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Vaccinations



Waldemar Haffkine

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Waldemar Haffkine (1860-1930) was a Russian-born immunologist, known for his development of both the cholera vaccine and a vaccine against the Bubonic plague.

Europe was hit again and again with cholera epidemics during the nineteenth century, and as a researcher at the Pasteur Institute in Paris, Haffkine made it his mission to develop an effective cholera vaccine. The process was full of challenges: at the time, humans were the only organisms able to be infected with cholera, so Haffkine first developed a strain that was able to infect, then inoculate, lab rabbits. However, Haffkine was creating a vaccine for human populations, and needed to ensure it was safe and effective for humans. His moment of heroism came when he inoculated himself in order to test the safety of the vaccine. No doubt to his relief, the only effects he experienced as a result of the injection were a slight swelling and a raise in temperature.

After this initial success, Haffkine took his vaccine to India, where it proved to be enormously effective. In one study involving 2,000 subjects, infection rate among those who had not been inoculated ranged between 22-45%, where those who had been given the vaccine had infection rates close to 2%.

Haffkine’s work with a vaccine against the Bubonic plague took place in a similar fashion. In 1896, the Bubonic plague hit Bombay, India, where Haffkine was working. He again developed a strain with which he could inject himself from Yersinia pestis samples, inoculated himself, lived, and the vaccine was distributed (1).

Though Haffkine’s work was unfortunately often met with skepticism and disapproval, without his work and his brave self-inoculations, many more people would have died from cholera and the plague, and his vaccinations paved the way for our modern vaccines (2).

Sources:

Waldemar Haffkine: Pioneer of Cholera Vaccine. EDYTHE LUTZKERAND and CAROL JOCHNOWITZ

Martinelli, Paul T., Adam Czelusta, and S. Ray Peterson. "Self-experimenters in Medicine: Heroes or Fools? Part II. Anesthesia, Surgery, Therapeutics, Vaccinations, and Vitamin C." ScienceDirect. Elsevier, 27 Oct. 2008. Web. 20 Jan. 2011.

Image:http://www.pasteur.fr/infosci/archives/

Contributed By: Sarah Kaewert


Edward Almroth Wright

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Edward Almroth Wright was a British bacteriologist and immunologist who is most known for his discovery of a vaccine for typhoid in 1897. He is also credited with promoting the technique of inoculation with dead or attenuated strains of pathogens to induce immunity (2).

After studying foreign languages, medicine, and law, Wright became the Chair of Pathology at the Army Medical College at the Royal Victoria Hospital. Before he turned to typhoid, he worked with Malta fever and became infected after injecting himself with a strain that he thought was attenuated (but was not). He proved himself brave yet again when he was among the first test subjects for his own typhoid vaccine, which was accompanied by some troublesome side effects but otherwise effective.

As a chair of the Army Medical College, Wright knew this vaccine could be extremely useful for soldiers. Up until his time, many of the casualties of war were caused by disease and not by the enemy—14,000 of 22,000 soldiers who were killed during the Boer War died of disease (and 9,000 of those from typhoid). Thanks to the acceptance and development of Wright’s vaccine, British troops were vaccinated at the start of World War I, which was to become the first war in which disease killed fewer British soldiers than injury. The vaccine proved its worth to the British troops by preventing all but 1,000 cases of typhoid during 1915, whereas the French forces suffered 69,000 cases.

Wright’s work saved thousands of lives and changed the way the world thought about immunization and warfare. In addition to his typhoid vaccine, his contributions to immunology also include vaccines for pneumonia and tuberculosis (1).

Sources:

Walker, N M (2007), "Edward Almroth Wright.", Journal of the Royal Army Medical Corps 153 (1): 16–7, 2007 Mar,

Martinelli, Paul T., Adam Czelusta, and S. Ray Peterson. "Self-experimenters in Medicine: Heroes or Fools? Part II. Anesthesia, Surgery, Therapeutics, Vaccinations, and Vitamin C." ScienceDirect. Elsevier, 27 Oct. 2008. Web. 20 Jan. 2011.

Image: homeopathy.wildfalcon.com

Contributed By: Sarah Kaewert


Jonas Edward Salk

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Jonas E. Salk was born to a family of poor Russian-Jewish immigrants, Dora and Daniel B. Salk. He graduated from the City College of New York and then received his medical degree from the College of Medicine at New York University in June 1939.

After graduating, Salk first worked as a staff physician at the Mount Sinai School of Medicine in New York City. In 1947, he led the Virus Research Lab at the University of Pittsburgh. During the 1950s, he developed, tested, and refined the first successful polio vaccine. In 1955 he began immunizations at Pittsburgh's Arsenal Elementary School in the Lawrenceville neighborhood and made international news as the man who beat polio.

In 1947, Salk received a position as the head of the Virus Research lab. Though he continued his research on improving the influenza vaccine, he set his sights on the Poliomyelitis virus. The poliovirus initially attacks the nervous system and within a few hours of infection, paralysis can occur. The death rate of the disease is about 5-10%. Death usually occurs when the breathing muscles become paralyzed. Polio was sometimes hard to diagnose because of its flu-like symptoms, which include stiff neck, fever, and headache.

Sources:

http://en.wikipedia.org/wiki/Jonas_Salk

http://www.myhero.com/myhero/hero.asp?hero=j_salk

http://www.notablebiographies.com/images/uewb_09_img0626.jpg


Jesse Gelsinger 

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Gelsinger was believed to be the first patient ever to die in clinical trials for gene therapy. He was 18 years old. He suffered from a genetic liver disease known as OTC (ornithine transcabamylase) deficiency, and X-linked liver disorder whose victims are unable to metabolize ammonia - a byproduct of protein breakdown. It is usually fatal at birth, but Gelsinger did not inherit the disease; it was the result of a genetic mutation and as such was not as severe - some of his cells were normal which enabled him to survive on a restricted diet and special medications.

On Monday, September 13 1999, Gelsinger was injected with adenoviruses carrying a corrected gene in the hope that it would manufacture the needed enzyme. He died four days later, apparently having suffered a massive immune response triggered by the use of the viral "vector" used to transport the gene into his cells. This led to multiple organ failure and brain death. Gelsinger died on Friday, September 17th at 2:30 PM

An Food and Drug Adminstration (FDA) investigation concluded that the scientists involved in the trial, including the lead researcher Dr. James M. Wilson (U Penn), broke several rules of conduct:

Inclusion of Gelsinger as a substitute for another volunteer who dropped out, despite having high ammonia levels that should have led to his exclusion from the trial; Failure by the university to report that two patients had experienced serious side effects from the gene therapy; Failure to mention the deaths of monkeys given a similar treatment in the informed consent documentation.

The University of Pennsylvania later issued a rebuttal but paid the parents an undisclosed amount in settlement. The Gelsinger case was a severe setback for scientists working in the field.

Sources:

http://www.upenn.edu/gazette/0500/0500pres.html

http://en.wikipedia.org/wiki/Jesse_Gelsinger


Stephen Epstein & Al Cotton

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Finding a cure for AIDS is no small feat. Raising awareness about safe sex practices and anti-retroviral medication is only half the fight. Today, researchers are searching to find a vaccination, which may help us eventually eradicate the incidence of HIV in the modern world. But, developing a vaccination does not happen overnight. Rather, these experimental tests require individuals to participate in vaccination trials to determine the efficacy of the treatments. Many people considering participating in vaccine trials are afraid of contracting HIV from the vaccine. To engage in a vaccination trial means taking a huge risk – one that most individuals are not ready to take.

Steven Epstein and Al Cotton, however, were ready. Both men joined the study, after having read about the HIV vaccine trial. Epstein later claimed, "I read all the reasons why people weren't signing up and it really bothered me, that people were choosing not to participate in the study for fear that they would get HIV."

Researchers at the National Institutes of Health claim that the fears of contracting HIV from the experimental tests are unfounded. As stated by Mary Allen, a researcher at NIH, "the vaccines do not contain HIV, they cannot give anyone HIV. No one can get AIDS from these vaccines."

Nevertheless, when researchers design a vaccine trial, they rely on the fact that some volunteers are going to be exposed to the disease. While the researchers try to choose volunteers based on who would likely be exposed to HIV because of their lifestyle, there is still a very real risk: a risk that both Epstein and Cotton were willing to take in the name of scientific discovery. The brave actions of both Epstein and Cotton are necessary for the growth and development of scientific research. By sacrificing themselves, they contributed to finding a cure. While research in the field of HIV treatment is nascent, there is hope for a cure, and it is due to the courage of individuals like Epstein and Cotton that the research can develop.

Sources:

http://archives.cnn.com/2001/HEALTH/conditions/09/06/vaccine.volunteers/

index.html

Contributed by: Lily Saadat


Mduduzi Sabath Nkosi

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HIV vaccination trials have been expanding to trial sites worldwide. Five months after clinical trials of a new type of AIDS vaccine began in Baltimore, Maryland, the trials were extended to Durban and Johannesburg. In Durban, Mduduzi Sabath Nkosi, at the age of 28, was the first South African to be vaccinated with this new vaccination strain, which was based on clade C strains of HIV.

The AIDS vaccine trials involved a copy of the virus gene, in which the reproductive, or retroviral elements, had been eliminated. The specific entry technique was developed at the Cape Town University by a group of South African scientists. The research included the use of the Venezuelan Equine Encephalitis virus, which was used to deliver the vaccine to the various parts of the body.

Having heard about the AIDS research opportunity from the Medical Research Council in the radio, Nkosi chose to embark on an 11-month journey. From the initial meeting to the day he was injected with the vaccine, Nkosi attended workshops at which he learned the details of the trial. In order to be eligible, patients had to be HIV-negative, have no other diseases, and be aged between 18 and 60.

In interviews, Nkosi argued that he believes it is important to have faith that the vaccination works, claiming, "If you don't believe it has a good chance, people will not worry to join teams like this." In the future, Nkosi dreams of having a baby that grows up in a country free of HIV and AIDS. However, Nkosi is careful to note the ambitious nature of his dream, emphasizing that "perhaps that dream will be for my grandchildren."

Nkosi’s courageous commitment to finding a cure was a huge contribution to his country. It was a commitment to the eradication of a disease, which has affected the lives of millions across the world. While there is still much research to be done, the commitment to overcoming this epidemic by individuals such as Nkosi is crucial to finding a cure.

Sources:

http://www.worldvolunteerweb.org/news-views/volunteer-stories/doc/im-no-hero.html

http://www.avac.org/ht/a/GetDocumentAction/i/2760

Contributed by: Lily Saadat


Dr. Rene Roy

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Rene Roy, a French-Canadian scientist from the University de Quebec in Montreal, discovered the first synthetic vaccine to treat kids affected by bacterial infections, caused by against Haemophilus influenzae type b (or Hib). These infections, which can develop into meningitis or pnemonia, are particularly prevalent in developing countries. The vaccine could potentially help treat children across the world, who are affected by these infections which take the lives of more than half a million kids per year. Kids would survive these infections may have irreversible brain damage, which could lead to mental retardation and a change in the quality of life.

Roy’s vision is the partner with countries in Latin and South America, like Brazil and Venezuela, to spread the accessibility of the vaccine. Since the drug is entirely synthetic, not comprised of any of the components of the bacteria, it is relatively affordable. Current vaccines cost about $5 per dosage; Roy is hoping to downsize that figure to approximately $1. According to Roy, this will hopefully help with accessibility and quality control.

In 2005, the Hib Vaccine Team received the Agilient Technologies Foundation Health Award for their efforts in creating an affordable vaccine against the bacteria that can cause meningitis and pneumonia.

According to Dr. Roy, the team is “on the verge of eradicating the disease in Cuba”. Hopefully with continued research and dedication to finding a cure, his team will be able to translate these positive results across the entire world.

Sources:

http://www.myhero.com/myhero/hero.asp?hero=Hib_Vaccine_Tech_2005

http://www.chop.edu/consumer/jsp/division/generic.jsp?id=75725

Contributed by: Lily Saadat


James Lind Haffkine

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Scurvy, a disease resulting from a deficiency of vitamin C, was once common among sailors, pirates and others at sea, since they did not access to perishable fruits and vegetables. Scurvy, which is caused by nutritional deficiency, was responsible for killing large numbers of passengers on long-distance voyages.

Today, scurvy is not as prevalent as it once was due to the work of James Lind. Lind (1716-1794) performed perhaps the first clinical trial, demonstrating that citrus fruits cure scurvy. Lind, who was the pioneer of naval hygiene in the Royal Navy, proposed not only that distilling seawater would result in fresh water but also that citrus fruits were necessary to help cure the symptoms of scurvy. Moreover, Lind urged better overall hygiene on the ships, suggesting better ventilation, improved cleanliness of the sailors, and fumigation with sulphur and arsenic.

In his clinic trials, Lind used various acidic substances, such as vinegar and cider, on different affected sailors. He concluded that those who were given oranges and lemons had recovered from scurvy after only 6 days.

Lind’s work was crucial in helping sailors overcome scurvy, a limitation to long distance travel. Lind’s work influenced practices of preventive medicine, and helped pave the way to new nutritional guidelines for sailors.

By his work he also influenced practices of preventive medicine and nutrition among British soldiers.

Sources:

http://www.jameslindlibrary.org/trial_records/17th_18th_Century/lind/

lind_biog.php

Contributed by: Lily Saadat


Dr. Evan Harris

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HIV and AIDS have devastated all parts of the world. The search for a vaccine for the deadly diseases has interested a variety of lab groups. Dr. Evan Harris, a Liberal Democrat with a long track record of supporting liberal causes, was caught in the search. While Dr. Evan Harris did not wish for publicity, he did attract the attention of many in the scientific community when he courageously agreed to put himself forward as a human guinea pig for a new AIDS vaccine.

Throughout college, Harris served as president of the Oxford Medical Students, working as an HIV/AIDS telephone counselor and heath advisor. When he was finishing his medical training in the early 1990s, Harris witnessed a young man dying from AIDS. This incidence changed his life completely.

From Harris’ perspective, his “act is neither brave nor heroic”. Instead he insists, “the bravery, if such a word is to be used, lies with the often dignified Aids patients in Africa dying from this modern-day plague”. Harris’ commitment to medical research and desire to help affect change has clearly impacted the scientific community. His act of courage placed our medical community one step closer to finding a cure.

Sources:

http://news.bbc.co.uk/1/hi/uk_politics/904525.stm


 

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