Vaccine Failure and Ability to Transmit Disease

Contents

• Ability to Transmit Disease
• Vaccine Failure

Ability to Transmit Disease

• Acellular pertussis vaccines protect against disease but fail to prevent infection and transmission in a nonhuman primate model
• Brother-to-sister transmission of measles after measles, mumps, and rubella immunisation
• Case report: probable transmission of vaccine strain of yellow fever virus to an infant via breast milk
• Chickenpox Attributable to a Vaccine Virus Contracted From a Vaccinee With Zoster Five months after 2 siblings were immunized with varicella vaccine, 1 developed zoster. Two weeks later the second sibling got a mild case of chickenpox. Virus isolated from the latter was found to be vaccine type. Thus, the vaccine strain was transmitted from the vaccinee with zoster to his sibling.
• Detection of measles vaccine in the throat of a vaccinated child Fever occurring subsequent to measles vaccination is related to the replication of the live attenuated vaccine virus. In the case presented here, the vaccine virus was isolated in the throat, showing that subcutaneous injection of an attenuated measles strain can result in respiratory excretion of this virus.
• The Evolutionary Consequences of Blood-Stage Vaccination on the Rodent Malaria Plasmodium chabaudi
• Long-Term Circulation of Vaccine-Derived Poliovirus That Causes Paralytic Disease
• Molecular and Antigenic Characterization of a Highly Evolved Derivative of the Type 2 Oral Poliovaccine Strain Isolated from Sewage in Israel
• Outbreak of Measles Among Persons With Prior Evidence of Immunity, New York City, 2011 This is the first report of measles transmission from a twice vaccinated individual. The clinical presentation and laboratory data of the index were typical of measles in a naïve individual….Of 88 contacts, four secondary cases were confirmed that had either two doses of measles-containing vaccine or a past positive measles IgG antibody. All cases had laboratory confirmation of measles infection….This outbreak underscores the need for thorough epidemiologic and laboratory investigation of suspected measles cases regardless of vaccination status.
• Prevalence of vaccine-derived polioviruses in the environment
• Prevention and Control of Seasonal Influenza with Vaccines: Recommendations of the Advisory Committee on Immunization Practices — United States, 2013–2014 Live Attenuated Influenza Vaccines One study of 197 children aged 8 through 36 months in a child care center assessed transmissibility of vaccine viruses from 98 vaccinated children to the 99 unvaccinated children; 80% of vaccine recipients shed one or more virus strains (mean duration: 7.6 days).
• Sibling Transmission of Vaccine-Derived Rotavirus (RotaTeq) Associated With Rotavirus Gastroenteritis
• Transmission of mumps virus from mumps-vaccinated individuals to close contact
• Transmission of varicella-vaccine virus from a healthy 12-month-old child to his pregnant mother A 12-month-old healthy boy had approximately 30 vesicular skin lesions 24 days after receiving varicella vaccine. Sixteen days later his pregnant mother had 100 lesions. Varicella-vaccine virus was identified by polymerase chain reaction in the vesicular lesions of the mother. After an elective abortion, no virus was detected in the fetal tissue.
• Vaccine-acquired Rotavirus Infection in Two Infants with Severe Combined Immunodeficiency

(Also see the Vaccine Failure section below, Death, Vaccine Contamination, and the Rotavirus Vaccine section of Vaccination with Specific Vaccines.)

Vaccine Failure

• Changing Pertussis Epidemiology: Everything Old is New Again Pertussis was made notifiable in the United States in 1922. For 2 decades, reported cases were never under 100 000 and in 1934 peaked at over 265 000….whole-cell vaccines were replaced by acellular vaccines, first as the fourth and fifth doses beginning in 1992 and then for the entire childhood series beginning in 1997. Since that time, 2 important and unprecedented changes have occurred in the epidemiology of pertussis: the emergence of disease among vaccinated adolescents during the early 2000s and more recently the emergence of disease among school-aged children….The epidemics in 2010 and 2012 had a dramatically different epidemiology. Of the 27 550 cases reported in 2010, over 9000 occurred in in California….The highest incidence was observed in infants under 1 year of age, but an unusually large burden of disease occurred among children aged 7–10 years. The large majority of the children in this age group with pertussis were fully vaccinated with 5 doses of diphtheria and tetanus toxoid, acellular pertussis (DTaP), indicating a problem of vaccine failure rather than failure to vaccinate….Case counts [for the whole US] in 2012 reached 48 277—more than were reported in any year since 1959….Collectively, these observations led to the hypothesis that the epidemics were being driven largely by waning of immunity and redevelopment of susceptibility within the birth cohorts of children vaccinated with acellular vaccines, even in the face of recent booster doses.
• Resurgence of Whooping Cough May Owe to Vaccine’s Inability to Prevent Infections  The article, published in F1000 Research, points to the differences in mucosal immunity between whole-cell pertussis (wP) vaccines and the newer acellular pertussis (aP) vaccines, first introduced in the 1990s, as playing a pivotal role in the resurgence of the disease.  “This disease is back because we didn’t really understand how our immune defenses against whooping cough worked, and did not understand how the vaccines needed to work to prevent it,” said Christopher J. Gill, associate professor of global health and lead author of the article. “Instead we layered assumptions upon assumptions, and now find ourselves in the uncomfortable position of admitting that we may made some crucial errors. This is definitely not where we thought we’d be in 2017.”
• The future of measles in highly immunized populations. A modeling approach A computer model was created to study the effect of the measles elimination program in the United States on the number of susceptibles in the population. The simulation reveals that in the prevaccine era, approximately 10.6% of the population was susceptible to measles, most of whom were children less than 10 years of age. With the institution of the measles immunization program, the proportion of susceptibles in the population fell to 3.1% from 1978 through 1981, but then began to rise by approximately 0.1% per year to reach about 10.9% in the year 2050. The susceptibles at this time were distributed evenly throughout all age groups….The results of this study suggest that measles elimination in the United States has been achieved by an effective immunization program aimed at young susceptibles combined with a highly, naturally immunized adult population. However, despite short-term success in eliminating the disease, long-range projections demonstrate that the proportion of susceptibles in the year 2050 may be greater than in the prevaccine era. Present vaccine technology and public health policy must be altered to deal with this eventuality.
• Epidemic of Mumps among Vaccinated Persons, the Netherlands, 2009–2012
• Acellular pertussis vaccination facilitates Bordetella parapertussis infection in a rodent model of bordetellosis
• Annual Report to the Nation on the Status of Cancer, 1975–2009, Featuring the Burden and Trends in Human Papillomavirus (HPV)–Associated Cancers and HPV Vaccination Coverage Levels From 2000 to 2009, incidence rates increased for…cancer of the vulva among white and black women….cervical cancer incidence rates decreased for women in all racial and ethnic groups, except AI/AN [ American Indian/Alaska Native] women. (Note that, in this study, the majority of the information about HPV referred to HPV vaccination, not HPV-associated disease; the details about increases in the latter had to be filtered out of the majority.)
• Case of vaccine-associated measles five weeks post-immunisation, British Columbia, Canada, October 2013
• The Compelling Need for Game-changing Influenza Vaccines
• Considerations for Viral Disease Eradication: Lessons Learned and Future Strategies Important and often overlooked, mass vaccinations itself can also exert tremendous selective pressures and lead to the evolution of new infectious agents.
• Effectiveness of Jeryl Lynn-containing vaccine in Spanish children
• HPV vaccine may not protect women against high-grade squamous intraepithelial lesions, dysplasias Also see commentary HPV Vaccine Maker’s Study Proves Natural HPV Infection Beneficial, Not Deadly: When we consider that the HPV vaccine has recently been found to present an “unavoidable” vaccine danger to those to which it is administered, that the PATRICIA trial found 35-36% of the subjects had “medically significant” adverse effects,  and that a growing body of peer-reviewed published literature already links it to over a dozen serious health side effects including death, what does a sane parent do? There is a growing chasm between policy makers driving mandatory HPV vaccines into schools, homes and workplaces, and the voice of reason and the precautionary principle that stands firm against any obviously unnecessary medical intervention that has not been adequately proven safe in extensive animal and human clinical trials.
• Late Onset of Vaccine-associated Measles in an Adult with Severe Clinical Symptoms: A Case Report Clinicians should be aware of the possibility of vaccine-associated measles in both children and adults.
• [Major measles epidemic in the region of Quebec despite a 99% vaccine coverage]
• Measles Inclusion-Body Encephalitis Caused by the Vaccine Strain of Measles Virus We report a case of measles inclusion-body encephalitis (MIBE) occurring in an apparently healthy 21-month-old boy 8.5 months after measles-mumps-rubella vaccination. He had no prior evidence of immune deficiency and no history of measles exposure or clinical disease.
• Evidence convincingly supports a causal relationship between MMR vaccine and measles inclusion body encephalitis in individuals with demonstrated immunodeficiencies Measles inclusion body encephalitis is confined to immunodeficient patients [NOT TRUE – see Measles Inclusion-Body Encephalitis Caused by the Vaccine Strain of Measles Virus listed above!] and is inevitably fatal….The latencies between vaccination and the development of measles inclusion body encephalitis in the publications described above were 4 and 9 months.
• Measles outbreak in a fully immunized secondary-school population
• Mumps Orchitis in the Post-Vaccine Era (1967-2009)
• Mumps outbreak among vaccinated university students associated with a large party, the Netherlands, 2010
• Pertussis Infections in Fully Vaccinated Children in Day-Care, Israel Vaccinated adolescents and adults may serve as reservoirs for silent infection and become potential transmitters to unprotected infants. The whole-cell vaccine for pertussis is protective only against clinical disease, not against infection. Therefore, even young, recently vaccinated children may serve as reservoirs and potential transmitters of infection.
• Recent Resurgence of Mumps in the United States
• Review of the United States universal varicella vaccination program: Herpes zoster incidence rates, cost-effectiveness, and vaccine efficacy based primarily on the Antelope Valley Varicella Active Surveillance Project data Prior to the universal varicella vaccination program, 95% of adults experienced natural chickenpox (usually as pre-school to early elementary school children) – these cases were usually benign….rather than eliminating varicella in children as promised, routine vaccination against varicella has proven extremely costly and has created continual cycles of treatment and disease.
• Risk of vaccine failure after Haemophilus influenzae type b (Hib) combination vaccines with acellular pertussis
• Selection of Hepatitis B Virus (HBV) Vaccine Escape Mutants in HBV-Infected and HBV/HIV-Coinfected Patients Failing Antiretroviral Drugs With Anti-HBV Activity
• Spotlight on measles 2010: Excretion of vaccine strain measles virus in urine and pharyngeal secretions of a child with vaccine associated febrile rash illness, Croatia, March 2010
• Unexpectedly limited durability of immunity following acellular pertussis vaccination in preadolescents in a North American outbreak
• Vaccine-Acquired Rotavirus in Infants with Severe Combined Immunodeficiency In summary, vaccine-acquired rotavirus disease was detected after the administration of RV5 in three infants with SCID. In two of the three, rotavirus disease developed after receipt of the second rotavirus immunization, not the first, which may reflect early protection in infancy by transplacentally acquired maternal antibodies. Rotavirus clearance was accomplished only after successful immune reconstitution. These cases of rotavirus infection raise concerns regarding the safety of rotavirus vaccines in severely immunocompromised patients and the need to prevent vaccine-acquired disease, as with other live viral vaccines.
• Vaccine-associated “wild-type” measles We report a 1-year-old boy who, 10 days after vaccination, developed vaccine measles which was clinically indistinguishable from the natural disease. Vaccine virus was detected by polymerase chain reaction in the patient’s nasopharyngeal secretions.
• Waning Protection after Fifth Dose of Acellular Pertussis Vaccine in Children
• What is the cause of a rash after measles-mumps-rubella vaccination? We describe a 17-month-old child with fever and rash after measles-mumps-rubella vaccination. Detection of vaccine-strain measles virus in his urine by polymerase chain reaction confirmed the diagnosis of a vaccine reaction rather than wild-type measles. We propose that measles virus should be sought and identified as vaccine or wild-type virus when the relationship between vaccination and measles-like illness is uncertain.
• Why Do Pertussis Vaccines Fail?

(Also see the Ability to Transmit Disease section above, Death, HPV Vaccine, Influenza Vaccine, MMR and derivaties, Pneumococcal Vaccine and Tetanus Vaccine sections under Vaccination with Specific Vaccines)