathogens like viruses. But important advances in cancer biology, the development of novel biotechnologies, and genomic sequencing now make it possible to design vaccines that can tell the difference.

This builds on important work done at MSK that has shown how critical tumor mutations are to triggering an immune response. In parallel with our work, major discoveries in mRNA technology over the past decades by scientists such as professor ahin and BioNTech co-founder and Chief Medical Officer zlem Treci, MD, paved the way to use mRNA in medicine. We all felt optimistic about the potential and decided to move ahead.

After a patient has a pancreatic tumor surgically removed, the tumor is genetically sequenced to look for up to 20 mutations that have the highest likelihood to produce the best neoantigens those that look the most foreign to the immune system. The cancer vaccine candidate is manufactured with mRNA specific to these neoantigens found in that individuals tumor.

The process to design and manufacture individualized vaccines for cancer treatment is more complex than making a preventive vaccine for an infectious disease, where each vaccine is the same and can be manufactured in large batches. An individualized therapeutic mRNA cancer vaccine must be tailored to each patients tumor. To do this, we take a sample of the tumor that is removed during the required cancer surgery and ship the sample to BioNTech in Germany. They analyze the tumor sample, and design and manufacture the cancer vaccine candidate, which is then sent back to New York.

The vaccine is infused into a persons bloodstream. In some patients it can cause immune cells called dendritic cells to make the neoantigen proteins. And in some cases, the dendritic cells also train the rest of the immune system, including T cells, to recognize and attack tumor cells that express these same proteins. With the T cells on high alert to destroy cells bearing these proteins, the cancer may have a lower chance of returning.

In patients treated in the phase 1 study, we are continuing to examine if vaccine-induced T cells last and remain functional long-term and how these features associate with patient outcomes.

This story was originally posted in July 2023 and has been updated.

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Investigational mRNA Vaccine Induced Persistent Immune Response in Phase 1 Trial of Patients With Pancreatic Cancer - On Cancer - Memorial Sloan...

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(Precision Vaccinations News)

Costa Rica's Ministry of Health (MOH) and the Caja Costarricense del Seguro Socialhave begun investigating a potential outbreak of Bordetella pertussis (whooping cough) in the district of Tibas, located north ofSan Jose.

This is the same area in Costa Rica where the MOH has reported chikungunya, dengue, malaria, and Zika cases in 2024.

As of April 11, 2024, given the contagious nature of whooping cough and its severity in children and unvaccinated populations, the U.S. Embassy urges heightened awareness and vaccination verification for U.S. citizens in Costa Rica.

Before visiting Costa Rica in April 2024, the U.S. CDC advises international travelersto speak with a travel vaccine expert regarding their options one month ahead of departure.

In the Boston, Massachusetts, area, travel vaccination services are offered at Destination HealthTravel Clinic.

See the article here:

Costa Rica Confirms Whooping Cough Outbreak in Tibas - Precision Vaccinations

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Insights into vaccines for elderly individuals: from the impacts of immunosenescence to delivery strategies | npj Vaccines - Nature.com

COVID Vaccination during Pregnancy Protects Newborn Babies

Studies show that vaccination against COVID during pregnancy provides a powerful safeguard for vulnerable infants too young to receive the vaccine on their own

By Shannon Hall

Stock photo. For illustrative purposes only.

ArtistGNDphotography/Getty Images

When Emily Kara was 34 weeks pregnant, she received an additional COVID vaccine. She did not technically qualify for one. She had received her latest dose merely five months earlier, and her midwife even advised against another shot. But Kara (who asked to go by her middle name out of concern for her privacy) was determined. She had read multiple studies that strongly suggested a maternal COVID vaccine would pass along antibodies to her baby girl and protect her after she was born, when she was vulnerable to SARS-CoV-2 (the virus that causes COVID) and too young to receive the vaccine herself.

So Kara received an extra shot. And she is incredibly thankful that she did. It gives me peace of mind, says Kara, whose baby is now nine months old and has not tested positive for COVID.

The first wave of COVID vaccine trials that began in 2020 excluded pregnant peopleleaving expectant parents in the dark as to the vaccines safety for themselves and their child. But now that millions of pregnant people have received the vaccines, the data are solid. Not only do they show that the vaccines are safe and effective during pregnancy, but a growing consensus is also emerging that vaccinating a pregnant person against COVID can protect their newborn at a time when their little ones immune system is not mature enough to mount its own defense. Some studies even suggest that the protection lasts until roughly six months of age, when infants are old enough to receive their own vaccine.

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The science is relatively simple: when a COVID vaccine is given during pregnancy, the parents immune system develops antibodies against a protein in SARS-CoV-2 that then cross the placenta to the fetus and thus protect the newborn. This is why pregnant people have long been advised to receive the flu shot and the Tdap (tetanus, diphtheria and pertussis) vaccine. And one vaccinethe respiratory syncytial virus (RSV) vaccine approved last yearwas even developed specifically to be given during pregnancy to protect the baby after birth. That is something that we really ought to be leveraging for COVID as well, says David Kimberlin, a pediatric infectious disease specialist at the University of Alabama at Birmingham. I think the data are clear.

A study published in March in Pediatrics from the National Institute of Allergy and Infectious Diseases (NIAID) found that mothers who received an mRNA-based COVID vaccine during pregnancy protected their infant against symptomatic COVID infection for at least six months after birth. Last fall the U.S. Centers for Disease Control and Prevention similarly noted that infants born to women who had received a COVID vaccinebe it the primary series or a boosterat any point during pregnancy had a decreased risk of COVID hospitalization compared with infants who were born to women who had never received a COVID vaccine. And a study published in Nature Medicine in March 2023 found that newborns born to mothers who were vaccinated with a third (booster) dose were half as likely to be hospitalized for COVID as newborns born to mothers who had received the primary series and were eligible for a third dose during pregnancy but had not received it.

This protection is great news given COVIDs risk to newborn babies. One of the facts that gets lost in the general public is that in the pediatric population, COVID is most severe among young infants, resulting in the highest rates of hospitalization and death in this young age group, says Cristina Cardemil of the NIAID, who led the Pediatrics investigation. The hospitalization rate in babies under six months increased during the Omicron period and rivals that of adults aged 65-74. Not only have these infants never encountered these infectious diseases but they also have small airways and become dehydrated easily. Theyre doubly at risk for being vulnerable to a number of infectious diseases, Cardemil says.

Now expectant parents have a tool to shield their baby. Multiple studies show similar findings, and many suggest that a COVID booster during the second or third trimester confers the best protection. The Nature Medicine study authors write: We anticipate that future guidelines will adopt recommendations for routine COVID booster vaccination during the third trimester, aiming to reduce early infant morbidity, similar to recommendations for pertussis and influenza prevention.

And yet that is not the case. The CDC currently recommends that everyone, pregnant people included, receive the most recent version of the COVID vaccine, but it does not recommend an additional booster to ensure vaccination during pregnancy or point toward a specific administration time. For example, a pregnant person could receive a COVID vaccine in the fall before conceiving and deliver a baby before the next fall vaccine is releasedthus missing out on the benefits that an extra vaccine dose confers. The World Health Organization does recommend a single additional dose of the COVID vaccine during pregnancy, but this guideline seems to be the exception. In January, for example, Canadas National Advisory Committee on Immunization provided guidance on who should get an additional spring booster, and pregnant people were not mentioned. The same was true for the U.K.s spring booster campaign. (Guidelines from both countries note that the vaccine is safe and effective during pregnancy.)

The issue, experts say, is COVID fatigue. Governing agencies must make recommendations based on what is actually feasible, and an extra booster might be a hard sell when so few pregnant people are up to date on their COVID vaccine in the first place. In the U.S., for example, a mere 13 percent of pregnant people aged 18 to 49 have received the updated 20232024 COVID booster. People are very lackadaisical about it, says Laura Riley, chair of obstetrics and gynecology at Weill Cornell Medicine in New York City. And Im in a place where people get vaccinated. So the CDC has streamlined the most important message: vaccination protects against disease.

In response to a request for comment, a spokesperson from the CDC said: Available data show the vaccines for all eligible peopleincluding pregnant peoplecontinue to be strongly protective against severe illness and death. For that reason, the agency recommends that pregnant people stay up to date on their vaccines, but it will continue to review available evidence on whether additional or differently timed doses might be needed.

Yet many experts argue that the recommendation does a disservice to pregnant people, who are at heightened risk from the disease, and their newborn. The politicization of vaccines has led to this vaccine not being utilized as much as it should be, says Sallie Permar, chair of pediatrics at Weill Cornell Medicine and pediatrician in chief at NewYork-Presbyterian Komansky Childrens Hospital. She argues that the COVID vaccine clearly falls into the same category as the flu and Tdap vaccines, whose safety records and the benefits to both mom and baby have just been universally awesome.

Kimberlin agrees and is hopeful that the tides will soon shift toward stronger recommendations and a higher vaccine uptake during pregnancy. This is a very easy way to keep your baby safe, he says. And it absolutely should be recommended vigorously.

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COVID Vaccination during Pregnancy Protects Newborn Babies - Scientific American

Key Takeaways

Moderna (MRNA) shares jumped Tuesday after the biotech firm reported positive results from a small trial involving those with head and neck cancers treated with its experimental individualized MRNA cancer vaccine combined with Mercks (MRK) blockbuster drug Keytruda.

The study involved 22 patients with human papillomavirus negative (HPV-) head and neck squamous cell carcinoma who received Modernas mRNA-4157 injection along with Keytruda.

The company reported the drug cocktail produced preliminary positive clinical responses and disease control, including two complete responses. It added that along with boosting the immune response, the treatment was well tolerated.

The data were presented at the American Association for Cancer Research annual meeting in San Diego, Calif. yesterday. In its report, Moderna explained that a randomized assessment of the mRNA-4157-Keytruda combinations effect in the advanced disease setting may be warranted.

In December, Moderna and Merck announced they were initiating a Phase 3 trial of the two drugs to treat certain forms of lung cancer.

Moderna stock gained 6.2% to close at $111.60, making it the biggest gainer on the S&P 500 Tuesday. Merck shares ended 0.1% higher at $126.71.

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Moderna Reports Positive Results from Cancer Vaccine-Keytruda Combination Trial - Investopedia

Catherine J. Wu has been a pioneer in a promising approach to fight cancer: a vaccine that targets the specific immunogenic peptides generated by the distinct tumor mutations of any individual cancer. Honored in February with the $1 million Sjberg Prize, given for cancer research, Wu, a professor of medicine at Harvard Medical School and Lavine Family Chair for Preventative Cancer Therapies at the Dana-Farber Cancer Institute, spoke with the Gazette about the technology, its promise, and expectations that patients might see it in the near future.

What is a cancer vaccine?

A cancer vaccine aims to vaccinate the individual against immune determinants present in cancer cells to mount an immune response and hopefully eliminate those cancer cells. In general, cancer vaccines are therapeutic vaccines, meaning that they are treating an existing cancer, as opposed to a prophylactic vaccine, which is what we typically imagine when we think about vaccines against infectious pathogens. So, a major goal of a cancer vaccine is to drive the generation and expansion of an army of T cells that specifically recognizes tumor cells and to carry a program to eradicate that cancer. The concept of cancer vaccines has been around for decades, but until only recently, its clinical development has been quite a rollercoaster.

A major goal of a cancer vaccine is to drive the generation and expansion of an army of T cells that specifically recognizes tumor cells and to carry a program to eradicate that cancer.

Youre talking about how the vaccines get around a hurdle in convincing our immune systems to attack cancer cells: The immune system is designed to attack things that are foreign to the body, whereas cancer cells though harmful come out of our own tissues. The immune system doesnt attack because it recognizes tumors as us. Is that right?

Exactly, this is a major challenge for cancer vaccines. Our innovation is that we were among the first to identify tumor-specific peptides that are recognized by the immune system so-called antigens through genomic approaches. These neoantigens originate from cancer mutations. Since neoantigens have exquisite restriction of their expression to tumor cells, these would be optimal cancer antigens to go after, setting up the possibility of specific targeting of the cancer cell and not normal tissue. However, a long-existing problem was always the understanding that these neoantigens would differ from individual to individual and thus the conundrum of how one could feasibly go about identifying them on a person-by-person basis.

How did sequencing technology make the difference?

The availability of next-generation sequencing over the past decade, in which time and cost advantages for the DNA and RNA sequencing of cancer samples has been achieved such that weve been able to sequence thousands upon thousands of cancers. That has given us the stark realization of the vast molecular heterogeneity from tumor to tumor, even among patients with the same type of cancer. This fact really brings home the idea that a one-size-fits-all approach to cancer treatment or immunotherapy has its limitations. The ability to readily scan cancer genomes through such technology has made it possible to directly find the mutational profile of each cancer, and then to identify those mutations that have the potential to generate neoantigens.

Once we realized that it was possible to systematically identify neoantigens from cancer sequences, we began to realize that perhaps we could generate a personalized cancer vaccine: that from the mutation profile of any patient, we could design peptides that encompass those mutations that were predicted to be immunogenic. We then devised a manufacture strategy to combine up to 20 of those peptides into a vaccine that we could administer to patients as a series of skin injections that we could give to patents over the course of several weeks.

Im sure readers have heard and read a lot about cancer immunotherapy. How are vaccines related?

There are many different types of immunotherapy and this fact reflects the many, many different functions and roles that T cells and other immune cells can play. Each immunotherapeutic modality leverages a different subset of those functionalities: A CAR-T cell or an immune checkpoint blockade are different from what a vaccine might do. What they have in common, however, is that they are each stimulating immunity. A vaccine is trying to either generate new immune responses in an antigen-specific way that didnt exist before or they can amplify small pre-existing responses to become bigger. So, a vaccine has the potential to cast a wide immunoprotective net that can endure over time.

I hope that sometime in the not-too-distant future our patients can go to a clinic and say, Order me up a vaccine personalized for my cancer, and well be able to administer it on site.

In your first study that came out in Nature in 2017, you treated six melanoma patients. Do we know how theyre doing today?

I do know that three to four years after receiving the vaccine, all patients were still alive. We reported this result in 2021. Remarkably, two study patients who had very advanced cancer stage IV disease saw their cancer recur soon after vaccination. However, they both also got the immune checkpoint blockade and within 12 weeks all detectable tumor melted away. Its been now about six or seven years since then and these patients are off therapy and doing really well. Thats a huge success story and speaks to the strong positive synergy between vaccines and immune checkpoint blockade therapy.

What other types of cancer have been treated with these vaccines?

At Dana-Farber, we have treated patients in ongoing trials who have glioblastoma, kidney cancer, ovarian cancer, melanoma, and chronic lymphocytic leukemia. Separately, I also co-founded a company called Neon Therapeutics several years ago that conducted a larger study that treated patients with melanoma, lung, and bladder cancer.

Are these cancers chosen for any particular reason?

Cancer vaccines are cross-cutting as a treatment modality and can be tested in virtually any setting and in any cancer. Our selection has to do with the research questions that we are pursuing and I truly have had the privilege of working with so many extraordinary clinical investigators.

Are these all small, like the initial melanoma trial?

Yes, at Dana-Farber, our academic trials continue to be small, Phase 1 studies, of 10 to 30 patients. Our focus has been to take deep dives into the study of every single patient to understand what our interventions are doing immunologically.

Whats exciting is that there also now is a series of industry-sponsored studies my research group is not involved in them that are ongoing nationwide, even worldwide, that, hopefully within the next two or three years, will give us a population-level view of the impact of such personal cancer vaccines. Last fall, the first randomized, Phase 2 trial was reported out that demonstrated in melanoma the benefits of immune checkpoint blockade with a personalized cancer vaccine compared to immune checkpoint alone. I think were at an inflection point where the conceptual advantage of targeting many, many personal neoantigens simultaneously is undergoing rigorous testing. Such a personalized, multitarget approach is of conceptual importance because of the tremendous heterogeneity of tumor cell populations.

Even within one persons body?

Yes, exactly, and that is why a multipronged attack against cancer is favorable.

How big a hurdle is the fact that because these are so personalized, even with a trial of 10 or 30 people, you have to find new neoantigens for each person in the trial? Its not like youre trying the same drug on all 30.

It has its challenges. But with teams like ours at DFCI we are a collection of immunologists, clinical investigators, computational biologists, surgeons, and medical oncologists we are able to design these vaccines together in real time. It certainly takes a village, and I am so grateful to be part of that village. Given the challenge of coordinating the many parts of vaccine manufacture, this is an instance where partnering with industry is helpful, because they have the resources to develop processes at scale, streamlining costs, time, and labor. All of this is actively being figured out.

How far away are these vaccines from getting into the clinic?

Sooner than we think, because of academic innovations and industry-level efforts. Many large trials are ongoing now and I do think that theyll read out within two years. So, I hope that sometime in the not-too-distant future our patients can go to a clinic and say, Order me up a vaccine personalized for my cancer, and well be able to administer it on site.

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When will patients see personalized cancer vaccines? Harvard Gazette - Harvard Gazette

Ways to bring up vaccinations with family and friends that maintains relationships and sets healthy boundaries.

Having conversations about sensitive topics can be difficult for anyone, especially something as personal as our health. It can be difficult to bring up topics such as health and vaccines with the people we love, set boundaries where needed, and reconcile the need for social connections to stay healthy overall.

The World Health Organization (WHO) recommends five steps for discussing vaccines with loved ones:

In a recent series of webinars, Dr. Ida Rubino, Katie Stanulis, and John Novello sat down with MSU Extensions Michigan Vaccine Project to discuss how we can gather safely and talk about sensitive topics with the ones we care about.

One question that often comes up is, Is it okay to ask family and friends if theyre vaccinated, and if so, how do I do that politely?

John Novello, a licensed clinical social worker with the State of Michigan and Director of MSUs Employee Assistance Program, explained that the simple answer is yes, its okay. You really want to start with yourself getting some clarity, and actually thinking about what you are okay with and what youre not okay with before you even get to a place where youre going somewhere. Think about things like are you going to be comfortable being around people that are not vaccinated? How many people are you comfortable being around? What kind of space does that look like? And then the most important thing is to have a conversation with those you will be around. The goal of the conversation isnt to try to convince other people or talk them into being like you or thinking like you. The goal is simply to state where youre at and get information so that you can all make good choices about what makes the most sense in terms of gathering.

Novello also says that its important to discuss new social norms with family and friends before gathering. Set up your gatherings and say something like, hey, Im uncomfortable going to places when people are having flu/cold/COVID symptoms, so as a group, can we agree that if somebody is having symptoms that they let us know beforehand so everybody has full information and can decide if theyre comfortable still meeting or not. Youre creating a culture of expectation or culture of open discussion about this which can make everyone involved feel more comfortable with meeting together.

When discussing vaccines with her patients in the clinical setting, Family Physician Dr. Rubino says she aims to have conversations, based on shared decision-making, but at the same time offering resources that are reputable. In social settings, Dr. Rubino advises being honest and advocating for those you love. She says, In my own family, there are people who have COPD and currently going through chemotherapy, so for them being exposed to something is risky. I think its very appropriate to say, By the way, have you had any vaccines recently? We all love this person. We all love everyone whos gathering, so if you dont mind, are you feeling OK? Have you considered getting the vaccine? Im really just trying to protect this family member.

I think part of vaccine hesitancy is that this generation has not seen vaccine-preventable diseases because many have been eradicated or nearly eradicated. So, I think we need to really refer people to reputable sources to read about vaccines. We need to be educated as medical people about the schedule and the changes and the efficacy of these vaccines. And it really is one of the best forms of prevention that we have.

Dr. Rubino also emphasizes the need to stay connected, at the same time being mindful of those around you. I think its important that we still gather. Stay at home if youre sick; always wash your hands. If youre going to shake somebodys hand, wash your hands before you eat. Be aware of how germs are transferred. Get enough sleep, drink enough fluids, and eat healthy nutrition. And of course, get vaccinated.

The big takeaway? Be courteous. If you dont feel well, dont go to a gathering, and meet another time when youre feeling better.

Watch the webinars with Dr. Rubino, Katie Stanulis, and Jonathon Novello.

If you need help finding a doctor, try searching for primary care physicians in your area that are highly recommended, search your insurance providers website for doctors in your network, or ask for recommendations from friends and neighbors. There are also search engines that can help you narrow your search based on region and specialty needed.

To find a vaccine, check with your primary care physician, local health departments, pharmacies, and clinics. You can also visit https://www.vaccines.gov/ to locate a vaccine clinic near you.

If you would like to learn more about vaccines, check out Michigan State University ExtensionsMichigan Vaccine Project to find links to event schedules, podcasts, publications, webinars, and videos relating to vaccine education.

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How to talk to family and friends about vaccines - Michigan State University

Most Republican voters support childhood vaccine mandates, yet may be discouraged from publicly expressing these views, a new study suggests.

To determine the source of this disconnect, researchers conducted a survey that revealed differences between Republican voters who support childhood vaccine mandates and those who do not.

According to the study, most Republicans surveyed supported immunization requirements for children and held favorable attitudes toward vaccine safety, while those who said they opposed vaccine mandates did not acknowledge this support exists and expressed a greater willingness to share their vaccine views to others.

In contrast, the Republicans who supported vaccine mandates were largely aware that their views were in the majority, but tended to be less outspoken.

This phenomenon, called the false consensus effect, describes a misperception by people about how widespread their views are and a belief that their opinions are shared by others when they are not.

These results suggest that conservative supporters of childhood vaccination are not discouraged from speaking out because they assume that they are in the minority, but because external information environments, like social media, are sometimes dominated by minority views, said Graham Dixon, lead author of the study and an associate professor of communication at The Ohio State University.

Those in the majority may simply sit out of the conversation because they see online environments as being dominated by extreme views and dont want to engage in uncivil discourse, said Dixon. Whats significant is that those in the majority may self-silence even when they are aware of their majority status.

The study was recently published in the journal Human Communication Research.

The work is especially notable because it corroborates recent research showing that much of social media content is driven by a minority of users who express more opinionated and politicized views than the typical user, said Dixon.

Social media has become the new public square, so its concerning that the overrepresentation of atypical and sometimes extreme views may discourage people from participating in the conversation, he said.

This overrepresentation, notes the study, can discourage those in the majority from speaking out because they fear that they may experience social conflict from doing so.

For example, when participants who supported immunization requirements were frequently exposed to anti-vaccine content on social media, they were more likely to believe that they would encounter conflict if they publicly voiced their support for vaccines.

This is likely a larger consequence of the online social environment, as social media can be used to amplify misleading information that represents the views of only a small subset of the population, said Dixon. In this case, such large-scale self-censorship could play a role in hindering public mobilization of important public health policies.

Researchers also found that the studys results reveal more about majority misconceptions about a number of other issues, including how much support there is for climate change mitigation policies. For society to combat these issues, Dixon suggests that helping individuals build more self-confidence when engaging in online discourse and encouraging them to gain greater media literacy to navigate societys fluctuating information environment could be better tools for overcoming self-silencing.

We need to figure out ways of motivating people to engage in online discourse and to have the self-confidence necessary to be able to present their views, he said. Instead of telling them that their views are in the majority, efforts should be made to empower peoples self-confidence to participate in online discourse in civil and constructive ways.

Other Ohio State co-authors include Blue Lerner and Samuel Bashian.

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Republicans who support childhood vaccine mandates often stay silent - The Ohio State University News