Vaccinating Against the Snivels?

I’m using a deliberately provocative title for a story that is quite serious, both medically and ethically.

We have today heard about two new developments. Researchers from the University of Rochester Medical Center announced that they are starting trials of a new vaccine aimed at eliminating childhood ear and sinus infections as well as many cases of bronchitis in adults. Second, and on the same day, the University of Rochester announced that it had won a $3.5 million grant from the National Institute of Deafness and Communication Disorders, one of the divisions of the National Institutes of Health, to develop the new vaccine. The team at Rochester helped to develop the vaccine marketed by Wyeth as Prevnar. It is used to protect infants and toddlers against some strains of bacteria that can cause pneumonia, meningitis and ear infections.

The vaccine will target Nontypeable Haemophilus influenzae or NTHi, which is the main remaining cause of ear and sinus infections and bronchitis, now that vaccines exist for various forms of streptococcal bacteria and Haemophilus influenzae B, the previous leading causes. NTHi is now the leading cause of ear and sinus infections, and of bronchitis in adults.

But why this news is so important for all of us, is that unlike virtually all other vaccines on the market, this one will not be aimed at saving lives, but at preventing what are usually nuisance illnesses. But please note my use of the word “usually.”

Dr. Michael Pichichero, a professor of microbiology, immunology, pediatrics, and medicine at the University of Rochester Medical Center who is leading the trial, was quoted as saying, “While ear infections are never fatal, they can cause serious damage in some children.” He went on to say that “83 percent of U.S. children experience one or more ear infections by age 3 and in some cases hearing loss becomes permanent.”

This is the point, and also why the National Institute of Deafness and Communication Disorders has chipped in. Most of these infections get better on their own, so an initial reaction might be to say, “why bother with this at all?” The trouble is that not only can they lead to long-term problems with hearing, I have seen more than one person develop a cerebral abscess as a result of a severe infection: the illness is not always innocuous.

Another problem is that infections of the sinuses and ears bring children to clinics and emergency rooms, and are the leading reason for antibiotic prescriptions. Even though many of the infections are viral, and viruses do not, of course, respond to antibiotics. Every expert agrees that antibiotics are overused in the United States, which wastes money and also helps the evolution of bacteria that ultimately resist all antibiotics.

What’s the downside of these announcements?

1. We have already run into a great many problems with previous vaccinations. Some long-term and some subtle; so we desperately need long-term safety data.I know many natural healers who blame many of our health woes on vaccinations.
2. I hope that the researchers have built into the contract a clause to allow them to report efficacy and safety data without having to clear everything with the study’s sponsor.
3. We are facing major resource problems, not just in the provision of health care, but also in the funding for research. So should we be diverting resources into these kinds of problems while every 30 seconds another child dies of malaria?
4. There has been a great deal of discussion about what is often called the “hygiene hypothesis:” the idea that the increasing rates of some allergic illnesses and asthma are a result of children having avoided minor infections early in life, that would have stimulated their immune systems. The hypothesis is not proven, but there is a great deal of circumstantial evidence.
5. If successful, would the vaccine create a host of secondary problems ten or twenty years from now?