national press foundation - understanding vaccines (david curry, peg willingham)

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National Press Foundation Vaccines Webinar Series 15 November 2011 David R. Curry, MS Executive Director Center for Vaccine Ethics and Policy Associate Fellow, Center for Bioethics University of Pennsylvania [email protected]

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Page 1: National Press Foundation - Understanding Vaccines (David Curry, Peg Willingham)

National Press FoundationVaccines Webinar Series

15 November 2011

David R. Curry, MSExecutive Director

Center for Vaccine Ethics and Policy Associate Fellow, Center for Bioethics

University of [email protected]

Page 2: National Press Foundation - Understanding Vaccines (David Curry, Peg Willingham)

Mission: Contribute to global public health as the

leading independent, academically-based center focused on immunization and vaccine

ethics and policy

www.centerforvaccineethicsandpolicy.org

Page 3: National Press Foundation - Understanding Vaccines (David Curry, Peg Willingham)

Adapted from: Jason L. Schwartz, MBE, AM, Center for Bioethics; Department of History & Sociology of

Science University of PennsylvaniaNVAC Health Care Personnel Influenza Vaccination Subgroup31 May 2011

Three Themes

Vaccines - fast history…fast forward

Vaccine Basics – What, How, Why

Vaccines – HPV Discussion: Public Health Deployment

Page 4: National Press Foundation - Understanding Vaccines (David Curry, Peg Willingham)

Adapted from: Jason L. Schwartz, MBE, AM, Center for Bioethics; Department of History & Sociology of

Science University of PennsylvaniaNVAC Health Care Personnel Influenza Vaccination Subgroup31 May 2011

Vaccines: Three Minute History ? Chinese employ smallpox inoculation (or variolation) as early as 1000 CE. Spreads to Africa and Turkey as well, before to Europe and the Americas. Edward Jenner successful 1796 use of cowpox material to create immunity to smallpox, quickly widespread Louis Pasteur’s 1885 rabies vaccine Antitoxins and vaccines against diphtheria, tetanus, anthrax, cholera, plague, typhoid, tuberculosis, and more developed through the 1930s. Vaccines for polio in mid-1950s Vaccines for measles, mumps, and rubella follow…

Page 5: National Press Foundation - Understanding Vaccines (David Curry, Peg Willingham)

Adapted from: Jason L. Schwartz, MBE, AM, Center for Bioethics; Department of History & Sociology of

Science University of PennsylvaniaNVAC Health Care Personnel Influenza Vaccination Subgroup31 May 2011

Main currently available vaccines

New vaccines anticipated before 2020

Cholera Diphtheria Tetanus Pertussis Hepatitis B Haemophilus

influenza type B

HPV Seasonal

Influenza

Measles Polio Rubella Tuberculosis Yellow Fever Meningitis Pneumococca

l Rotavirus Japanese

Encephalitis

Dengue Leishmaniasis Malaria Typhoid

Decade of Vaccines Collaboration Global Vaccine Action Plan draft materials, Nov 2011

Vaccines: What, How, Why

Page 6: National Press Foundation - Understanding Vaccines (David Curry, Peg Willingham)

Adapted from: Jason L. Schwartz, MBE, AM, Center for Bioethics; Department of History & Sociology of

Science University of PennsylvaniaNVAC Health Care Personnel Influenza Vaccination Subgroup31 May 2011

Vaccine Futures

Neglected Tropical Diseases (NTDs)

Non-Communicable Diseases (NCDs)

Therapeutic Vaccines

Behavioral Vaccines

Page 7: National Press Foundation - Understanding Vaccines (David Curry, Peg Willingham)

Adapted from: Jason L. Schwartz, MBE, AM, Center for Bioethics; Department of History & Sociology of

Science University of PennsylvaniaNVAC Health Care Personnel Influenza Vaccination Subgroup31 May 2011

Vaccine Development, Testing, RegulationFirst Steps: Laboratory and Animal Studies Exploratory Stage Pre-Clinical Stage IND Application

Next Steps: Clinical Studies with Human Subjects Phase I Vaccine Trials Phase II Vaccine Trials Phase III Vaccine Trials

Next Steps: Approval and Licensure Licensure (FDA; national authorities) Pre-Qualification (WHO) Schedules/Recommendation (ACIP; national authorities) Post-Licensure Monitoring (VAERS+) Phase IV Trials

Page 8: National Press Foundation - Understanding Vaccines (David Curry, Peg Willingham)

Adapted from: Jason L. Schwartz, MBE, AM, Center for Bioethics; Department of History & Sociology of

Science University of PennsylvaniaNVAC Health Care Personnel Influenza Vaccination Subgroup31 May 2011

Vaccines: How They Work [Live Attenuated]History of Vaccines website: http://www.historyofvaccines.org/content/types-vaccines

Page 9: National Press Foundation - Understanding Vaccines (David Curry, Peg Willingham)

Adapted from: Jason L. Schwartz, MBE, AM, Center for Bioethics; Department of History & Sociology of

Science University of PennsylvaniaNVAC Health Care Personnel Influenza Vaccination Subgroup31 May 2011

Vaccines: How They Work [Inactivated]History of Vaccines website: http://www.historyofvaccines.org/content/types-vaccines

Page 10: National Press Foundation - Understanding Vaccines (David Curry, Peg Willingham)

Adapted from: Jason L. Schwartz, MBE, AM, Center for Bioethics; Department of History & Sociology of

Science University of PennsylvaniaNVAC Health Care Personnel Influenza Vaccination Subgroup31 May 2011

Vaccines: How They Work [Subunit/Conjugate]History of Vaccines website: http://www.historyofvaccines.org/content/types-vaccines

Page 11: National Press Foundation - Understanding Vaccines (David Curry, Peg Willingham)

Adapted from: Jason L. Schwartz, MBE, AM, Center for Bioethics; Department of History & Sociology of

Science University of PennsylvaniaNVAC Health Care Personnel Influenza Vaccination Subgroup31 May 2011

Formulating Immunization Recommendations for New Vaccines: Can – and How – Should ‘Values’ be Added to the Process? Glen Nowak, Ph.D., Senior Advisor, National Center for Immunization and Respiratory Diseases. Washington, D.C., May 25,

2011.

Page 12: National Press Foundation - Understanding Vaccines (David Curry, Peg Willingham)

Adapted from: Jason L. Schwartz, MBE, AM, Center for Bioethics; Department of History & Sociology of

Science University of PennsylvaniaNVAC Health Care Personnel Influenza Vaccination Subgroup31 May 2011

Formulating Immunization Recommendations for New Vaccines: Can – and How – Should ‘Values’ be Added to the Process? Glen Nowak, Ph.D., Senior Advisor, National Center for Immunization and Respiratory Diseases. Washington, D.C., May 25,

2011.

Page 13: National Press Foundation - Understanding Vaccines (David Curry, Peg Willingham)

Adapted from: Jason L. Schwartz, MBE, AM, Center for Bioethics; Department of History & Sociology of

Science University of PennsylvaniaNVAC Health Care Personnel Influenza Vaccination Subgroup31 May 2011

HPV Types 6 and 11 cause about 90% of genital warts cases in females and males. HPV Types 16 and 18 cause about 75% of cervical cancer cases in females. HPV Types 16 and 18 also cause about 70% of vaginal cancer cases and up to 50% of vulvar cancer cases in females. All HPV types that affect the genital area can cause abnormal Pap tests in females. Every year, about 12,000 women are diagnosed with cervical cancer and 4,000 women die from this disease in the U.S.

Electron micrograph of human papillomavirus (HPV). Courtesy of

NCI. 1986.

HPV & HPV Vaccines

Page 14: National Press Foundation - Understanding Vaccines (David Curry, Peg Willingham)

Adapted from: Jason L. Schwartz, MBE, AM, Center for Bioethics; Department of History & Sociology of

Science University of PennsylvaniaNVAC Health Care Personnel Influenza Vaccination Subgroup31 May 2011

Page 15: National Press Foundation - Understanding Vaccines (David Curry, Peg Willingham)

Adapted from: Jason L. Schwartz, MBE, AM, Center for Bioethics; Department of History & Sociology of

Science University of PennsylvaniaNVAC Health Care Personnel Influenza Vaccination Subgroup31 May 2011

http://www.gardasil.com/hpv/hpv-types/hpv-transmission/http://www.cervarix.com/

How do HPV vaccines work? The HPV vaccines work like other immunizations that guard against viral infections. The investigators hypothesized that the unique surface components of HPV might create an antibody response that is capable of protecting the body against infection, and that these components could be used to form the basis of a vaccine.

The HPV surface components can interact with one another to form virus-like particles (VLP) that are not infectious, because they lack DNA. However, these VLPs can attach to cells and stimulate the immune system to produce antibodies that can prevent the complete papillomavirus, in future encounters, from infecting cells.

Page 16: National Press Foundation - Understanding Vaccines (David Curry, Peg Willingham)

Adapted from: Jason L. Schwartz, MBE, AM, Center for Bioethics; Department of History & Sociology of

Science University of PennsylvaniaNVAC Health Care Personnel Influenza Vaccination Subgroup31 May 2011

David R. Curry, MSExecutive DirectorCenter for Vaccine Ethics and Policy Associate Fellow, Center for Bioethics University of [email protected]

Vaccines: Public Health Deployment (U.S.)

Page 17: National Press Foundation - Understanding Vaccines (David Curry, Peg Willingham)

Adapted from: Jason L. Schwartz, MBE, AM, Center for Bioethics; Department of History & Sociology of

Science University of PennsylvaniaNVAC Health Care Personnel Influenza Vaccination Subgroup31 May 2011

2. Human papillomavirus vaccine (HPV). (Minimum age: 9 years) • Quadrivalent HPV vaccine (HPV4) or bivalent HPV vaccine (HPV2) is recommended for the prevention of cervical precancers and cancers in females. • HPV4 is recommended for prevention of cervical precancers, cancers, and genital warts in females. • HPV4 may be administered in a 3-dose series to males aged 9 through 18 years to reduce their likelihood of genital warts.

• Administer the second dose 1 to 2 months after the first dose and the third dose 6 months after the first dose (at least 24 weeks after the first dose).

Page 18: National Press Foundation - Understanding Vaccines (David Curry, Peg Willingham)

Adapted from: Jason L. Schwartz, MBE, AM, Center for Bioethics; Department of History & Sociology of

Science University of PennsylvaniaNVAC Health Care Personnel Influenza Vaccination Subgroup31 May 2011

Human Papillomavirus Vaccine (HPV)• Introduction  Dr. J Bocchini

• Safety of Quadrivalent Human Papillomavirus (HPV4) Vaccine  

Ms. J Gee

• Post-licensure Safety Study of Quadrivalent Human Papillomavirus Vaccine among 189,629 Females    Dr. C Velicer

• HPV Vaccine for Males Background and Review of Data    Dr. L Markowitz

• HPV Vaccine Considerations for Males    Dr. E Dunne

• VFC Resolution Update: HPV Vaccines    Dr. J Santoli

Page 19: National Press Foundation - Understanding Vaccines (David Curry, Peg Willingham)

Adapted from: Jason L. Schwartz, MBE, AM, Center for Bioethics; Department of History & Sociology of

Science University of PennsylvaniaNVAC Health Care Personnel Influenza Vaccination Subgroup31 May 2011

Page 20: National Press Foundation - Understanding Vaccines (David Curry, Peg Willingham)

Adapted from: Jason L. Schwartz, MBE, AM, Center for Bioethics; Department of History & Sociology of

Science University of PennsylvaniaNVAC Health Care Personnel Influenza Vaccination Subgroup31 May 2011

Page 21: National Press Foundation - Understanding Vaccines (David Curry, Peg Willingham)

Adapted from: Jason L. Schwartz, MBE, AM, Center for Bioethics; Department of History & Sociology of

Science University of PennsylvaniaNVAC Health Care Personnel Influenza Vaccination Subgroup31 May 2011

Page 22: National Press Foundation - Understanding Vaccines (David Curry, Peg Willingham)

Adapted from: Jason L. Schwartz, MBE, AM, Center for Bioethics; Department of History & Sociology of

Science University of PennsylvaniaNVAC Health Care Personnel Influenza Vaccination Subgroup31 May 2011

Page 23: National Press Foundation - Understanding Vaccines (David Curry, Peg Willingham)

Adapted from: Jason L. Schwartz, MBE, AM, Center for Bioethics; Department of History & Sociology of

Science University of PennsylvaniaNVAC Health Care Personnel Influenza Vaccination Subgroup31 May 2011

Page 24: National Press Foundation - Understanding Vaccines (David Curry, Peg Willingham)

Adapted from: Jason L. Schwartz, MBE, AM, Center for Bioethics; Department of History & Sociology of

Science University of PennsylvaniaNVAC Health Care Personnel Influenza Vaccination Subgroup31 May 2011

Page 25: National Press Foundation - Understanding Vaccines (David Curry, Peg Willingham)

Adapted from: Jason L. Schwartz, MBE, AM, Center for Bioethics; Department of History & Sociology of

Science University of PennsylvaniaNVAC Health Care Personnel Influenza Vaccination Subgroup31 May 2011

David R. Curry, MSExecutive DirectorCenter for Vaccine Ethics and Policy Associate Fellow, Center for Bioethics University of [email protected]

Vaccines: Public Health Deployment (U.S.)

Page 26: National Press Foundation - Understanding Vaccines (David Curry, Peg Willingham)

Adapted from: Jason L. Schwartz, MBE, AM, Center for Bioethics; Department of History & Sociology of

Science University of PennsylvaniaNVAC Health Care Personnel Influenza Vaccination Subgroup31 May 2011

Questions/Discussion