Vaccine May Stop Immune Attack in Type 1 Diabetes, Study Suggests

Early trial found it boosts insulin production, appears safe

By Serena Gordon

HealthDay Reporter

WEDNESDAY, June 26 (HealthDay News) -- A new type of vaccine may stop the autoimmune attack that occurs in people with type 1 diabetes, researchers report.

Although an initial trial of the vaccine wasn't able to free anyone from their daily insulin injections, it did boost insulin production, which could help prevent some of type 1 diabetes' most devastating complications.

Instead of increasing the immune system's activity like the polio or influenza vaccine does, the new vaccine turns off a portion of the immune response, acting as a reverse vaccine. The researchers were able to isolate a part of the immune response that only seems to be involved with type 1 diabetes, according to the study. That means the vaccine likely wouldn't have the risks that medications that suppress the immune system do.

"We were able to destroy the rogue cells that are attacking the insulin-producing cells without destroying any other part of the immune system, and that's truly exciting," said senior study author Dr. Lawrence Steinman, a professor of pediatrics and neurology and neurological sciences at Stanford University School of Medicine.

"Once the immune attack is stopped, I believe there's great potential for recovery in the beta cells," Steinman added.

Beta cells in the pancreas produce the hormone insulin. In people with type 1 diabetes, it's believed that the immune system mistakenly destroys the healthy beta cells, leaving the person with no or too little insulin.

Insulin is a crucial hormone because it's involved in the metabolism of the carbohydrates. It allows the glucose (sugar) from those carbohydrates to fuel the cells in the body and brain. Without enough insulin, a person will die. That's why people with type 1 diabetes must take multiple daily injections of insulin, or deliver insulin through a catheter inserted under the skin that's attached to an insulin pump.

The vaccine was designed by changing a piece of immune-system DNA so that it would shut down the immune system's response to signals in the body that have previously triggered the mistaken destruction of beta cells. These signals come from fragments of a protein (peptides) called proinsulin, which is found on the surface of beta cells. Proinsulin is a precursor to insulin.

"We just wanted to throw the off switch for the one cell being attacked," Steinman explained.

The researchers recruited 80 volunteers diagnosed with type 1 diabetes during the past five years. They were randomly placed in one of five groups. Four groups received various doses of the vaccine, and the fifth group received placebo injections. Shots were given weekly for 12 weeks.

No one in the study was able to stop using insulin. "That's a possible goal, but it's too early to start saying cure," Steinman noted.

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HPV Vaccine Lowering Infection Rates Among Girls: CDC

Extent of protection from sexually transmitted virus higher than expected, suggesting 'herd immunity' is at work, experts say

By Dennis Thompson

HealthDay Reporter

WEDNESDAY, June 19 (HealthDay News) -- Vaccination against the cancer-causing human papillomavirus (HPV) is proving highly effective in reducing the spread of the sexually transmitted virus among young women, new research shows.

The rate of new infections with strains of HPV targeted by the vaccine have dropped by 56 percent among females aged 14 to 19 since the first vaccine was approved in 2006, report researchers at the U.S. Centers for Disease Control and Prevention.

According to the CDC, HPV infection is known to be the major cause of cervical cancer, and has also been strongly linked to vulvar, vaginal, penile, anal, and certain throat/oral cancers.

The new findings "are striking results, and I think they should be a wake-up call that we should increase vaccination rates, because we can protect the next generation of adolescents and young girls against cancer," CDC director Dr. Tom Frieden said in a press conference held Wednesday.

The findings are published in the June issue of The Journal of Infectious Diseases.

Each year in the United States about 19,000 cancers caused by HPV occur in women, with cervical cancer being the most common. Virtually all cases of cervical cancer are caused by HPV, and just two HPV subtypes, 16 and 18, are responsible for seven out of every 10 cervical cancers.

About 8,000 cancers caused by HPV occur each year in men in the United States, most commonly being throat cancer.

The decline in HPV infections among girls is actually higher than had been expected, indicating that "herd immunity" may have taken effect as more girls receive the vaccine, study lead author Dr. Lauri Markowitz said at the press conference.

Herd immunity occurs when widespread vaccination shrinks the pool of infected people to the point that it becomes less likely that a person can catch the disease from someone else. In this type of scenario, "even people who aren't vaccinated will have some protection due to the vaccination program," Markowitz said.

Another possible reason for the better-than-expected results could be that the vaccine is so effective that a girl receives protection from HPV even if she receives only one or two shots out of the full recommended three-dose series of vaccination.

Whatever the reason, the new statistics are "great news," according to Dr. Jay Brooks, chairman of hematology/oncology at Ochsner Health System in Baton Rouge, La. "I think every young woman should have the opportunity to have this vaccine. That's what I've been telling people for however long the vaccine has been available."

HPV is highly infectious. In fact, about 79 million Americans, most in their late teens and early 20s, are thought to be currently infected with HPV, and each year about 14 million people become newly infected.

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Study: Older Whooping Cough Vaccine More Effective

But it was phased out because of side effects; newer version works, study notes

By Serena Gordon

HealthDay Reporter

MONDAY, May 20 (HealthDay News) -- The older vaccine for whooping cough that was phased out in the late 1990s is more effective than the current version of the vaccine, a new study contends.

Teenagers who received four shots with the older vaccine -- called whole-cell vaccine -- before they were 2 years old were significantly less likely to become infected with whooping cough during a recent outbreak in California, compared to children who received all of their immunizations with the new vaccines, called the acellular vaccine.

"Teens who were vaccinated with the acellular vaccine appear to have a six times higher risk of [whooping cough] than teens who received four doses of the whole-cell vaccine. And, the teens who received some whole-cell vaccine and some acellular had about a four times higher risk than teens who received all whole-cell vaccines," said the study's lead author, Dr. Nicola Klein, co-director of the Northern California Kaiser Permanente Vaccine Study Center, in Oakland.

Whooping cough, which is also known as pertussis, is a highly contagious respiratory infection. In 2012, the United States had the highest number of whooping cough cases since 1959 with more than 41,000 infections and 18 deaths. Most of the deaths occurred among infants, according to the U.S. Centers for Disease Control and Prevention.

The whole-cell vaccine was used from the 1940s to the 1990s, but was phased out due to potential side effects. "The reason we switched away from the whole-cell vaccine was that there were some safety concerns, such as high fevers," Klein explained.

The acellular vaccine was introduced in the 1990s, and has few side effects. However, in recent years, a number of studies have found that the newer vaccine doesn't seem to work for as long as the older vaccine.

California experienced an outbreak of whooping cough in 2010 and 2011. This gave researchers the chance to see how effective the acellular vaccine was compared to the whole-cell vaccine in teens who may have received all of their shots with one or the other vaccine, or possibly with both.

The study included teens born from 1994 to 1999 who got their initial four shots of whooping cough vaccine before they were 2 years old at Kaiser Permanente Northern California.

Of the study participants, 138 teens had confirmed whooping cough. They were compared to 899 teens who'd had a lab test that confirmed they didn't have whooping cough, and to 54,339 "matched control" teens.

The researchers found that the fewer number of whole-cell vaccines a teen had received, the greater the risk of whooping cough.

Teens who had received all acellular vaccines had a 5.63 times greater risk of whooping cough than teens who'd gotten all whole-cell vaccines. Teens who received both acellular and whole-cell vaccines had a 3.77 times higher risk of whooping cough compared to those who had all whole-cell vaccines.

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Parents' Worries About HPV Vaccine on the Rise: Study

Title: Parents' Worries About HPV Vaccine on the Rise: Study
Category: Health News
Created: 3/18/2013 12:56:00 PM
Last Editorial Review: 3/18/2013 12:00:00 AM

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Flu Vaccine Fell Short for Seniors This Season: CDC

By Steven Reinberg

HealthDay Reporter

THURSDAY, Feb. 21 (HealthDay News) -- The flu vaccine has fallen markedly short of expectations for older Americans this winter, offering this vulnerable population protection against the most virulent strain of flu virus just 9 percent of the time, U.S. health officials reported Thursday.

Even among the general population, the vaccine's effectiveness was just 56 percent, which is considered slightly below average, according to the latest data from the U.S. Centers for Disease Control and Prevention.

Complicating matters, the 2012-13 season has turned out to be one of the more severe flu seasons in recent years because of the presence of the H3N2 virus -- a strain associated with severe bouts of influenza.

"This was really a worse-than-average flu season," said CDC spokesman Tom Skinner. "It hit the elderly particularly hard. We saw a lot of hospitalizations and, unfortunately, a lot of deaths of the elderly."

"For reasons we don't fully understand, the efficacy rate in those 65 and older against H3N2 was lower than what we would like," he said.

This makes it even more important for the elderly, even if they've been vaccinated, to seek treatment early with antiviral drugs like Tamiflu when they come down with the flu, Skinner said.

Dr. Marc Siegel, associate professor of medicine at NYU Langone Medical Center in New York City, agreed that it's "not an ideal vaccine, but it offers a public health advantage -- it's worth taking."

"The reason this vaccine is not that effective for the elderly is because it's hard for the elderly to mount an immune response," he added.

The vaccine is most effective against influenza B viruses, reaching a level of 67 percent protection both overall and among seniors, the CDC report showed.

"The message is we need better vaccines," Skinner said.

Skinner noted that vaccination is still the best protection against the flu, because even if you get sick the vaccine may make the illness milder.

"If people use these numbers not to get vaccinated, I think that will be a tragedy," Skinner said. "Some protection is certainly better than no protection at all."

The findings were published Feb. 22 in the CDC publication Morbidity and Mortality Weekly Report.

This flu season has caused high hospitalization rates, with seniors accounting for 50 percent of all those admitted for the flu.

"This is the highest hospitalization rate [for seniors] since 2003, and may be the highest ever," Siegel said.

Also, nearly 10 percent of deaths up to Feb. 9 have been attributed to the flu or pneumonia associated with the flu. Again, the elderly were hit the hardest, Skinner said.

Sixty-four children have died from flu this season. That number is precise, because the federal government keeps track of pediatric flu deaths. No such count is kept on adults. Typically, approximately 25,000 Americans die from the flu every year, according to the CDC.

Skinner said this year's flu season started early, but seems to be winding down. "But we'll see if that trend continues," he added.

More information

For more on the flu, visit the U.S. Centers for Disease Control and Prevention.

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Flu Vaccine Fell Short for Seniors This Season: CDC

Title: Flu Vaccine Fell Short for Seniors This Season: CDC
Category: Health News
Created: 2/21/2013 2:36:00 PM
Last Editorial Review: 2/22/2013 12:00:00 AM

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Untreated Depression May Cut Shingles Vaccine Effectiveness

Title: Untreated Depression May Cut Shingles Vaccine Effectiveness
Category: Health News
Created: 2/14/2013 10:35:00 AM
Last Editorial Review: 2/14/2013 12:00:00 AM

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Whooping Cough Vaccine for Pregnant Women Among New Recommendations

MONDAY, Jan. 28 (HealthDay News) -- The U.S. Centers for Disease Control and Prevention and the American Academy of Pediatrics have released new vaccine guidelines for 2013.

One change is a recommendation for women to receive a dose of the whooping cough (pertussis) vaccine with each pregnancy. Another is the suggestion that mild egg allergy need no longer prevent people from getting the flu vaccine under certain circumstances.

The guidelines also clarify the use of the pneumococcal vaccine -- which protects against sometimes life-threatening meningitis, pneumonia and blood infections -- in certain vulnerable populations.

Current levels of vaccination in adults are low, according to the CDC's Advisory Committee on Immunization Practices. Because of this, the committee recommended that providers review patients' vaccination records and recommend needed vaccines.

"It's so important to adhere to these immunization schedules. People need to understand: These schedules are put together with great care and discussion and review of scientific data," said Dr. H. Cody Meissner, a member of the American Academy of Pediatrics committee that makes vaccine recommendations.

Meissner said sometimes parents will ask to alter the way vaccines are given, requesting things like a half-dose now and the rest of the dose at a later time. "We just don't know if vaccines work at half-doses. It's critically important to adhere to the schedule," he said.

The latest vaccine recommendations can be found in the Feb. 5 issue of the journal Annals of Internal Medicine and the February issue of the journal Pediatrics.

The most notable change is the new recommendation that pregnant women -- whether adolescent or adult -- receive a booster dose of the tetanus, diphtheria and acellular pertussis (TDaP) vaccine during each pregnancy. Ideally, this booster will be given between 27 and 36 weeks of gestation.

"We're seeing more pertussis now than we have in earlier years. When the final numbers are in for 2012, the number of reported cases will probably be around 35,000," Meissner said. "But the actual number could be far more than that, because they don't all get documented. There were about 20 deaths last year, primarily children in the first two to three months of life."

Meissner, who also is chief of pediatric infectious disease at the Floating Hospital for Children at Tufts Medical Center in Boston, said that children in this age group don't yet have protection from vaccines. Since the vaccine crosses through the placenta, an immunization given later in the pregnancy should offer a high level of immunity to the baby.

He added that it's also a good idea for anyone who will be around the baby, including the father, siblings and grandparents, to be sure they're up to date on their vaccines.

Another expert said the resurgence of whooping cough is most likely due to a change in vaccine design that got rid of many side effects, but did so at the cost of long-term effectiveness.

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