NEJM â Collection Updates for Vaccines

CORRESPONDENCE: Responses to 2009 H1N1 Vaccine in Children 3 to 17 Years of Age

Adriano Arguedas, M.D., Carolina Soley, M.D., and Kelly Lindert, M.D. — Thu, 28Â JanÂ 2010 00:00:00 -05:00

To the Editor: The current 2009 pandemic influenza A (H1N1) virus is associated with substantial morbidity in children, with 45% of hospitalizations occurring in patients under 18 years of age.1...

EDITORIAL: Rotavirus Vaccine â A Powerful Tool to Combat Deaths from Diarrhea

Mathuram Santosham, M.D., M.P.H. — Thu, 28Â JanÂ 2010 00:00:00 -05:00

Rotavirus infection, the leading cause of severe childhood diarrhea in both developed and developing countries, results in over half a million deaths each year.1 Currently, two rotavirus vaccines (Rotarix [GlaxoSmithKline...

ORIGINAL ARTICLE: Vaccine-Acquired Rotavirus in Infants with Severe Combined Immunodeficiency

Thu, 28Â JanÂ 2010 00:00:00 -05:00

Live pentavalent humanâbovine reassortant rotavirus vaccine is recommended in the United States for routine immunization of infants. We describe three infants, two with failure to thrive, who had dehydration and...

ORIGINAL ARTICLE: Effect of Rotavirus Vaccination on Death from Childhood Diarrhea in Mexico

Thu, 28Â JanÂ 2010 00:00:00 -05:00

Background: A phased introduction of a monovalent rotavirus vaccine occurred in Mexico from February 2006 through May 2007. We assessed the effect of vaccination on deaths from diarrhea in Mexican...

ORIGINAL ARTICLE: Effect of Human Rotavirus Vaccine on Severe Diarrhea in African Infants

Thu, 28Â JanÂ 2010 00:00:00 -05:00

Background: Rotavirus is the most common cause of severe gastroenteritis among young children worldwide. Data are needed to assess the efficacy of the rotavirus vaccine in African children.

Methods: We conducted...

PERSPECTIVE: The Emotional Epidemiology of H1N1 Influenza Vaccination

Thu, 31Â DecÂ 2009 00:00:00 -05:00

Last spring, when 2009 H1N1 influenza first came to our attention, my patients were in a panic. Our clinic was flooded with calls and walk-in patients, all with the same...

PERSPECTIVE: Australia's Winter with the 2009 Pandemic Influenza A (H1N1) Virus

Thu, 31Â DecÂ 2009 00:00:00 -05:00

When the World Health Organization declared a âpublic health emergency of international concernâ on April 25, 2009, after the emergence in Mexico of pandemic influenza A (H1N1) virus, Australia activated...

CORRESPONDENCE: Holiday Spikes in Pneumococcal Disease among Older Adults

Thu, 24Â DecÂ 2009 00:00:00 -05:00

To the Editor: Rates of invasive pneumococcal disease in the United States increase dramatically, or âspike,â during winter holidays.1 We analyzed population-based surveillance data to determine whether spikes may be...

CORRESPONDENCE: Bacterial Pathogens and Death during the 1918 Influenza Pandemic

Thu, 24Â DecÂ 2009 00:00:00 -05:00

To the Editor: A review of recut lung-tissue specimens and published autopsy series from the 1918 influenza pandemic suggests that secondary bacterial pneumonia1 was an important cause of death, consistent...

EDITORIAL: Pandemic Influenza Vaccine Policy â Considering the Early Evidence

Kathleen M. Neuzil, M.D., M.P.H. — Thu, 17Â DecÂ 2009 00:00:00 -05:00

âPolicy decisions regarding influenza rest on judgments about the behavior of the virus, the impact of the disease and our ability to interdict its course. But the virus is capricious,...

ORIGINAL ARTICLE: Trial of 2009 Influenza A (H1N1) Monovalent MF59-Adjuvanted Vaccine

Thu, 17Â DecÂ 2009 00:00:00 -05:00

Background: The 2009 pandemic influenza A (H1N1) virus has emerged to cause the first pandemic of the 21st century. Development of effective vaccines is a public health priority.

Methods: We conducted...

ORIGINAL ARTICLE: A Novel Influenza A (H1N1) Vaccine in Various Age Groups

Thu, 17Â DecÂ 2009 00:00:00 -05:00

Background: There is an urgent need for a vaccine that is effective against the 2009 pandemic influenza A (H1N1) virus.

Methods: A split-virus, inactivated candidate vaccine against the 2009 H1N1 virus...

ORIGINAL ARTICLE: Response to a Monovalent 2009 Influenza A (H1N1) Vaccine

Thu, 17Â DecÂ 2009 00:00:00 -05:00

Background: A novel 2009 influenza A (H1N1) virus is responsible for the first influenza pandemic in 41 years. A safe and effective vaccine is needed. A randomized, observer-blind, parallel-group trial...

EDITORIAL: HIV Vaccine Trial Results â An Opening for Further Research

Raphael Dolin, M.D. — Thu, 03Â DecÂ 2009 00:00:00 -05:00

HIV-AIDS has emerged as an enormous, worldwide public health problem over the past 25 years. An estimated 33 million persons are infected with human immunodeficiency virus type 1 (HIV-1), and...

ORIGINAL ARTICLE: Vaccination with ALVAC and AIDSVAX to Prevent HIV-1 Infection in Thailand

Thu, 03Â DecÂ 2009 00:00:00 -05:00

Background: The development of a safe and effective vaccine against the human immunodeficiency virus type 1 (HIV-1) is critical to pandemic control.

Methods: In a community-based, randomized, multicenter, double-blind, placebo-controlled efficacy...

ORIGINAL ARTICLE: Cross-Reactive Antibody Responses to the 2009 Pandemic H1N1 Influenza Virus

Thu, 12Â NovÂ 2009 00:00:00 -05:00

Background: A new pandemic influenza A (H1N1) virus has emerged, causing illness globally, primarily in younger age groups. To assess the level of preexisting immunity in humans and to evaluate...

PERSPECTIVE: Defeating Rotavirus? The Global Recommendation for Rotavirus Vaccination

Thu, 12Â NovÂ 2009 00:00:00 -05:00

This past April, the World Health Organization (WHO) Strategic Advisory Group of Experts (SAGE) on Immunization announced a global recommendation that rotavirus vaccines be included in national immunization programs. The...

EDITORIAL: Human Papillomavirus Vaccine for Cancer Prevention

Olivera J. Finn, Ph.D., and Robert P. Edwards, M.D. — Thu, 05Â NovÂ 2009 00:00:00 -05:00

Cancer immunoprevention has become synonymous with the vaccines that have been approved for the prevention of infection with highly transmissible strains of human papillomavirus (HPV) that establish chronic infection and...

ORIGINAL ARTICLE: Vaccination against HPV-16 Oncoproteins for Vulvar Intraepithelial Neoplasia

Thu, 05Â NovÂ 2009 00:00:00 -05:00

Background: Vulvar intraepithelial neoplasia is a chronic disorder caused by high-risk types of human papillomavirus (HPV), most commonly HPV type 16 (HPV-16). Spontaneous regression occurs in less than 1.5% of...

ORIGINAL ARTICLE: Comparative Efficacy of Inactivated and Live Attenuated Influenza Vaccines

Thu, 24Â SepÂ 2009 00:00:00 -05:00

Background: The efficacy of influenza vaccines may vary from year to year, depending on a variety of factors, and may differ for inactivated and live attenuated vaccines.

Methods: We carried out...

PERSPECTIVE: Poverty, Wealth, and Access to Pandemic Influenza Vaccines

Thu, 17Â SepÂ 2009 00:00:00 -05:00

On June 11, 2009, Margaret Chan, director general of the World Health Organization (WHO), declared that the status of the influenza A (H1N1) pandemic had reached phase 6 â active...

ORIGINAL ARTICLE: Protection against a Malaria Challenge by Sporozoite Inoculation

Thu, 30Â JulÂ 2009 00:00:00 -05:00

Background: An effective vaccine for malaria is urgently needed. Naturally acquired immunity to malaria develops slowly, and induction of protection in humans can be achieved artificially by the inoculation of...

EDITORIAL: Typhoid Vaccines Ready for Implementation

Myron M. Levine, M.D., D.T.P.H. — Thu, 23Â JulÂ 2009 00:00:00 -05:00

Enteric fevers encompass typhoid fever caused by Salmonella enterica serotype Typhi (S. Typhi) and paratyphoid fever caused by serotype Paratyphi A or B (S. Paratyphi). These human-restricted pathogens are acquired...

ORIGINAL ARTICLE: A Cluster-Randomized Effectiveness Trial of Vi Typhoid Vaccine in India

Thu, 23Â JulÂ 2009 00:00:00 -05:00

Background: Typhoid fever remains an important cause of illness and death in the developing world. Uncertainties about the protective effect of Vi polysaccharide vaccine in children under the age of...

CLINICAL THERAPEUTICS: HPV Vaccination for the Prevention of Cervical Intraepithelial Neoplasia

Jessica A. Kahn, M.D., M.P.H. — Thu, 16Â JulÂ 2009 00:00:00 -05:00

A sexually active 18-year-old woman presents to her internist for an annual examination. During the review of her family history, she notes that her mother recently received a diagnosis of...

PERSPECTIVE: Litigation, Regulation, and Education â Protecting the Public's Health through Childhood Immunization

Thu, 11Â JunÂ 2009 00:00:00 -05:00

Recently, three special masters of the U.S. Court of Federal Claims issued carefully reasoned, strongly worded opinions rejecting claims that medical and scientific evidence could demonstrate causal links between thimerosal-containing...

PERSPECTIVE: When Vaccine Injury Claims Go to Court

Thu, 11Â JunÂ 2009 00:00:00 -05:00

In February 2009, the National Vaccine Injury Compensation Program (VICP) released decisions for the first three test cases heard under the program's Omnibus Autism Proceeding. In each of the cases...

SPECIAL ARTICLE: Vaccine Refusal, Mandatory Immunization, and the Risks of Vaccine-Preventable Diseases

Thu, 07Â MayÂ 2009 00:00:00 -05:00

Vaccines are among the most effective prevention tools available to clinicians. However, the success of an immunization program depends on high rates of acceptance and coverage. There is evidence of...

CORRESPONDENCE: Effectiveness of One Dose of SA 14-14-2 Vaccine against Japanese Encephalitis

Rashmi Kumar, M.D., Piyush Tripathi, M.Sc., and Anwar Rizvi, B.M.S. — Thu, 02Â AprÂ 2009 00:00:00 -05:00

To the Editor: Japanese encephalitis remains a major cause of viral encephalitis in Asia, imposing a significant burden on poor rural families. Vaccination is an important element of disease control....

CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL: Case 10-2009 â A 23-Year-Old Woman with an Abnormal Papanicolaou Smear

Thu, 26Â MarÂ 2009 00:00:00 -05:00

Dr. Naana Afua Jumah (Student, Harvard Medical School): A 23-year-old woman was seen in the gynecology clinic of this hospital because of a high-grade squamous intraepithelial lesion seen on pathological...

EDITORIAL: One Step Closer to a CMV Vaccine

Cornelia L. Dekker, M.D., and Ann M. Arvin, M.D. — Thu, 19Â MarÂ 2009 00:00:00 -05:00

In this issue of the Journal, Pass and colleagues describe the results of a phase 2 trial of a vaccine containing recombinant cytomegalovirus (CMV) glycoprotein B subunit antigen combined with...

ORIGINAL ARTICLE: Vaccine Prevention of Maternal Cytomegalovirus Infection

Thu, 19Â MarÂ 2009 00:00:00 -05:00

Background: Congenital infection with cytomegalovirus (CMV) is an important cause of hearing, cognitive, and motor impairments in newborns.

Methods: In this phase 2, placebo-controlled, randomized, double-blind trial, we evaluated a vaccine...

BOOK REVIEW:

Thu, 12Â MarÂ 2009 00:00:00 -05:00

In recent years, the public has been increasingly concerned about adverse events that have been attributed to vaccines. Although such safety concerns have existed since the days of Edward Jenner,...

PERSPECTIVE: Rotavirus Vaccines â Early Success, Remaining Questions

Thu, 12Â MarÂ 2009 00:00:00 -05:00

In 2006, the results of pivotal clinical trials of two new rotavirus vaccines â RotaTeq (Merck) and Rotarix (GlaxoSmithKline) â were published, and high efficacy (85 to 98%) against severe...

ORIGINAL ARTICLE: Effect of Pneumococcal Conjugate Vaccine on Pneumococcal Meningitis

Thu, 15Â JanÂ 2009 00:00:00 -05:00

Background: Invasive pneumococcal disease declined among children and adults after the introduction of the pediatric heptavalent pneumococcal conjugate vaccine (PCV7) in 2000, but its effect on pneumococcal meningitis is unclear.

Methods:...

EDITORIAL: A Hopeful Beginning for Malaria Vaccines

William E. Collins, Ph.D., and John W. Barnwell, M.P.H., Ph.D. — Thu, 11Â DecÂ 2008 00:00:00 -05:00

An effective human malaria vaccine has been sought for over 70 years, with little success.1 A successful malaria vaccine used in conjunction with other control interventions would help reduce and...

CLINICAL PRACTICE: Prevention and Treatment of Seasonal Influenza

W. Paul Glezen, M.D. — Thu, 11Â DecÂ 2008 00:00:00 -05:00

In February 2007, fever developed in a previously healthy 15-year-old girl, with a peak temperature of 102Â°F (38.9Â°C) and mild upper respiratory congestion. The next day she was seen by...

ORIGINAL ARTICLE: Safety and Immunogenicity of RTS,S/AS02D Malaria Vaccine in Infants

Thu, 11Â DecÂ 2008 00:00:00 -05:00

Background: The RTS,S/AS malaria vaccine is being developed for delivery through the World Health Organization's Expanded Program on Immunization (EPI). We assessed the feasibility of integrating RTS,S/AS02D into a standard...

ORIGINAL ARTICLE: Efficacy of RTS,S/AS01E Vaccine against Malaria in Children 5 to 17 Months of Age

Thu, 11Â DecÂ 2008 00:00:00 -05:00

Background: Plasmodium falciparum malaria is a pressing global health problem. A previous study of the malaria vaccine RTS,S (which targets the circumsporozoite protein), given with an adjuvant system (AS02A), showed...

CLINICAL IMPLICATIONS OF BASIC RESEARCH: Attenuation by a Thousand Cuts

John M. Coffin, Ph.D. — Thu, 20Â NovÂ 2008 00:00:00 -05:00

Vaccination with live attenuated virus can be highly effective for the induction of protective immunity and is critical in the prevention of once devastating epidemic diseases. Vaccines containing live attenuated...

EDITORIAL: Monovalent Oral Poliovirus Vaccines â A Good Tool but Not a Total Solution

Ellie Ehrenfeld, Ph.D., and Konstantin Chumakov, Ph.D. — Thu, 16Â OctÂ 2008 00:00:00 -05:00

The polio eradication campaign initiated in 1988 by the World Health Organization (WHO) led to an impressive decline in cases of paralytic poliomyelitis around the world. The eradication strategy involved...

ORIGINAL ARTICLE: Effectiveness of Immunization against Paralytic Poliomyelitis in Nigeria

Thu, 16Â OctÂ 2008 00:00:00 -05:00

Background: The number of cases of paralytic poliomyelitis has declined in Nigeria since the introduction of newly licensed monovalent oral poliovirus vaccines and new techniques of vaccine delivery. Understanding the...

ORIGINAL ARTICLE: Monovalent Type 1 Oral Poliovirus Vaccine in Newborns

Thu, 16Â OctÂ 2008 00:00:00 -05:00

Background: In 1988, the World Health Assembly resolved to eradicate poliomyelitis. Although substantial progress toward this goal has been made, eradication remains elusive. In 2004, the World Health Organization called...

CORRESPONDENCE: Antigenically Distinct MF59-Adjuvanted Vaccine to Boost Immunity to H5N1

Thu, 09Â OctÂ 2008 00:00:00 -05:00

To the Editor: Antigenically distinct avian influenza A (H5N1) viruses are widely dispersed.1 Clade 1 H5N1 viruses previously predominated in Indochina. Indonesian, Eurasian, and African viruses are clustered in a...

ORIGINAL ARTICLE: Effectiveness of Maternal Influenza Immunization in Mothers and Infants

Thu, 09Â OctÂ 2008 00:00:00 -05:00

Background: Young infants and pregnant women are at increased risk for serious consequences of influenza infection. Inactivated influenza vaccine is recommended for pregnant women but is not licensed for infants...

PERSPECTIVE: An HIV Vaccine â Challenges and Prospects

Thu, 28Â AugÂ 2008 00:00:00 -05:00

Now well into the third decade of the pandemic of human immunodeficiency virus (HIV) and AIDS, we have seen dramatic successes in the treatment of HIV-infected persons in the United...

CORRESPONDENCE: Human Papillomavirus Vaccine in Males

Mark A. Goldstein, M.D. — Thu, 21Â AugÂ 2008 00:00:00 -05:00

To the Editor: In 2006, the Food and Drug Administration (FDA) licensed the human papillomavirus (HPV) vaccine for use in females 9 to 26 years old. The vaccine helps prevent...

EDITORIAL: Human Papillomavirus Vaccination â Reasons for Caution

Charlotte J. Haug, M.D., Ph.D. — Thu, 21Â AugÂ 2008 00:00:00 -05:00

Despite great expectations and promising results of clinical trials, we still lack sufficient evidence of an effective vaccine against cervical cancer. Several strains of human papillomavirus (HPV) can cause cervical...

SPECIAL ARTICLE: Health and Economic Implications of HPV Vaccination in the United States

Jane J. Kim, Ph.D., and Sue J. Goldie, M.D., M.P.H. — Thu, 21Â AugÂ 2008 00:00:00 -05:00

Background: The cost-effectiveness of prophylactic vaccination against human papillomavirus types 16 (HPV-16) and 18 (HPV-18) is an important consideration for guidelines for immunization in the United States.

Methods: We synthesized epidemiologic...

ORIGINAL ARTICLE: A Clinical Trial of a Whole-Virus H5N1 Vaccine Derived from Cell Culture

Thu, 12Â JunÂ 2008 00:00:00 -05:00

Background: Widespread infections of avian species with avian influenza H5N1 virus and its limited spread to humans suggest that the virus has the potential to cause a human influenza pandemic....

PERSPECTIVE: Vaccine Preparedness â Are We Ready for the Next Influenza Pandemic?

Thu, 12Â JunÂ 2008 00:00:00 -05:00

The quest for a fully immunogenic vaccine against influenza H5N1 viruses has gone on for more than 10 years, since this family of potentially pandemic viruses emerged as a cause...

PERSPECTIVE: Vaccines and Autism Revisited â The Hannah Poling Case

Thu, 15Â MayÂ 2008 00:00:00 -05:00

On April 11, 2008, the National Vaccine Advisory Committee took an unusual step: in the name of transparency, trust, and collaboration, it asked members of the public to help set...

ORIGINAL ARTICLE: Recent Resurgence of Mumps in the United States

Thu, 10Â AprÂ 2008 00:00:00 -05:00

Background: The widespread use of a second dose of mumps vaccine among U.S. schoolchildren beginning in 1990 was followed by historically low reports of mumps cases. A 2010 elimination goal...

PERSPECTIVE: Challenges to HIV Prevention â Seeking Effective Measures in the Absence of a Vaccine

Thu, 10Â AprÂ 2008 00:00:00 -05:00

In this issue of the Journal, Watson-Jones et al. (pages 1560â1571) report anxiously awaited findings about a strategy for preventing infection with the human immunodeficiency virus (HIV) by pharmacologically suppressing...

PERSPECTIVE: One Step Forward, Two Steps Back â Will There Ever Be an AIDS Vaccine?

Thu, 27Â DecÂ 2007 00:00:00 -05:00

In April 1984, when the human immunodeficiency virus (HIV) and AIDS were just beginning to be understood, a senior official in the Department of Health and Human Services stated at...

ORIGINAL ARTICLE: Duration of Humoral Immunity to Common Viral and Vaccine Antigens

Ian J. Amanna, Ph.D., Nichole E. Carlson, Ph.D., and Mark K. Slifka, Ph.D. — Thu, 08Â NovÂ 2007 00:00:00 -05:00

Background: Maintenance of long-term antibody responses is critical for protective immunity against many pathogens. However, the duration of humoral immunity and the role played by memory B cells remain poorly...

EDITORIAL: Another Success for Hepatitis A Vaccine

Carol J. Baker, M.D. — Thu, 25Â OctÂ 2007 00:00:00 -05:00

Before the licensure of the first inactivated hepatitis A vaccine in 1995, hepatitis A caused a substantial disease burden in the United States. Annual cases reported to the Centers for...

ORIGINAL ARTICLE: Hepatitis A Vaccine versus Immune Globulin for Postexposure Prophylaxis

Thu, 25Â OctÂ 2007 00:00:00 -05:00

Background: Hepatitis A vaccine administered to persons after exposure to the hepatitis A virus has not been compared directly with immune globulin, which is known to be highly effective in...

EDITORIAL: Influenza â The Goal of Control

John D. Treanor, M.D. — Thu, 04Â OctÂ 2007 00:00:00 -05:00

Annual administration of inactivated influenza vaccine to older adults has long been recommended by public health authorities.1 The risks of influenza-related complications, hospitalizations, and deaths increase with age, as does...

ORIGINAL ARTICLE: Effectiveness of Influenza Vaccine in the Community-Dwelling Elderly

Thu, 04Â OctÂ 2007 00:00:00 -05:00

Background: Reliable estimates of the effectiveness of influenza vaccine among persons 65 years of age and older are important for informed vaccination policies and programs. Short-term studies may provide misleading...

ORIGINAL ARTICLE: Early Thimerosal Exposure and Neuropsychological Outcomes at 7 to 10 Years

Thu, 27Â SepÂ 2007 00:00:00 -05:00

Background: It has been hypothesized that early exposure to thimerosal, a mercury-containing preservative used in vaccines and immune globulin preparations, is associated with neuropsychological deficits in children.

Methods: We enrolled 1047...

PERSPECTIVE: Thimerosal and Vaccines â A Cautionary Tale

Thu, 27Â SepÂ 2007 00:00:00 -05:00

In 1997, Frank Pallone, a U.S. congressman from New Jersey, attached a simple, 133-word amendment to a Food and Drug Administration (FDA) reauthorization bill. This amendment gave the FDA 2...

PERSPECTIVE: Cases in Vaccine Court â Legal Battles over Vaccines and Autism

Thu, 27Â SepÂ 2007 00:00:00 -05:00

Do childhood vaccines cause autism? This scientific question has now become a legal one â perhaps inevitable in our society. Some families with autistic children are pursuing legal channels in...

PERSPECTIVE: Putting Typhoid Vaccination on the Global Health Agenda

Thu, 13Â SepÂ 2007 00:00:00 -05:00

Although typhoid fever, caused by infection with Salmonella enterica serovar Typhi (often called S. typhi), long ago ceased to be a public health problem in industrialized countries, it is still...

REVIEW ARTICLE: Control of Neglected Tropical Diseases

Thu, 06Â SepÂ 2007 00:00:00 -05:00

The neglected tropical diseases are a group of 13 major disabling conditions that are among the most common chronic infections in the world's poorest people. A blueprint for the control...

REVIEW ARTICLE: An HIV Vaccine â Evolving Concepts

Margaret I. Johnston, Ph.D., and Anthony S. Fauci, M.D. — Thu, 17Â MayÂ 2007 00:00:00 -05:00

Classic preventive vaccines are designed to mimic the effects of natural exposure to microbes. They provide a high level of long-lasting protection against infection in the vast majority of recipients...

EDITORIAL: HPV Vaccination â More Answers, More Questions

George F. Sawaya, M.D., and Karen Smith-McCune, M.D., Ph.D. — Thu, 10Â MayÂ 2007 00:00:00 -05:00

The availability of a âcancer vaccineâ has elicited enormous enthusiasm from the medical community and the public, culminating in advocacy for mandatory vaccination against human papillomavirus (HPV) and a recommendation...

EDITORIAL: Human Papillomavirus Vaccine â Opportunity and Challenge

Thu, 10Â MayÂ 2007 00:00:00 -05:00

In this issue of the Journal, we publish three Original Articles,123 two Perspective articles,45 two editorials,67 a letter to the editor,8 and an audio interview9 on the subject of human...

ORIGINAL ARTICLE: Quadrivalent Vaccine against Human Papillomavirus to Prevent Anogenital Diseases

Thu, 10Â MayÂ 2007 00:00:00 -05:00

Background: A phase 3 trial was conducted to evaluate the efficacy of a prophylactic quadrivalent vaccine in preventing anogenital diseases associated with human papillomavirus (HPV) types 6, 11, 16, and...

ORIGINAL ARTICLE: Quadrivalent Vaccine against Human Papillomavirus to Prevent High-Grade Cervical Lesions

The FUTURE II Study Group — Thu, 10Â MayÂ 2007 00:00:00 -05:00

Background: Human papillomavirus types 16 (HPV-16) and 18 (HPV-18) cause approximately 70% of cervical cancers worldwide. A phase 3 trial was conducted to evaluate a quadrivalent vaccine against HPV types...

PERSPECTIVE: Introducing HPV Vaccine in Developing Countries â Key Challenges and Issues

Thu, 10Â MayÂ 2007 00:00:00 -05:00

More than any other cancer, cervical cancer reflects striking global health inequity. It is the second most common cancer among women worldwide, with about 493,000 new cases diagnosed annually (see...

PERSPECTIVE: Politics, Parents, and Prophylaxis â Mandating HPV Vaccination in the United States

Thu, 10Â MayÂ 2007 00:00:00 -05:00

Cancer prevention has fallen victim to the culture wars. Throughout the United States, state legislatures are scrambling to respond to the availability of Merck's human papillomavirus (HPV) vaccine, Gardasil, and...

CLINICAL IMPLICATIONS OF BASIC RESEARCH: Tolls and Beyond â Many Roads to Vaccine Immunity

Bali Pulendran, Ph.D. — Thu, 26Â AprÂ 2007 00:00:00 -05:00

Of all the public health measures against infections, vaccination is arguably the most cost-effective. Most successful vaccines can be divided into two types â live attenuated vaccines and nonreplicating vaccines....

ORIGINAL ARTICLE: Randomized, Placebo-Controlled Trial of Inactivated Poliovirus Vaccine in Cuba

The Cuba IPV Study Collaborative Group — Thu, 12Â AprÂ 2007 00:00:00 -05:00

Background: After poliomyelitis has been eradicated, access to live polioviruses will be highly restricted and the use of oral poliovirus vaccine (OPV) will probably be discontinued. Countries using OPV must...

CLINICAL THERAPEUTICS: VaricellaâZoster Vaccine for the Prevention of Herpes Zoster

David W. Kimberlin, M.D., and Richard J. Whitley, M.D. — Thu, 29Â MarÂ 2007 00:00:00 -05:00

A 64-year-old man presents to his internist for his annual examination. He has been in good general health, although he received a diagnosis of pneumonia 8 months ago, for which...

ORIGINAL ARTICLE: Loss of Vaccine-Induced Immunity to Varicella over Time

Thu, 15Â MarÂ 2007 00:00:00 -05:00

Background: The introduction of universal varicella vaccination in 1995 has substantially reduced varicella-related morbidity and mortality in the United States. However, it remains unclear whether vaccine-induced immunity wanes over time,...

EDITORIAL: Hepatitis E Vaccine â Ready for Prime Time?

Krzysztof Krawczynski, M.D., Ph.D. — Thu, 01Â MarÂ 2007 00:00:00 -05:00

Large outbreaks of hepatitis E virus (HEV) infection were first recognized as a distinct clinical entity in the early 1980s.12 Outbreaks continue and involve thousands of patients in certain geographic...

ORIGINAL ARTICLE: Safety and Efficacy of a Recombinant Hepatitis E Vaccine

Thu, 01Â MarÂ 2007 00:00:00 -05:00

Background: Hepatitis E virus (HEV) is an important cause of viral hepatitis. We evaluated the safety and efficacy of an HEV recombinant protein (rHEV) vaccine in a phase 2, randomized,...

EDITORIAL: Inactivated and Live Attenuated Influenza Vaccines in Young Children â How Do They Compare?

Nancy J. Cox, Ph.D., and Carolyn Buxton Bridges, M.D. — Thu, 15Â FebÂ 2007 00:00:00 -05:00

Two quite different influenza vaccines are now licensed for use in the United States â a trivalent inactivated influenza vaccine that is administered intramuscularly and a live attenuated influenza vaccine...

ORIGINAL ARTICLE: Live Attenuated versus Inactivated Influenza Vaccine in Infants and Young Children

Thu, 15Â FebÂ 2007 00:00:00 -05:00

Background: Universal vaccination of children 6 to 59 months of age with trivalent inactivated influenza vaccine has recently been recommended by U.S. advisory bodies. To evaluate alternative vaccine approaches, we...

PERSPECTIVE: Expanding Priorities â Confronting Chronic Disease in Countries with Low Income

Thu, 18Â JanÂ 2007 00:00:00 -05:00

In a ceremony held at the New York Public Library on June 26, 2006, Microsoft founder and global health philanthropist Bill Gates expressed his belief that âthere is no reason...

PERSPECTIVE: The Control of Pertussis â 2007 and Beyond

Thu, 11Â JanÂ 2007 00:00:00 -05:00

November 2, 2006: the Boston Globe reports an outbreak of whooping cough affecting one patient and 15 staff members at Boston Children's Hospital; 60 other staff members have respiratory symptoms...

EDITORIAL: Different Approaches to Influenza Vaccination

Keiji Fukuda, M.D., M.P.H., and Marie Paule Kieny, Ph.D. — Thu, 14Â DecÂ 2006 00:00:00 -05:00

In this issue of the Journal, two important and timely studies address basic questions related to the use and performance of influenza vaccines.12 The findings are also informative because both...

ORIGINAL ARTICLE: Effectiveness of School-Based Influenza Vaccination

Thu, 14Â DecÂ 2006 00:00:00 -05:00

Background: Vaccination of children in school is one strategy to reduce the spread of influenza in households and communities.

Methods: We identified 11 demographically similar clusters of elementary schools in four...

ORIGINAL ARTICLE: Prevention of Antigenically Drifted Influenza by Inactivated and Live Attenuated Vaccines

Thu, 14Â DecÂ 2006 00:00:00 -05:00

Background: The efficacy of influenza vaccines may decline during years when the circulating viruses have antigenically drifted from those included in the vaccine.

Methods: We carried out a randomized, double-blind, placebo-controlled...

PERSPECTIVE: The Eradication of Polio â Progress and Challenges

Thu, 14Â DecÂ 2006 00:00:00 -05:00

Six years after the original 2000 target date for the global eradication of polio, public health workers are encountering several stumbling blocks. Poliovirus circulation persists in countries where the virus...

PERSPECTIVE: The Ethics and Politics of Compulsory HPV Vaccination

Thu, 07Â DecÂ 2006 00:00:00 -05:00

On September 12, 2006, 3 months after the Food and Drug Administration licensed a vaccine against human papillomavirus (HPV), Michigan lawmakers became the first in the United States to propose...

CLINICAL PRACTICE: Prevention of Meningococcal Disease

Pierce Gardner, M.D. — Thu, 05Â OctÂ 2006 00:00:00 -05:00

A previously healthy 18-year-old college freshman presented to an emergency department with acute onset of fever and headache. He was listless and in distress. His temperature was 40.0Â°C, his pulse...

EDITORIAL: Pneumococcal Vaccine â Direct and Indirect (âHerdâ) Effects

Daniel M. Musher, M.D. — Thu, 06Â AprÂ 2006 00:00:00 -05:00

A nationwide vaccination program may have direct or indirect health effects that may be anticipated or unanticipated; although these effects are, of course, intended to be beneficial, some potentially adverse...

ORIGINAL ARTICLE: Effect of Introduction of the Pneumococcal Conjugate Vaccine on Drug-Resistant

Thu, 06Â AprÂ 2006 00:00:00 -05:00

Background: Five of seven serotypes in the pneumococcal conjugate vaccine, introduced for infants in the United States in 2000, are responsible for most penicillin-resistant infections. We examined the effect of...

EDITORIAL: Vaccines against Avian Influenza â A Race against Time

Gregory A. Poland, M.D. — Thu, 30Â MarÂ 2006 00:00:00 -05:00

Avian influenza A (H5N1) virus poses an important pandemic threat. A study by the Congressional Budget Office estimates that the consequences of a severe pandemic could, in the United States,...

ORIGINAL ARTICLE: Safety and Immunogenicity of an Inactivated Subvirion Influenza A (H5N1) Vaccine

Thu, 30Â MarÂ 2006 00:00:00 -05:00

Background: Influenza A (H5N1) viruses could cause a severe worldwide epidemic, with high attack rates, large numbers of deaths and hospitalizations, and wide disruption. Effective vaccines against these viruses in...

PERSPECTIVE: The Potential of Human Papillomavirus Vaccines

Thu, 16Â MarÂ 2006 00:00:00 -05:00

The anticipated licensure within the next three months of a vaccine against human papillomavirus (HPV) would represent a major public health advance against cervical cancer and other, less common cancers,...

EDITORIAL: Hepatitis B â Preventable and Now Treatable

Jay H. Hoofnagle, M.D. — Thu, 09Â MarÂ 2006 00:00:00 -05:00

Chronic infection with hepatitis B virus (HBV) accounts for an enormous burden of disease worldwide, including up to half of all cases of cirrhosis, end-stage liver disease, and hepatocellular carcinoma.1...

EDITORIAL: The Promise of New Rotavirus Vaccines

Roger I. Glass, M.D., Ph.D. and Umesh D. Parashar, M.B., B.S., M.P.H. — Thu, 05Â JanÂ 2006 00:00:00 -05:00

Rotavirus disease kills approximately half a million children annually in developing countries and accounts for one third of hospitalizations for diarrhea worldwide.1 In 1999, global efforts to control the tremendous...

ORIGINAL ARTICLE: Safety and Efficacy of a Pentavalent HumanâBovine (WC3) Reassortant Rotavirus Vaccine

Thu, 05Â JanÂ 2006 00:00:00 -05:00

Background: Rotavirus is a leading cause of childhood gastroenteritis and death worldwide.

Methods: We studied healthy infants approximately 6 to 12 weeks old who were randomly assigned to receive three oral...

ORIGINAL ARTICLE: Safety and Efficacy of an Attenuated Vaccine against Severe Rotavirus Gastroenteritis

Thu, 05Â JanÂ 2006 00:00:00 -05:00

Background: The safety and efficacy of an attenuated G1P[8] human rotavirus (HRV) vaccine were tested in a randomized, double-blind, phase 3 trial.

Methods: We studied 63,225 healthy infants from 11 Latin...

ORIGINAL ARTICLE: Influenza-Associated Deaths among Children in the United States, 2003â2004

Thu, 15Â DecÂ 2005 00:00:00 -05:00

Background: Although influenza is common among children, pediatric mortality related to laboratory-confirmed influenza has not been assessed nationally.

Methods: During the 2003â2004 influenza season, we requested that state health departments report...

PERSPECTIVE: The Promise of Global Cervical-Cancer Prevention

Mark Schiffman, M.D., M.P.H., and Philip E. Castle, Ph.D., M.P.H. — Thu, 17Â NovÂ 2005 00:00:00 -05:00

Cytologic screening has significantly reduced the rates of cervical cancer in many developed countries. However, cervical cancer remains a leading form of cancer among women living in low-resource regions of...

PERSPECTIVE: Betting on a Malaria Vaccine

Susan Okie, M.D. — Thu, 03Â NovÂ 2005 00:00:00 -05:00

Sometime within the next two years, clinical researchers are expected to begin inoculating at least 2000 African infants in the largest trial ever undertaken of an experimental vaccine for malaria....

CLINICAL IMPLICATIONS OF BASIC RESEARCH: Rational Vaccine Development â A New Trend in Tuberculosis Control

Gilla Kaplan, Ph.D. — Thu, 13Â OctÂ 2005 00:00:00 -05:00

Viable Mycobacterium bovis bacille CalmetteâGuÃ©rin (BCG) is one of the most widely used vaccines to control tuberculosis. Administered as a single shot to newborns, it prevents severe disease and reduces...

EDITORIAL: Pertussis â A Disease and Vaccine for All Ages

Scott A. Halperin, M.D. — Thu, 13Â OctÂ 2005 00:00:00 -05:00

There is increasing evidence and awareness that pertussis is not just a disease of children. Although most severe disease and almost all mortality occur in young infants, the overall disease...

ORIGINAL ARTICLE: Efficacy of an Acellular Pertussis Vaccine among Adolescents and Adults

Thu, 13Â OctÂ 2005 00:00:00 -05:00

Background: Pertussis immunization of adults may be necessary to improve the control of a rising burden of disease and infection. This trial of an acellular pertussis vaccine among adolescents and...

EDITORIAL: Immunotherapy for Congenital Cytomegalovirus Infection

Patrick Duff, M.D. — Thu, 29Â SepÂ 2005 00:00:00 -05:00

Cytomegalovirus (CMV) is an extremely important perinatal pathogen. Each year, approximately 1 percent of susceptible women seroconvert during pregnancy. Although sexual transmission of CMV can occur, most pregnant women acquire...

REVIEW ARTICLE: Neuraminidase Inhibitors for Influenza

Anne Moscona, M.D. — Thu, 29Â SepÂ 2005 00:00:00 -05:00

The impact of influenza infection is felt globally each year when the disease develops in approximately 20 percent of the world's population. In the United States, influenza infections occur in...

ORIGINAL ARTICLE: Passive Immunization during Pregnancy for Congenital Cytomegalovirus Infection

Thu, 29Â SepÂ 2005 00:00:00 -05:00

Background: Currently, there is no effective intervention for a primary cytomegalovirus (CMV) infection during pregnancy.

Methods: We studied pregnant women with a primary CMV infection. The therapy group comprised women whose...

PERSPECTIVE: The Search for Effective HIV Vaccines

Howard Markel, M.D., Ph.D. — Thu, 25Â AugÂ 2005 00:00:00 -05:00

In February 2003, after more than a decade of work, a team of scientists representing the biotechnology company VaxGen announced the results of the first phase 3 trial to test...

CLINICAL IMPLICATIONS OF BASIC RESEARCH: How Ebola Virus Infects Cells

Yoshihiro Kawaoka, D.V.M., Ph.D. — Thu, 23Â JunÂ 2005 00:00:00 -05:00

Despite its isolation three decades ago, Ebola virus continues to cause periodic outbreaks of severe hemorrhagic fever in humans, and the closely related Marburg virus is responsible for a recent...

EDITORIAL: Recovery from Rabies

Alan C. Jackson, M.D. — Thu, 16Â JunÂ 2005 00:00:00 -05:00

Worldwide, some 55,000 people die every year from rabies, mostly in Asian and African countries where canine rabies is endemic. Children are frequently the victims of rabies. In the United...

EDITORIAL: VaricellaâZoster Virus Vaccine â Grown-ups Need It, Too

Donald H. Gilden, M.D. — Thu, 02Â JunÂ 2005 00:00:00 -05:00

A few years ago, I had zoster (shingles) â no surprise, since I was over 60 years of age, and zoster is usually a disease of later life. Fortunately, both...

ORIGINAL ARTICLE: A Vaccine to Prevent Herpes Zoster and Postherpetic Neuralgia in Older Adults

Thu, 02Â JunÂ 2005 00:00:00 -05:00

Background: The incidence and severity of herpes zoster and postherpetic neuralgia increase with age in association with a progressive decline in cell-mediated immunity to varicellaâzoster virus (VZV). We tested the...

PERSPECTIVE: Aging, Immunity, and the VaricellaâZoster Virus

Ann Arvin, M.D. — Thu, 02Â JunÂ 2005 00:00:00 -05:00

Older people and their physicians are all too well acquainted with herpes zoster â commonly called shingles, from the Latin cingulum, or âgirdle.â Most recognize that aging creates a special...

PERSPECTIVE: Preparing for the Next Pandemic

Michael T. Osterholm, Ph.D., M.P.H. — Thu, 05Â MayÂ 2005 00:00:00 -05:00

Annual influenza epidemics are like Minnesota winters â all are challenges, but some are worse than others. No matter how well we prepare, some blizzards take quite a toll. Each...

EDITORIAL: RSV Infection â Not for Kids Only

Sanjay Sethi, M.D., and Timothy F. Murphy, M.D. — Thu, 28Â AprÂ 2005 00:00:00 -05:00

It is ironic that respiratory syncytial virus (RSV) infection in adults, though recognized for several decades, has been overlooked, at least in part, because of the importance of RSV in...

ORIGINAL ARTICLE: Respiratory Syncytial Virus Infection in Elderly and High-Risk Adults

Thu, 28Â AprÂ 2005 00:00:00 -05:00

Background: Respiratory syncytial virus (RSV) is an increasingly recognized cause of illness in adults. Data on the epidemiology and clinical effects in community-dwelling elderly persons and high-risk adults can help...

CLINICAL IMPLICATIONS OF BASIC RESEARCH: Arrest in the Liver â A Genetically Defined Malaria Vaccine?

Ute Frevert, D.V.M., Ph.D., and Elizabeth Nardin, Ph.D. — Thu, 14Â AprÂ 2005 00:00:00 -05:00

Malaria is a disease with far-reaching effects: 40 percent of the world's population is at risk for malarial infection, approximately 300 million to 400 million cases occur annually, and each...

PERSPECTIVE: The Cutter Incident, 50 Years Later

Paul A. Offit, M.D. — Thu, 07Â AprÂ 2005 00:00:00 -05:00

On April 12, 1955, Jonas Salk's polio vaccine â made by inactivating poliovirus with formaldehyde â was declared to be safe and effective. The trial of Salk's vaccine had included...

PERSPECTIVE: April 12, 1955 â Tommy Francis and the Salk Vaccine

Howard Markel, M.D., Ph.D. — Thu, 07Â AprÂ 2005 00:00:00 -05:00

April 12, 1955, was supposed to be Tommy Francis's day. At 10:20 a.m., the distinguished epidemiologist was scheduled to conduct an international press conference in Rackham Auditorium at the University...

EDITORIAL: Disaster, Water, Cholera, Vaccines, and Hope

Jeffrey M. Drazen, M.D., and Mark S. Klempner, M.D. — Thu, 24Â FebÂ 2005 00:00:00 -05:00

The world is now all too familiar with images of the destruction caused by the tsunami that struck Southeast Asia on December 26 of last year. In a natural disaster,...

ORIGINAL ARTICLE: Effectiveness of Mass Oral Cholera Vaccination in Beira, Mozambique

Thu, 24Â FebÂ 2005 00:00:00 -05:00

Background: New-generation, orally administered cholera vaccines offer the promise of improved control of cholera in sub-Saharan Africa. However, the high prevalence of human immunodeficiency virus (HIV) infection in many cholera-affected...

PERSPECTIVE: Individual Rights versus the Public's Health â 100 Years after v.

Thu, 17Â FebÂ 2005 00:00:00 -05:00

On February 20, 1905, ruling in Jacobson v. Massachusetts, the U.S. Supreme Court upheld the right of the city of Cambridge, Massachusetts, to mandate vaccination against smallpox. Rejecting the contention...

ORIGINAL ARTICLE: Decline in Mortality Due to Varicella after Implementation of Varicella Vaccination in the United States

Thu, 03Â FebÂ 2005 00:00:00 -05:00

Background: Varicella disease has been preventable in the United States since 1995. Starting in 1999, active and passive surveillance data showed sharp decreases in varicella disease. We reviewed national death...

PERSPECTIVE: Varicella Vaccine and Infection with VaricellaâZoster Virus

Marietta VÃ¡zquez, M.D., and Eugene D. Shapiro, M.D. — Thu, 03Â FebÂ 2005 00:00:00 -05:00

Varicellaâzoster virus is the cause of both varicella (chickenpox) and herpes zoster (shingles). A live attenuated varicella vaccine was developed in Japan in 1974, and in 1995 it was approved...

EDITORIAL: Avian Influenza and Pandemics â Research Needs and Opportunities

Klaus StÃ¶hr, Ph.D. — Thu, 27Â JanÂ 2005 00:00:00 -05:00

As the year 2004 progressed, so did conditions favoring the start of an influenza pandemic. The first warning came in January, when Thailand and Vietnam reported fatal human cases of...

PERSPECTIVE: The Threat of an Avian Influenza Pandemic

Arnold S. Monto, M.D. — Thu, 27Â JanÂ 2005 00:00:00 -05:00

There have been three influenza pandemics during the past century â in 1918, 1957, and 1968. Although the severity of the epidemics and the primary age groups affected varied, each...

CLINICAL PRACTICE: Prevention of Hepatitis B with the Hepatitis B Vaccine

Gregory A. Poland, M.D., and Robert M. Jacobson, M.D. — Thu, 30Â DecÂ 2004 00:00:00 -05:00

A 25-year-old registered nurse comes for a visit to initiate prenatal care after receiving a positive result on a pregnancy test. On review of her vaccination status, she reports that...

ORIGINAL ARTICLE: Risk of Myocardial Infarction and Stroke after Acute Infection or Vaccination

Thu, 16Â DecÂ 2004 00:00:00 -05:00

Background: There is evidence that chronic inflammation may promote atherosclerotic disease. We tested the hypothesis that acute infection and vaccination increase the short-term risk of vascular events.

Methods: We undertook within-person...

SOUNDING BOARD: The Fragility of the U.S. Vaccine Supply

Thu, 02Â DecÂ 2004 00:00:00 -05:00

Vaccines have eradicated smallpox, eliminated major outbreaks of diseases, and prevented thousands of deaths annually. This success can be attributed to a private vaccine industry that has produced many important...

PERSPECTIVE: Rationing Influenza Vaccine

Thomas H. Lee, M.D. — Thu, 02Â DecÂ 2004 00:00:00 -05:00

It was two days after the presidential election and only a week after the Red Sox won the World Series, but all anyone could talk about at my Boston hospital...

EDITORIAL: Intradermal Influenza Vaccination â Can Less Be More?

John R. La Montagne, Ph.D., and Anthony S. Fauci, M.D. — Thu, 25Â NovÂ 2004 00:00:00 -05:00

The current shortfall in anticipated doses of vaccine for the upcoming influenza season1 makes the reports by Belshe et al.2 and Kenney et al.3 in this issue of the Journal...

ORIGINAL ARTICLE: Dose Sparing with Intradermal Injection of Influenza Vaccine

Thu, 25Â NovÂ 2004 00:00:00 -05:00

Background: The loss of half the U.S. supply of influenza vaccine due to contamination has created a critical shortage. Dose-sparing strategies that use intradermal delivery of vaccines may be one...

ORIGINAL ARTICLE: Serum Antibody Responses after Intradermal Vaccination against Influenza

Thu, 25Â NovÂ 2004 00:00:00 -05:00

Background: If found to be safe and immunogenic, reduced doses of influenza vaccine given by the intradermal route could increase the number of available doses of vaccine.

Methods: In an open-label...

PERSPECTIVE: Weathering the Influenza Vaccine Crisis

John Treanor, M.D. — Thu, 11Â NovÂ 2004 00:00:00 -05:00

Contamination problems in their British manufacturing facility at Speke, Liverpool, recently forced the Chiron Corporation of San Francisco, one of only two companies licensed to provide inactivated influenza vaccine in...

PERSPECTIVE: From Culture to Vaccine â Salk and Sabin

Samuel L. Katz, M.D. — Thu, 07Â OctÂ 2004 00:00:00 -05:00

The Nobel Prizeâwinning demonstration by John Enders, Frederick Robbins, and Thomas Weller that polioviruses could be propagated successfully in nonneural cell cultures paved the way for two brilliant, ambitious scientists...

PERSPECTIVE: Advances in Virology â Weller and Robbins

Martha L. Lepow, M.D. — Thu, 07Â OctÂ 2004 00:00:00 -05:00

Book Review: This article reviews the book Growing Pathogens in Tissue Culture: Fifty Years in Academic Tropical Medicine, Pediatrics, and Virology, by Thomas H. Weller, published by Science History Publishers,...

PERSPECTIVE: Isolation of Poliovirus â John Enders and the Nobel Prize

Fred S. Rosen, M.D. — Thu, 07Â OctÂ 2004 00:00:00 -05:00

When John Enders was informed, 50 years ago this month, that he was the sole recipient of the Nobel Prize in Medicine or Physiology for 1954, he declined the honor....

PERSPECTIVE: Eradicating Polio

David L. Heymann, M.D., and R. Bruce Aylward, M.D. — Thu, 23Â SepÂ 2004 00:00:00 -05:00

During the past 12 months, poliovirus has been spreading to states in Nigeria that were previously free of poliomyelitis. Moreover, global surveillance for acute flaccid paralysis1 â involving the genomic...

CLINICAL IMPLICATIONS OF BASIC RESEARCH: A Candidate Vaccine for Severe Acute Respiratory Syndrome

Robert E. Johnston, Ph.D. — Thu, 19Â AugÂ 2004 00:00:00 -05:00

The story of the epidemic of severe acute respiratory syndrome (SARS) is a frightening one in many respects, but it provides heartening news about our ability to respond to an...

ORIGINAL ARTICLE: Childhood Vaccination and Type 1 Diabetes

Thu, 01Â AprÂ 2004 00:00:00 -05:00

Background: A link between childhood vaccinations and the development of type 1 diabetes has been proposed.

Methods: We evaluated a cohort comprising all children born in Denmark from January 1, 1990,...

PERSPECTIVE: Childhood Immunizations and Chronic Illness

Lynne L. Levitsky, M.D. — Thu, 01Â AprÂ 2004 00:00:00 -05:00

These hopeful words of Edward Jenner (see Figure) were prescient, although their promise remained unfulfilled for almost 200 years. One hundred years ago, more than 48,000 people contracted smallpox annually...

ORIGINAL ARTICLE: Use of the Inactivated Intranasal Influenza Vaccine and the Risk of Bell's Palsy in Switzerland

Thu, 26Â FebÂ 2004 00:00:00 -05:00

Background: After the introduction of an inactivated intranasal influenza vaccine that was used only in Switzerland, 46 cases of Bell's palsy were reported.

Methods: We conducted a matched caseâcontrol study and...

PERSPECTIVE: Nasal Vaccination, Enterotoxin, and Bell's Palsy

Robert B. Couch, M.D. — Thu, 26Â FebÂ 2004 00:00:00 -05:00

In 1997, a Swiss Company (Berna Biotech) received approval to market an inactivated influenza vaccine for parenteral administration that consists of the hemagglutinin and neuraminidase surface antigens of influenzavirus incorporated...

PERSPECTIVE: Getting Polio Eradication Back on Track in Nigeria

Ebrahim Samba, M.D., Francis Nkrumah, M.D., M.P.H., and Rose Leke, M.D. — Thu, 12Â FebÂ 2004 00:00:00 -05:00

The recent cancellation of polio-vaccination campaigns in several key northern Nigerian states where poliomyelitis is endemic1 has focused attention on this African country, which reported more cases of the disease...

CLINICAL PRACTICE: Prevention of Hepatitis A with the Hepatitis A Vaccine

Allen S. Craig, M.D., and William Schaffner, M.D. — Thu, 29Â JanÂ 2004 00:00:00 -05:00

A 34-year-old man presented to the emergency department two weeks after returning from a trip to India, reporting a six-day history of anorexia, vomiting, malaise, fatigue, and dark urine. His...

PERSPECTIVE: Influenza Vaccine â Outmaneuvering Antigenic Shift and Drift

John Treanor, M.D. — Thu, 15Â JanÂ 2004 00:00:00 -05:00

The winter of 2003â2004 will be remembered as a year in which stories about influenza dominated the news and patients young and old clamored for influenza vaccination. This intense interest...

SOUNDING BOARD: The Meningococcal Vaccine â Public Policy and Individual Choices

Paul A. Offit, M.D., and Georges Peter, M.D. — Thu, 11Â DecÂ 2003 00:00:00 -05:00

On December 11, 2002, a 12-year-old girl from suburban Philadelphia died as a result of serogroup C meningococcal infection. Death occurred within hours after the initial manifestation of the illness....

ORIGINAL ARTICLE: A Trial of a 9-Valent Pneumococcal Conjugate Vaccine in Children with and Those without HIV Infection

Thu, 02Â OctÂ 2003 00:00:00 -05:00

Background: Acute respiratory tract infections caused by Streptococcus pneumoniae are a leading cause of morbidity and mortality in young children. We evaluated the efficacy of a 9-valent pneumococcal conjugate vaccine...

PERSPECTIVE: Great Expectations for a New Vaccine

Kathryn M. Edwards, M.D., and Marie R. Griffin, M.D., M.P.H. — Thu, 02Â OctÂ 2003 00:00:00 -05:00

Despite the fact that a licensed pneumococcal capsular polysaccharide vaccine has been available for more than 30 years, Streptococcus pneumoniae continues to sicken and kill children and adults throughout the...

ORIGINAL ARTICLE: Effectiveness of Pneumococcal Polysaccharide Vaccine in Older Adults

Thu, 01Â MayÂ 2003 00:00:00 -05:00

Background: Streptococcus pneumoniae is the chief cause of pneumonia in older adults, but it remains unclear whether use of the pneumococcal polysaccharide vaccine alters the overall risk of community-acquired pneumonia....

ORIGINAL ARTICLE: Decline in Invasive Pneumococcal Disease after the Introduction of ProteinâPolysaccharide Conjugate Vaccine

Thu, 01Â MayÂ 2003 00:00:00 -05:00

Background: In early 2000, a proteinâpolysaccharide conjugate vaccine targeting seven pneumococcal serotypes was licensed in the United States for use in young children.

Methods: We examined population-based data from the Active...

ORIGINAL ARTICLE: Influenza Vaccination and Reduction in Hospitalizations for Cardiac Disease and Stroke among the Elderly

Thu, 03Â AprÂ 2003 00:00:00 -05:00

Background: Upper respiratory tract illnesses have been associated with an increased risk of ischemic heart disease and stroke. During two influenza seasons, we assessed the influence of vaccination against influenza...

CLINICAL IMPLICATIONS OF BASIC RESEARCH: In Search of a Better HIV Vaccine â The Heat Is On

Elizabeth G. Phimister, Ph.D. — Thu, 13Â FebÂ 2003 00:00:00 -05:00

Human immunodeficiency virus type 1 (HIV-1) is notorious for its ability to evade the immune system. A recent study by Kwong and colleagues1 has uncovered a new molecular mechanism of...

SOUNDING BOARD: Preventing the Return of Smallpox

Joel G. Breman, M.D., D.T.P.H., Isao Arita, M.D., and Frank Fenner, M.D. — Thu, 30Â JanÂ 2003 00:00:00 -05:00

It is imperative and urgent that we prevent the intentional or unintentional release of variola (smallpox) virus into an essentially unprotected global population that continues to benefit from 25 years...

SOUNDING BOARD: A Different View of Smallpox and Vaccination

Thomas Mack, M.D., M.P.H. — Thu, 30Â JanÂ 2003 00:00:00 -05:00

According to federal,1 academic,2 and lay3 observers, smallpox might be used as a weapon of terrorism. Variola virus is presumed to be available,4 and a terrorist could introduce it, leading...

REVIEW ARTICLE: How Contagious Is Vaccinia?

Kent A. Sepkowitz, M.D. — Thu, 30Â JanÂ 2003 00:00:00 -05:00

The Department of Health and Human Services is finalizing plans for a U.S. vaccination program against smallpox. As more vaccinia virus vaccine has become available, the debate over how many...

IMAGES IN CLINICAL MEDICINE: Progression of the Lesion at the Site of Inoculation after Smallpox Vaccination

Kathleen Rubins, B.S. and David A. Relman, M.D. — Thu, 30Â JanÂ 2003 00:00:00 -05:00

Photographs show the progression of a lesion from vaccination in a healthy, previously unvaccinated 23-year-old woman. Undiluted smallpox vaccine (Dryvax, Wyeth Laboratories) was introduced into the skin of the upper...

PERSPECTIVE: Smallpox Vaccination â The Call to Arms

Terry L. Schraeder, M.D., and Edward W. Campion, M.D. — Thu, 30Â JanÂ 2003 00:00:00 -05:00

The possibility of biologic warfare has entered the national psyche. Vaccination against smallpox has begun. For physicians and other health care professionals, the current call to arms means more than...

EDITORIAL: The Global Implications of Influenza in Hong Kong

Thu, 26Â DecÂ 2002 00:00:00 -05:00

Was the disappearance of brooding storks in Germany during the latter half of the last century really responsible for the precipitous decline in the number of newborn babies there? This...

EDITORIAL: Varicella Vaccine â Are Two Doses Better Than One?

Thu, 12Â DecÂ 2002 00:00:00 -05:00

The live attenuated varicella vaccine was approved by the Food and Drug Administration in 1995 for routine use in healthy persons older than one year of age who are susceptible...

ORIGINAL ARTICLE: Outbreak of Varicella at a Day-Care Center despite Vaccination

Thu, 12Â DecÂ 2002 00:00:00 -05:00

Background: In seven studies of the effectiveness of the varicella vaccine conducted since it was licensed, the effectiveness was 71 to 100 percent against disease of any severity and 95...

EDITORIAL: The Beginning of the End for Cervical Cancer?

Thu, 21Â NovÂ 2002 00:00:00 -05:00

In this issue of the Journal, Koutsky et al.1 complete a 20-year odyssey that began with the isolation of the cancer-causing human papillomaviruses (HPVs).23 In 1983, investigators in zur Hausen's...

ORIGINAL ARTICLE: Glycoprotein-DâAdjuvant Vaccine to Prevent Genital Herpes

Thu, 21Â NovÂ 2002 00:00:00 -05:00

Background: An effective prophylactic vaccine would help control the spread of genital herpes.

Methods: We conducted two double-blind, randomized trials of a herpes simplex virus type 2 (HSV-2) glycoprotein-Dâsubunit vaccine with...

ORIGINAL ARTICLE: A Controlled Trial of a Human Papillomavirus Type 16 Vaccine

Thu, 21Â NovÂ 2002 00:00:00 -05:00

Background: Approximately 20 percent of adults become infected with human papillomavirus type 16 (HPV-16). 02112129.xml Although most infections are benign, some progress to anogenital cancer. A vaccine that reduces the...

ORIGINAL ARTICLE: A Population-Based Study of Measles, Mumps, and Rubella Vaccination and Autism

Thu, 07Â NovÂ 2002 00:00:00 -05:00

Background: It has been suggested that vaccination against measles, mumps, and rubella (MMR) is a cause of autism.

Methods: We conducted a retrospective cohort study of all children born in Denmark...

PERSPECTIVE: Suspicions about the Safety of Vaccines

Thu, 07Â NovÂ 2002 00:00:00 -05:00

Vaccines represent one of the most effective interventions in medicine. They can protect whole populations from potentially dangerous diseases. Because vaccines are usually given to healthy people, especially children, any...

PERSPECTIVE: West Nile Virus Encephalitis

Thu, 17Â OctÂ 2002 00:00:00 -05:00

In August 1999, Dr. Deborah Asnis, an infectious-disease clinician in Queens, New York, reported two cases of encephalitis associated with muscle weakness to the New York City Department of Health....

ORIGINAL ARTICLE: Use of an Inactivated Varicella Vaccine in Recipients of Hematopoietic-Cell Transplants

Thu, 04Â JulÂ 2002 00:00:00 -05:00

Background: The reactivation of varicellaâzoster virus from latency causes zoster and is common among recipients of hematopoietic-cell transplants.

Methods: We randomly assigned patients who were scheduled to undergo autologous hematopoietic-cell transplantation...

OCCASIONAL NOTES: Clinical Investigation of Smallpox in 1767