Michigan bill would mandate HPV vaccination

It was only a matter of time until a state legislator offered a bill mandating HPV vaccination as a condition of school or day-care entry, yet the news from Michigan this week was somewhat surprising only for how quickly the time came. Here's the AP story from CNN and an editorial supporting the bill in the Detroit Free Press.

Noteworthy is the statement from the Free Press that the bill in the Michigan Senate was co-sponsored by every female member of the body, across the political spectrum. We've written previously about HPV mandates, but now that a bill has been offered, what goes on in Michigan in the weeks and months ahead will be an important test case for the reception HPV mandates receive from legislators and the public across the country in the future.

CDC report on 2005 infant vaccination coverage

The National Immunization Survey is an annual effort by the CDC to evaluate coverage rates in infant populations (19-35 months) across the country. The telephone survey has several limitations and many critics, but it remains the best available, most comprehensive source of data on the success of vaccination programs nationwide.

In this week's MMWR, the 2005 data and discussion has been published. The report doesn't lend itself well to summary here, but suffice it to say that it is an excellent starting point for those looking for data of the scope of U.S. vaccination efforts in infants.

Impact of air travel on flu season; bird flu vaccine plans

A few items in the news this week that have implications on continuing avian flu pandemic preparedness efforts...

1) While not directly vaccine-related, an interesting paper appears in the October issue of PLoS Medicine titled "Empirical Evidence for the Effect of Airline Travel on Inter-Regional Influenza Spread in the United States". In short, the paper presents evidence suggesting that the 2001 flu season was delayed as a result of reduced air travel in the U.S. following the 9/11 attacks. While starting later than usual, the trade-off was that the flu season extended farther than is typically seen. (That finding isn't altogether surprising, however, considering the resumption of domestic and international air travel shortly after the attacks.) These observations could be of use when evaluating the impact of limiting air travel in order to mitigate the spread of a potential pandemic. Here's the Washington Post story on the paper.

2) As for vaccines in a pandemic, the September 29 issue of Vaccine includes a report of a meeting of global vaccine policy leaders titled "A global pandemic influenza vaccine action plan." (subscription required for full text). It's a sobering assessment of our current vaccine production capabilities, as the paper begins by noting a worldwide production capacity of one billion doses per year (less than 1/6th the world's population). That's a best case scenario, as the need for a two-dose vaccination series would cut that capacity in half. Of course, production is in many respects the "easy" part; getting those vaccines administered to at-risk populations is an even greater challenge.

That said, the authors propose three somewhat self-evident approaches for improving the otherwise-gloomy pandemic vaccine picture... 1) Increasing seasonal vaccine demand to stimulate market forces and augment supply, 2) Increasing production capacity for pandemic vaccines, and 3) Developing new technologies that offer broader immunity or improve long-term efforts. Good ideas all, but many questions remain about how to achieve them and how much time we have to do so.

News, research, and opinion on HPV vaccines

While the amount of information and discussion about HPV vaccines continues to surpass all other vaccine issues combined, we'll periodically put together a post noting some of what comes to us that's of value for those looking for further info...

• Vaccine supplement -- Late last month, the international journal Vaccine published a special issue devoted exclusively to HPV vaccines. The 264-page issue (Vol. 24, Supplement 3) is beyond impressive, including a who's who of vaccine researchers and policymakers exploring virtually every imaginable aspect of HPV science and policy. Included are papers on immunology, epidemiology, public health, developing countries issues, social/behavioral aspects of vaccination, and many more. Abstracts are free, but a subscription (or access through a library) is necessary to view the full text of any paper. The perfect launch point for anyone interested in examining the medical literature on HPV vaccines.

• HPV Today -- An international newsletter devoted to all aspects of HPV infection and treatment, vaccines have (understandably) received considerable attention in recent issues. The current edition includes an interview with Harvard's Sue Goldie on decision science and what it reveals about HPV vaccine policy options.

• "Benefits of new vaccine outweigh ethics concerns" -- That's the title of an op-ed by our colleague Anita Allen in her regular column, "The Moralist", in Sunday's Newark Star-Ledger. Allen, a contributor to the Ethics of Vaccines Project, writes,

"New immunization programs always raise legitimate ethical concerns, and the recently proposed cervical cancer vaccine programs are no different. But the particular ethical concerns raised by the HPV vaccine should not stand in the way of public acceptance. The potential health benefits of the vaccine are enormous."

Rotavirus inventors to receive CHOP gold medal

As this front-page story in today's Philadelphia Inquirer reports, the three researchers responsible for the discovery of what ultimately became Merck's new rotavirus vaccine, RotaTeq, will receive the "Gold Medal" from the Children's Hospital of Philadelphia. As even the brief outline in the Inquirer story suggests, the story of RotaTeq could be a case study for the difficulties of developing new vaccines -- the work leading to this year's FDA licensure and ACIP recommendation extends all the way back to research conducted in 1980.

Congratulations to Paul Offit, Stanley Plotkin, and Fred Clark on this latest honor. (For the record, Offit and Plotkin are friends and colleagues who have contributed their insights and expertise in various ways to the development of the Ethics of Vaccines Project.)

'06 flu vaccine supply might set records

During our Labor Day publishing hiatus, good news came from CDC that the total supply of flu vaccine for the upcoming flu season may reach an all-time high. The headline is that more than 100 million doses are expected to be available by late fall, a number that could reach as high as 115 million if a new vaccine from ID Biomedical (part of GSK) is licensed in the near future, as is anticipated. Either estimate would easily surpass the previous all-time high of 83 million doses administered in a single season.

Here's the detailed CDC press release as well as the related news story from CIDRAP. Between the impressive supply forecasts and the expected arrival of a fifth vaccine, signs suggest that at least some lessons were learned from the Chiron-induced flu vaccine shortage of 2004. The next challenge will be working to ensure that those 100+ million doses are administered, particularly to those groups identified as high-risk populations.