Commentary on medical news by a practicing physician.

  • Epocrates MedSearch Drug Lookup


    "When many cures are offered for a disease, it means the disease is not curable" -Anton Chekhov

    ''Once you tell people there's a cure for something, the more likely they are to pressure doctors to prescribe it.''
    -Robert Ehrlich, drug advertising executive.

    "Opinions are like sphincters, everyone has one." - Chris Rangel

    email: medpundit-at-ameritech.net

    or if that doesn't work try:


    Medpundit RSS

    Quirky Museums and Fun Stuff

    Who is medpundit?

    Tech Central Station Columns

    Book Reviews:
    Read the Review

    Read the Review

    Read the Review

    More Reviews

    Second Hand Book Reviews


    Medical Blogs


    DB's Medical Rants

    Family Medicine Notes

    Grunt Doc




    Code Blog: Tales of a Nurse

    Feet First

    Tales of Hoffman

    The Eyes Have It


    SOAP Notes


    Cut-to -Cure

    Black Triangle



    Kevin, M.D

    The Lingual Nerve

    Galen's Log



    Doctor Mental



    Finestkind Clinic and Fish Market

    The Examining Room of Dr. Charles

    Chronicles of a Medical Mad House



    Health Facts and Fears

    Health Policy Blogs

    The Health Care Blog

    HealthLawProf Blog

    Facts & Fears

    Personal Favorites

    The Glittering Eye

    Day by Day


    The Business Word Inc.

    Point of Law

    In the Pipeline


    Tim Blair

    Jane Galt

    The Truth Laid Bear

    Jim Miller

    No Watermelons Allowed

    Winds of Change

    Science Blog

    A Chequer-Board of Night and Days

    Arts & Letters Daily

    Tech Central Station





    The Skeptic's Dictionary

    Recommended Reading

    The Doctor Stories by William Carlos Williams

    Pox Americana: The Great Smallpox Epidemic of 1775-82 by Elizabeth Fenn

    Intoxicated by My Illness by Anatole Broyard

    Raising the Dead by Richard Selzer

    Autobiography of a Face by Lucy Grealy

    The Man Who Mistook His Wife for a Hat by Oliver Sacks

    The Sea and Poison by Shusaku Endo

    A Midwife's Tale by Laurel Thatcher Ulrich



    American Academy of Pediatrics

    General Health Info

    Travel Advice from the CDC

    NIH Medical Library Info



    Saturday, October 01, 2005

    When Vaccines Bite Back: Earlier this year, the new meningitis vaccine, Menactra, became the latest addition to the childhood immunization schedule. It was recommended for 11-12 year olds, not because they have a high rate of meningococcal meningitis, but because health officials thought it would be a good way to get the kids in to see the doctor:

    CDC's Advisory Committee on Immunization Practices (ACIP) recommends routine vaccination of young adolescents (defined in this report as persons aged 11--12 years) with MCV4 at the preadolescent health-care visit (at age 11--12 years). Introducing a recommendation for MCV4 vaccination among young adolescents might strengthen the role of the preadolescent visit and have a positive effect on vaccine coverage among adolescents.

    There were better reasons than suggested by that report. According to The Medical Letter, the number of cases of meningococcal meningitis in the United Kingdom declined from 67 to 5 within a year of vaccinating 80% of children under 18. The number of cases remained the same in unvaccinated age groups, so the strategy of vaccinating younger children rather than waiting until they go to college makes some sense, if your goal is to eliminate as much disease as possible the American way - without regard to cost. (The vaccine is $80 per dose)

    But now, the FDA is investigating potential serious side effects of the vaccine:

    The government is investigating five reports of teenagers who came down with a serious neurological disorder after receiving a new vaccine against meningitis.

    ....The five cases reported two to four weeks after Menactra vaccination occurred in 17- or 18-year-olds in New York, Ohio, Pennsylvania and New Jersey, FDA said. All are reported to be recovering.

    Studies of more than 7,000 Menactra recipients by manufacturer Sanofi-Pasteur showed no GBS
    [Guillian-Barre Syndrome - see above link - ed.] cases, and more than 2.5 million doses have been administered since it hit the market, FDA said. The rate of GBS is similar to what is expected without vaccination, but the timing of the cases is of concern and warrants further investigations, FDA said.

    Five cases out of 2.5 million doses is quite small, especially compared to the number of cases of meningitis:

    While there are fewer than 3,000 cases of invasive meningococcal meningitis each year, and 300 deaths, people ages 15 to 24 have the highest mortality rates, and survivors can suffer mental disabilities, hearing loss and paralysis.

    However, the disease incidence is higher in those under 1 years old and ages 18-24 than it is in the 11-12 year age group. Furthermore, the duration of the vaccine's effectiveness is not known, which means these pre-adolescents may end up needing boosters before they go off to college - when they'll be at a higher risk of catching the disease.

    So, while the number of Guillian-Barre cases may seem quite low, so is the incidence of meningococcal disease in the group getting the shots. The vaccine needs to be scrutinized a little more before it's given to every child in the country.

    posted by Sydney on 10/01/2005 01:14:00 PM 0 comments


    Post a Comment

    This page is powered by Blogger, the easy way to update your web site.

    Main Page


    Home   |   Archives

    Copyright 2006