05 - February 6, 2013.docx

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Cell and Systems Biology
Gray- Owen

A clinical and public health perspective on vaccines Vaccinology – science of understanding host and pathogen, and getting the host to protect itself against future pathogens …. To… protecting lives An invention that allows each vaccine vial to have a colour-coded dot to indicate whether it has gone out of the temperature range and it thus no longer usable – this is the most important invention for the last twenty years Polio – Temporal causal association; future risk – humans view vaccine with distrust, opposed to antibiotics No rational response to risk in humans 1880s, London, England – water sanitation – John Snow – thought that water was causing cholera Epideiomology – infer pathogenesis of disease from studies of population that get disease; After food and water, vaccines are most important Invasive Hib disease – first vaccine where it was clear that it wasn’t increasing socioeconomic status and changes in toher things, but the vaccine itself, was the one against Hemophohilus influenza type b (Hib) Antigen people respond to is a polyscharride antigen – kids under two cannot be vaccinated, because do not respond to it The conjugate vaccine Increase in cases from 80 to 86 – due to reporting artifact – reporting sensitivity goes up because once the vaccine was announced, reporting became more useful Did not vaccinate kids under two until 92, yet there was a decrease since 86 – HERD IMMUNITY – protection of vaccinated two year olds, meant they weren’t carrying this bacteria and didn’t give it to younger siblings – Hib disappeared in adults once children were vaccinated – Streptococcus pneumonia – vaccine – once introduced in children, disease was also eliminated in the adults – Sometimes vaccination of selected individuals will have a much bigger impact on disease than vaccinating the whole population How to decide which vaccines – burden of disease; Things are continuously changing – distrubtion and burden of disease changes over time New vaccine AUTHORIZATION Phase 1 study in humans – safety studies – no unexpected adverse consequences Phase 2 – to identify the dose, the schedule, how many doses need, getting the immune response wanted? Which populations will get it, etc. Phase 3- efficacy – big randomized controlled trials Phase 4 – after drug is authorized – If have a potential vaccine, go to Health Canada, Biologic Genetics and Therapeutics sector, which must be convinced that the ingredients are well-known, - Manufacturing practise extremely important – nowadays, drugs often made in one factory Before phase 1 can begin, Health Canada would want more animal studies – also have plan for development, what is the endgame? Vaccines in Canada Vaccine gone through phase 3 – BGTD has looked at it, sees that in soe populatuions, benefits are greater than risk – in those circumstances, will authorize use in Canada Vaccines in Canada seen as public health responsibility; for kids, effective system where BGTD decides vaccine is authorized for sale, National Advisory Committee on Immunization (now publich health agency of Canada), looks at all the data on the vaccine, decides what the best use of the vaccine it, makes recombination; provincial governments pay for it; del
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