ACIP COVID-19 vaccines meeting – summary of August 2020 discussions

This article about the August 2020 ACIP COVID-19 vaccines meeting was written by Dorit Rubinstein Reiss, Professor of Law at the University of California Hastings College of the Law (San Francisco, CA), who is a frequent contributor to this and many other blogs, providing in-depth, and intellectually stimulating, articles about vaccines, medical issues, social policy, and the law.

Professor Reiss writes extensively in law journals about the social and legal policies of vaccination. Additionally, Reiss is also a member of the Parent Advisory Board of Voices for Vaccines, a parent-led organization that supports and advocates for on-time vaccination and the reduction of vaccine-preventable disease.

On August 26, 2020, the Advisory Committee on Immunization Practices (ACIP) held an emergency meeting to discuss COVID-19 vaccines. This was an emergency meeting, as opposed to one of its three annual scheduled meetings, but it was not “emergency” in the sense of being unplanned – it was announced long in advance, and the announcement was repeated during the June and July emergency meetings.

The ACIP COVID-19 vaccines meeting consisted of four to five hours of presentations from the COVID-19 vaccines workgroup, convened in April, and one hour of public comments that included multiple pro-vaccine speakers and four anti-vaccine individuals.

The main takeaway most people would have from the meetings are, I expect, the same as mine – that COVID-19 vaccines safety is taken extremely seriously by the workgroup and the committee, that there is still a lot of uncertainty about which of the vaccine in the pipeline will be effective, and that there are thorny, hard questions in deciding how to allocate the first vaccine doses.

This will be a very short overview of the meeting. The next meeting is on September 22, and I encourage and urge people to listen and learn from it. The presentation slides for the previous meetings can be found here. Continue reading “ACIP COVID-19 vaccines meeting – summary of August 2020 discussions”

Coronavirus vaccine clinical trials – keeping up with everything out there

coronavirus vaccine clinical trials

This article about coronavirus vaccine clinical trials will be regularly updated as new clinical trials are registered or early results are published about an ongoing trial. Again, this article will focus on coronavirus clinical trials – treatments and diagnostic tests are outside of the scope of this article.

Keeping up with COVID-19 vaccine candidates has gotten out of hand, so for brevity, I’ve created a separate list of coronavirus vaccine clinical trials. The interest in clinical trials for a new vaccine is unprecedented, so I thought this might be the best way to keep loyal readers up-to-date.

Recently, the World Health Organization (WHO) has listed over 110 vaccine candidates, which is amazing, but it is way too difficult to tell which ones have any chance of actually becoming a real product.

Right now, there are numerous vaccine candidates in clinical trials – this article will analyze these coronavirus vaccine clinical trials.

Continue reading “Coronavirus vaccine clinical trials – keeping up with everything out there”

Prices of vaccines–an uncomfortable discussion

Injection of FundsSuddenly, there has been a lot of noise about the price of vaccines. Well, there’s always been over-exaggerations and outright misinformation about vaccine prices and profits from the antivaccination gang, and they must be embarrassed by the quality of their arguments. OK, I doubt that. But there is noise out there.

But when the criticism comes from the “pro-vaccine” world, I needed to stand up and see what was being said. In my world of vaccines, I believe that anyone, especially children, who needs vaccines should get them for free. This is true in the USA (which leads the world in this one facet of healthcare), thus, any argument about vaccines costing too much falls rather flat to me. I hate dropping anecdotal data on my readers, but the fact is my health insurance plan, by no means some corporate executive level concierge plan, pays for all vaccines. In fact, I asked for one vaccination out of indication (meaning I was about 10 years too young to receive it), and the insurance company paid for it immediately and without question.

In the USA, the Affordable Care Act (best known as Obamacare) mandates vaccinations for adults and children with no out-of-pocket costs. Medicaid pays for vaccines. Medicare pays for vaccines, though the rules for payment are unnecessarily bureaucratic and confusing, unless the member is in Medicare Advantage. Maybe not as of today, but certainly soon, the cost of vaccines shouldn’t matter to the average rich or poor or middle-class American. And considering the number of lives saved by vaccines, this is an incredible and modern aspect of the USA health care system. Continue reading “Prices of vaccines–an uncomfortable discussion”

What is causing the fatal meningitis outbreak?

Over the past week or so, there have been numerous reports about a fungal meningitis outbreak that was traced to medicines associated with three lots of preservative-free methylprednisolone acetate produced by the New England Compounding Center.  The drug is an injectable steroid that is used for pain relief. The potentially contaminated injections were given starting May 21, 2012. Symptoms of the fungal meningitis include: fever, new or worsening headache, neck stiffness, sensitivity to light, new weakness or numbness, increasing pain, redness or swelling of the injection site. So far, 7 people in the US have died.

Because the drug is delivered via an epidural injection directly into the epidural space, any contamination can lead to a meningitis infection. In this case the steroid produced by the New England Compounding Center was contaminated with a fungus which caused the fungal meningitis. It’s important to note that unlike other types of meningitis, such as bacterial meningitis, it is not contagious. Fungal meningitis also does not have a vaccine, because it is quite rare. (Viral meningitis is less severe, and usually resolves itself without treatment.)

Data Table for Persons with Meningitis Linked to Epidural Steroid Injections, as of October 7, 2012

Continue reading “What is causing the fatal meningitis outbreak?”