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Biotech / Medical : North American Vaccine -- Ignore unavailable to you. Want to Upgrade?

To: Don W Stone who wrote (263)	1/30/1998 4:58:00 PM
From: aknahow	Respond to of 507

Gee, Don your really great!!! Did you buy me a fax?? Did not have one until you told me about it. Guess you have been right all along and Rick has been wrong.<g> Don't need another fax but willing to change my opinion- hint for RS. BTW Don, your post did make sense, just as I thought it would.

To: Don W Stone who wrote (263)	1/31/1998 9:34:00 PM
From: Cacaito	Read Replies (2) \| Respond to of 507

"There isn't a single vaccine out there that will cause an epidemic that i am aware of.." Don W., inactivated (dead)vaccines do not cause epidemics, all the pertusis vaccines are in this group. But there was in the 1980s a significant limphadenitis epidemic in Jamaica due to a new active (attenuated and living)BCG vaccine. They were trying to improve the tuberculosis vaccine, but created the epidemic. The vaccine was withdrew. Even more interesting is the active (attenuated)and higly succesful Oral Polio Vaccine (OPV). This vaccine ability to infect the people around the children and other children creating "silence" and constant miniepidemics is well known and is one of the caracteristics invoke by many epidemiologist as highly desirable for the erradication of the disease. Recently in the US and the rest of the Americas only post vaccination paralitic disease has being found, now they are using the Inactivated polio vaccine (IPOL) in the first two shots, to decrease or eliminate the few cases of paralitic disease, combined with the subsequent use of OPV (and the benefit of the continue miniepidemics). OPV is not use in pediatric hospital wards to avoid spreading the vaccine virus to very sick children (cancer, AIDS). And before giving it to other children pediatricians must ask if any of these type of patients are at home (use IPOL instead). Back to Pertussis, miniepidemics will happen every certain number of years (7 to 10) due to the 5% to 10% of children that do not respond well (decrease to smaller numbers, due to repeat shots, total of 4 to 5 in most vaccination schedules). Then there is a population at risk that accumulates over the years. The patients that who have no response at all will have the worst clinical presentation. But the disesase will be of less severity in the immunized children (still a big benefit, not a complete failure). Another problem are migrant populations. For the recent Dutch epidemics it will be good to know the degree of expresion of the clinical disease (morbidity, hospitalization rates, mortality)before judging it a complete failure of the whole cell approach. Whole cell and multicomponents will have a better outcome (no wonder that most pharmas has goen this way). Certiva argument could be that the very specific aim of its single component will create a better immunity. But their efficacy (71%) is lower than the others (85%) as per Sturza. Multicomponents is a much better strategy in Pertussis. This not the case of diphtheria or tetanus were the exotoxins are the main responsible for the clinical picture and damage. Pertussis is not an exclusivily exotoxin disease, this is just part of the problem. I do not see the case that the lack of Pertactin will protect children better to the new strain. I see exactly the opposite. A much vulnerable population. Only one gun to fight a multiattack. Remember that part of the protection afforded by Certiva is due to the high inmunization rates in the enviroment where the studies are carry on (this is the rest of the children and adults are immunized artificially or naturally). This is called the "herd immunity". Of course the other vaccines also are subject to this benefit. Even if they are approved, they have a big problem with the combination vaccines (DTP-HiB) that are already in the market. And if the expected (DTaP-HiB) comes out soon then it will be a bigger competitive disadvantage. The GBS vaccine sounds interesting concept, but tough to put it to work. This is intended (I think) for women thinking in their possible pregnancy problems with GBS. Pediatricians agree with the concept (they have to take care of the sick neonate) but the ones to give it are the Obstetrics physicians, or the Adolescent speciallists (pediatricians and Family practice). This logistics problem could be overcome (and I wish it so)with the Vaccine panels "recommendations" (they are almost a sure thing one this panel go ahead, and make it the new standard, most abide for it, physicians and the payers). BTW, I got the fax (not george) the "Special Report" is a neat piece of work. But I am not putting my money on it. Bear on NVX, but no with my money. I like to invest in what I like. I follow the company not for Certiva, but for the possibilities of the GBS vaccine from the clinical and financial rewards it could bring. But I will like to see the development of it a little bit further.