Saturday, July 28, 2012

The Vaccination Research Group at Virginia Tech

http://www.vaccination.english.vt.edu/
The Vaccination Research Group (VRG) at Virginia Tech is a collaborative research group that brings together faculty and students from a variety of disciplines, including English, Public Health, History, and Computer Science.

Together, we conduct research projects into historical and contemporary vaccine controversy with the aim of increasing understanding of vaccine skepticism and achieving improved communications among doctors, patients, health officials, and communities nationwide.

The group encourages undergraduate research by involving undergraduate researchers who conduct their own original research in support of faculty projects; student members create reports and other deliverables for publication on our website.

Graduate students (like myself) have also supported the group by bringing their dissertation or other research projects to the group for assistance, support, and feedback. I've been fortunate enough to be involved in the group since it began, and it has richly inspired and informed my graduate and professional work.

If you're interested in issues related to vaccination, please check out our website; send questions to vaccine@vt.edu.

Friday, July 27, 2012

Pertussis...

The pertussis outbreaks in Floyd County last year didn't quite make national (or even regional) headlines, but it appears that the depth and breath of this year's outbreaks of pertussis are gaining a lot of press (and specific coverage in last week's MMWR, which only focuses on Washington state, where the Secretary of Health declared a pertussis epidemic in April).

Outbreaks are happening nationwide and internationally, as The Guardian reported today that 5 infants have died from pertussis so far this year. Lots more to look into there, particularly as it relates to the Olympics and travel to/from London.

Interesting trends that I'm seeing, both in the actual outbreaks and the reporting:

  1. Lots of emphasis on getting vaccinated as a way to control these outbreaks and to lessen the intensity of symptoms if one does contract pertussis. 
  2. This article in the LA Times gives, I think, an interesting explanation for why so many teens and adults have waning immunity: the change to acellular DTaP vaccinations in the late 1990's. 
  3. The article describes the change from DTP to DTaP as a response to concerns about side effects, namely rare, "inconsistently" proven neurological side effects (like those first brought up in DPT (sic): Vaccine Roulette, I believe).  It will be interesting to see how those claims continue to develop as a part of popular and government reporting on the outbreaks.
  4. Most of the articles I'm seeing don't use that rationale for blaming antivaccinators for these outbreaks and focus instead on the risk that low vaccination rates pose to herd immunity. This article in Forbes is particularly harsh.

A Vaccine for AIDS?

"Scientists Hunting for an AIDS Vaccine May be Getting Close," The Washington Post, Alyssa Bothello, July 23, 2012

http://www.washingtonpost.com/national/health-science/scientists-hunting-for-an-aids-vaccine-may-be-getting-close/2012/07/23/gJQA9TJt4W_story.html

The idea of a vaccine for AIDS is powerful in the context of vaccine controversy.

Vaccines against diseases perceived to be sexually transmitted have historically been controversial.  Elena Conis's brilliant 2011 article in the Journal of the Medical Humanities, "'Do We Really Need Hepatitis B on the Second Day of Life?' Vaccination Mandates and Shifting Representations of Hepatitis B" offers an extensive--and remarkable--history of hepatitis B vaccination regulations in the United States. But, even without access to JSTOR, you only need to read a few articles on controversies around Gardasil to know that, as much as it was marketed as a vaccine against cervical cancer, nearly all of the chatter that arose following its deployment related to its protection against HPV infection, which is of usually sexually transmitted. The argument that these vaccines should not be required because the diseases they prevent are avoidable and not communicable in a public setting has some validity (and is the basis for the Gardasil exemption in Virginia).

Yet at the same time, I don't know that, in the popular sense anyway, cervical cancer or hepatitis B are quite the same as AIDS. There isn't the same fear attached, the same seeming ubiquitousness, the same mystery of the virus to end all viruses. The same death toll, expenses, or community action. I grew up in the 1980's, so the full impact of AIDS was a bit before my time. Yet, even I have distinct memories of AIDS in ways that I don't have about other diseases--Ryan White, the child with AIDS; Pedro on The Real World; the loss of my uncle to HIV/AIDS in 2008. I imagine everyone has some combination of the personal and media experiences with AIDS that aren't quite the same as those we might have about cervical cancer or hepatitis.

So, what will the public reaction be to the AIDS vaccine in the United States, if it ever gets here? Will people clamber for it? Refuse and protest in droves? React with apathy? Rejoice? Will it make a difference? How will AIDS change culturally as a disease? Will it become like polio or rubella--something you get vaccinated for that you wouldn't even know you had if you came down with it?

Either way, in addition to having a potentially powerful effect on global health, the social implications of such a vaccine will be considerable, and fascinating to watch.