Rate of HPV infection in U.S. teenage girls plummeted after vaccine introduction
HPV rates decreased substantially in the U.S. after 4-valent vaccine was introduced and recommended in 2006. According to a study published in Pediatrics,1 64% and 34% fewer girls aged, respectively, 14–19 and 20–24 suffered from the infection in 2009–12 compared to 2003–6. Part of the effect might be accounted for by herd immunity.
The vaccine prevents infections by four HPV strains responsible for virtually all cases of cervical cancer in females as well as other types of cancer in both males and females. Despite its excellent safety and efficacy record, uptake has been problematic due to public controversy and insufficient endorsement in doctors' offices.
According to the Centers for Disease Control and Prevention (CDC), only 40% of girls and 21% of boys in the U.S. have been vaccinated. In response, the National Cancer Institute has issued a statement calling for increased recommendation and uptake.
Markowitz LE, Liu G, Hariri S, Steinau M, Dunne EF, Unger ER. Prevalence of HPV After Introduction of the Vaccination Program in the United States. Pediatrics 2015; doi: 10.1542/peds.2015–1968
CAR-T therapy successful in treating blood cancer in early trial
27 of 29 patients with acute lymphoblastic leukemia (ALL) had complete remission after treatment with experimental adoptive Tcell therapy. Additionally, 19 of 30 non-Hodgkin lymphoma patients had partial or complete responses in a Phase 1/2 trial held at the Fred Hutchinson Cancer Research Center. Some patients had no signs of their tumors within weeks of the injection.
In CAR-T therapy, the patient's own T cells are engineered to express a chimeric receptor recognizing tumor cells. The T cells can replicate in the body eliminating the need for repeated treatment. The current study, which started in 2013, involves patients with ALL, non-Hodgkin lymphoma and chronic lymphocytic leukemia.
Dengue vaccine campaign starts in the Philippines
The Philippines are the first nation to start an immunization program against dengue. The first million doses of the recently approved Dengvaxia vaccine (Sanofi) have been shipped to the country, which reported >200,000 dengue cases in 2015. The campaign aims at vaccinating one million schoolchildren in the most vulnerable regions. Dengvaxia has also been approved in Brazil, Mexico and El Salvador, and applications are pending in 16 other endemic countries.
Additionally, Brazil will sponsor a clinical study of another dengue vaccine candidate developed at the U.S. National Institutes of Health. The Phase 3 trial will involve 17,000 subjects in the country, which reported 1.5 million dengue cases in 2015.
Anti-inflammation immunotherapy might alleviate some schizophrenia symptoms
The immunosuppressive drug tocilizumab was shown to improve cognitive ability in a handful of schizophrenia patients enrolled in a small-scale Phase 1 trial.1 The five subjects that completed the study showed improvement in verbal fluency and digit symbol coding, but no change in psychiatric symptoms such as hallucinations.
Tocilizumab is a monoclonal antibody targeting IL-6 receptor. It is approved for treatment of rheumatoid and juvenile arthritis.
“This adds to the growing evidence that inflammation plays a role in patients with schizophrenia and again suggests that targeting inflammation may be a viable therapeutic target, at least for cognitive impairment, which is a huge area of unmet need,” senior author Brian Miller of Augusta University said in a statement.
Cognitive problems are among the earliest symptoms of schizophrenia. Around 25–50% of patients have brain inflammation that contributes to this impairment.
Miller BJ, Dias JK, Lemos HP, Buckley PF. An Open-Label, Pilot Trial of Adjunctive Tocilizumab in Schizophrenia. J Clin Psychiatry 2015; 77:275−276
Development of Zika vaccines
With the Zika virus becoming a global health concern, vaccines are being developed on several fronts. The most advanced candidate, from the U.S. National Institute of Allergy and Infectious Diseases, is planned to be tested in early-stage clinical trials in summer 2016, and hopefully in larger trials by early 2017.
India's Bharat Biotech has been developing a Zika vaccine since 2014, which is in animal studies. Inovio's synthetic vaccine, which was able to elicit strong immune responses in mice, is planned to be tested in a clinical trial before the end of 2016. In total, around 15 groups are working on a Zika vaccine.
The World Health Organization (WHO) has declared Zika a global health emergency after the virus is thought to have caused a surge in infant microcephaly cases mostly in Latin America. Brazil alone has reported >4,000 suspected cases.
Recommendation for HPV and MenB vaccines expanded in the U.S.
The U.S. CDC has updated the childhood immunization schedule with a few expanded indications. HPV vaccine has been recommended for girls and boys aged 11–12 years. The new schedule pushes this age back by two years for children with a history of sexual abuse. Moreover, CDC has endorsed the relatively new 9-valent HPV vaccine as a more effective tool in preventing HPV-associated cancers than the 4-valent vaccines previously in routine use.
In addition, the updated schedule recommends serogroup B meningococcal vaccine for all adolescents 16–18 years old, which is a controversial decision due to low prevalence of meningococcal B meningitis in the U.S. Currently, meningococcal B vaccine is routinely administered in high-risk children.
Anti-opioid vaccine successful in preclinical setting
A new vaccine against fentanyl prevented the opioid from reaching the brain in mouse models. According to a study published in Angewandte Chemie,1 three doses of fentanyl-like antigen elicited neutralizing antibodies that persisted for months, and ablated behavior normally seen in intoxicated individuals. Moreover, a 30-fold higher dose was necessary to activate neural circuits in vaccinated mice.
Fentanyl is a painkiller drug widely abused for recreational purposes as a more potent substitute for heroin. According to the U.S. CDC, fentanyl contributed to the recent sharp increase in overdose deaths.
Bremer PT, Kimishima A, Schlosburg JE, Zhou B, Collins KC, Janda KD. Combatting Synthetic Designer Opioids: A Conjugate Vaccine Ablates Lethal Doses of Fentanyl Class Drugs. Angew Chem Int Ed Engl 2015; 55:3772–5
U.S. parents consider influenza vaccine less important than other childhood vaccines
Around one-third of U.S. parents rate influenza vaccine as less important and less effective than other childhood vaccines. According to the C.S. Mott Children's Hospital National Poll on Children's Health, the proportion is almost twice as high in parents whose children did not receive the influenza vaccine (half of all questioned parents).
“Despite substantial public health efforts, flu vaccine rates for U.S. children are well below national targets,” lead author Sarah Clark of University of Michigan said in a press release. “Our poll findings are evidence that many parents don't realize that influenza can be a deadly disease for children.”
In the U.S., ∼20,000 children under the age of 5 are hospitalized every year because of influenza complications. Some cases may lead to death.
MERS vaccine candidate has entered clinical trials
A Phase 1 study of a MERS vaccine candidate GLS-5300 (Inovio & GeneOne) has started at the Walter Reed Army Institute of Research in Maryland, U.S. Safety and immunogenicity will be evaluated in 75 participants.
MERS has infected >1,600 people leading to almost 600 deaths mostly in the Middle East where it emerged in 2012. It has spread to 26 countries according to WHO.
This year's influenza vaccine is 59% effective
According to the U.S. CDC's preliminary analysis, influenza vaccine for this season is 59% effective. Efficacy reached 76% against B strains and 51% against H1N1.
“It's good news and underscores the importance and the benefit of both annual and ongoing vaccination efforts this season,” Joseph Bresee, chief of CDC's Epidemiology and Prevention Branch, said in a statement. “This season, CDC has received reports of hospitalizations and deaths in young, otherwise healthy people who were infected with influenza A H1N1, but not vaccinated.”
Success for three Ebola vaccine candidates in Phase 2 trials
Two Ebola vaccine candidates, rVSV-ZEBOV and cAd3-EBOZ, were well tolerated and immunogenic in a Phase 2 study in Liberia. The vaccines, developed in the U.S. and Canada, induced antibodies in ∼90% of the 1,500 adult volunteers. The originally planned 28,000-subject trial had to be reduced in size after the epidemics had retreated.
Another candidate, called GamEvac-Combi, has been developed by the Russian vaccine research institute. It had encouraging results in Phase 1 and 2 trials, and will move to further testing in Guinea.