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While we can attribute many public health successes to vaccination, the future presents continued challenges. Diseases remain for which researchers have been unable to find effective vaccines (such as HIV/AIDS, Malaria, and Leishmaniasis) or that flourish in areas of the world where infrastructures for vaccination are poor or nonexistent and even the currently available vaccines cannot be delivered. In other cases, the cost of vaccines is too high for poorer countries to afford, even though this is often where they are most needed. And, of course, although many of the current vaccines are highly effective, efforts continue to develop vaccines that are more effective than those available today. Thus, researchers continue to explore new possibilities. Higher effectiveness, lower cost, and convenient delivery are some of the main goals.

New Development Techniques

The first vaccine—the smallpox vaccine—consisted of a live, attenuated virus. “Attenuation” means weakening a virus to the point where it can still provoke an immune response, but doesn’t cause illness in a human host.

Many of the vaccines used today, including those for measles and some influenza vaccines, use live, attenuated viruses. Others used killed forms of viruses, pieces of bacteria, or inactivated forms of toxins that the bacteria create. Killed viruses, pieces of bacteria and inactivated toxins can’t cause illness, but can still provoke an immune response that protects against future infection.

New techniques are also being employed, however, to create different types of vaccines. Some of these new types include:

• Live recombinant vaccines
• DNA vaccines  

Live recombinant vaccines use attenuated viruses (or bacterial strains) as vectors: a virus or bacterium from one disease essentially acts as a delivery device for an immunogenic protein from another infectious agent. In some cases this approach is used to enhance the immune response; in others, it is used when giving the actual agent as a vaccine would cause disease. For example, HIV cannot be attenuated enough to be given as a vaccine in humans—it could cause AIDS.

Starting with a complete virus, researchers identify a section of the virus’s DNA that is not necessary for replication. One or more genes that code for immunogens of other pathogens are then inserted into this region. (Each gene essentially contains instructions that tell the body how to make a certain protein. In this case, researchers select genes that code for a protein specific to the target pathogen: an immunogen that will generate an immune response to that pathogen.) For example, a baculovirus (a virus that only infects insects) can be used as a vector and the gene for a particular immunogenic surface protein of an influenza virus may be inserted. 

When the modified virus is introduced into a person’s body, the immunogen is expressed and presented, generating an immune response against the immunogen—and, as a result, against the pathogen it originates from. In addition to insect viruses, human adenoviruses have been considered as potential vectors for use in recombinant vaccines, particularly against diseases such as AIDS. The vaccinia virus, which is the basis for the smallpox vaccine, was the first used in live recombinant vaccine approaches.^[1] Experimental recombinant vaccinia strains have been designed to deliver protection against influenza, rabies, and hepatitis B, among other diseases. 

DNA vaccines consist of DNA coding for a particular antigen, which is directly injected into the muscle. The DNA itself inserts into the individual’s cells, which then produce the antigen from the infectious agent. Since this antigen is foreign, it generates an immune response. This type of vaccine has the benefit of being relatively easy to produce, since DNA is very stable and easy to manufacture, but is still experimental because no DNA-based vaccines have been shown to elicit the substantial immune response required to prevent infection. Researchers are hopeful, however, that DNA vaccines may be able to generate immunity against parasitic diseases such as malaria—currently, there is no human vaccine in use against a parasite.^[2]

New Delivery Techniques

When you think of vaccination, you probably think of a doctor or nurse administering a shot. Future immunization delivery methods, however, may be quite different from what we use today.

Inhaled vaccines, for example, are already used in some cases: influenza vaccines have been made in the form of a nasal spray. One of these vaccines is available every year for seasonal flu. Other possibilities include a patch application, where a patch containing a matrix of extremely tiny needles delivers a vaccine without the use of a syringe. This method of delivery could be particularly useful in remote areas, as its application would not require delivery by a trained medical person, which is generally needed for vaccines delivered as a shot by syringe.

Another issue researchers are attempting to address is the so-called cold chain problem. Many vaccines require cool storage temperatures in order to remain viable. Unfortunately, temperature-controlled storage is often unavailable in parts of the world where vaccination is vital for disease control. One of the reasons smallpox eradication was successful was that the smallpox vaccine could be stored at relatively high temperatures and remain viable for reasonable periods of time; some contemporary vaccines, however, cannot withstand such temperatures. The eruption of the Eyjafjallaajokull volcano in Iceland in April 2010 brought air traffic to a standstill in Northern Europe, including planes carrying 15 million doses of polio vaccine bound for West Africa. Officials feared that the delay in delivering the vaccines would allow polio to spread, or that temperatures in the cargo holds of the grounded planes would render the vaccines ineffective.^[3]

Such situations highlight the need for vaccine materials that can be easily transported in a range of conditions and still remain viable. One possible approach to this problem was studied in early 2010 by researchers at the Jenner Institute of the University of Oxford. Starting with a small filter-like membrane, the researchers coated it with an ultrathin layer of sugar glass, with viral particles trapped inside it. In this form, the viruses the researchers used could be stored at temperatures of up to 113°F for six months without losing their ability to provoke an immune response. By comparison, when maintained in liquid storage at 113°F for just one week, one of the two viruses tested was essentially destroyed.

The researchers also demonstrated that the vaccine material could be placed in a holder designed to attach to a syringe, allowing a vaccinator to prepare the vaccine material (with a fluid medium inside the syringe) and administer the vaccine almost simultaneously.

Although this research was preliminary, it offers a promising new avenue for vaccine storage and delivery. With a stabilization method like this one, widespread vaccination campaigns may be possible in areas previously difficult or impossible to reach.^[4]

The future of immunization depends on the success of medical research for vaccines that are simpler to administer, will survive transport even without refrigeration, and will provide a more substantial and long-lasting immune response. And in parallel, the continuing success of vaccines against so many infectious diseases has inspired scientists to try to use similar methods to combat diseases that remain lethal to many people, such as malaria, HIV/AIDS, and other diseases for which there are not yet vaccines. 

Sources

1. Plotkin S, Mortimer E. Vaccines. New York: Harper Perennial; 1988.
2. Volcanic ash delays West African polio vaccination. Updated April 20, 2010. Accessed October 2, 2013.
3. Carvalho JA, Rodgers J, Atouguia J, Prazeres DM, Monteiro GA. DNA vaccines: a rational design against parasitic diseases. Expert Rev Vaccines. 2010 Feb;9(2):175-91.
4. Alcock R, Cottingham M, Rollier C et al. Long-Term Thermostabilization of Live Poxviral and Adenoviral Vaccine Vectors at Supraphysiological Temperatures in Carbohydrate Glass.Sci. Transl. Med. 2010;  2(19), 19ra12.

Last update 10 Jan 2014

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Connie’s comments: I delayed the vaccine schedule for my newborn to 12m and not to start at 2m for many research reasons.

Physicians per 1000 people in the world, more pain med prescriptions after OBAMACARE.

Walking and running increase the brain’s hippocampal volume preventing Alzheimer’s and pulmonary diseases.

Obamacare stress points.

1. Deductibles that can be skyhigh for low-income households.
2. Ultra-narrow provider networks that make it hard for some to get care while socking others with unexpectedly large bills.
3. A family penalty that denies subsidies to modest-income households when one spouse is offered employer coverage.
4. A subsidy cliff that can leave older workers of moderate means paying an excessive share of income for coverage.
5. Tax penalties that employers have sought to avoid by cutting low-wage worker schedules below 30 hours per week.
6. A Medicaid gap opened by a Supreme Court decision that has left millions below the poverty line, including those who have lost work hours, with no help in states that have opted against the expansion.

Endocrine disruptors are chemicals that at certain doses, can interfere with the endocrine (or hormone system) in mammals. These disruptions can cause cancerous tumors, birth defects, and other developmental disorders.^[1] Any system in the body controlled by hormones, can be derailed by hormone disruptors. Specifically, endocrine disruptors may be associated with the development of learning disabilities, severe attention deficit disorder, cognitive and brain development problems; deformations of the body (including limbs); breast cancer, prostate cancer, thyroid and other cancers; sexual development problems such as feminizing of males or masculine effects on females, etc.^{[citation needed]} The critical period of development for most organisms is between the transition from a fertilized egg, into a fully formed infant. As the cells begin to grow and differentiate, there are critical balances of hormones and protein changes that must occur. Therefore, a dose of disrupting chemicals may do substantial damage to a developing fetus (baby). The same dose may not significantly affect adult mothers.^{[citation needed]}

There has been controversy over endocrine disruptors, with some groups calling for swift action by regulators to remove them from the market, and regulators and other scientists calling for further study. Some endocrine disruptors have been identified and removed from the market (for example, a drug called diethylstilbestrol), but it is uncertain whether some endocrine disruptors on the market actually harm humans and wildlife at the doses to which wildlife and humans are exposed. Additionally, a key scientific paper, published in the journal Science, which helped launch the movement of those opposed to endocrine disruptors, was retracted and its author found to have committed scientific misconduct.^[2]

Found in many household and industrial products, endocrine disruptors are substances that “interfere with the synthesis, secretion, transport, binding, action, or elimination of natural hormones in the body that are responsible for development, behavior, fertility, and maintenance of homeostasis (normal cell metabolism).”^[3] They are sometimes also referred to as hormonally active agents,^[4] endocrine disrupting chemicals,^[5] or endocrine disrupting compounds (EDCs).^[6]

Studies in cells and laboratory animals have shown that EDs can cause adverse biological effects in animals, and low-level exposures may also cause similar effects in human beings.^[7] The term endocrine disruptor is often used as synonym for xenohormone although the latter can mean any naturally occurring or artificially produced compound showing hormone-like properties (usually binding to certain hormonal receptors). EDCs in the environment may also be related to reproductive and infertility problems in wildlife and bans and restrictions on their use has been associated with a reduction in health problems and the recovery of some wildlife populations.

Triclosan has been used since 1972, and it is present in soaps (0.10-1.00%), shampoos, deodorants, toothpastes, mouth washes, and cleaning supplies,^[8] and is incorporated into an increasing number of consumer products, such as kitchen utensils, toys, bedding, socks, and trash bags.^[9][10] It is also found in health care settings in surgical scrubs and personnel hand washes.^[11] Triclosan has been shown to be effective in reducing and controlling bacterial contamination on the hands and on treated products. More recently, showering or bathing with 2% triclosan has become a recommended regimen in surgical units for the decolonization of patients whose skin is carrying methicillin-resistant Staphylococcus aureus (MRSA)^[12] following the successful control of MRSA outbreaks in several clinical settings. Use in surgical units is effective with a minimum contact time of approximately 2 minutes.^[13][14]

Antimicrobial hand soaps including those containing triclosan have been shown in studies to provide a slightly greater bacterial reduction on the hands compared to plain soap.^[15] In addition, researchers at Dial found that the transfer of bacteria to objects was reduced following washing with antimicrobial hand soap containing triclosan compared to plain soap.^[16] The FDA’s current stance on triclosan differs, based on their analysis of the body of research, and is as follows: “At this time, FDA does not have evidence that triclosan added to antibacterial soaps and body washes provides extra health benefits over soap and water. Consumers concerned about using hand and body soaps with triclosan should wash with regular soap and water.” ^[17]

Triclosan is regulated by the U.S. Food and Drug Administration, the Environmental Protection Agency, and the European Union. During wastewater treatment, a portion of triclosan is degraded, while the remaining adsorbs to sewage sludge or exits the plant in wastewater effluent.^[18][19] In the environment, triclosan may be degraded by microorganisms or react with sunlight, forming other compounds, which include between 3 and 12% of chlorophenols and dioxin

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Call Connie Dello Buono 408-854-1883 motherhealth@gmail.com for access to funds up to $1.5M when cancer,stroke or disability occurs. In 50 US states.