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Is Prevnar, the Ear Infection Vaccine, Worth the Price?
Since 2000, children have been routinely vaccinated with four doses of Prevnar, the vaccine that creates antibodies to seven different strains of pneumococcal bacteria.
Prevnar is referred to as a “cell wall antigen” vaccine. The vaccine consists of a small particle outside the capsule of each streptococcal bacterium. After injecting part of the microbial cell wall, the body creates an antibody to protect the bacteria. When exposed to one of the strains, the antibody latches onto the live pathogen and effectively kills it.
Prevnar contains the antigens of the most common strains circulating in the United States even though there are more than 90 strains of pneumococci in nature. Prevnar was initially released to prevent progressive pneumococcal disease even though the chance of an infant contracting progressive pneumococcal disease was determined to be about 0.15%, Soon, Prevnar was promoted to parents to prevent ear infections even though the package admits that the vaccine only reduces . ear infections by about 9 percent.
However, problems arose. Several studies suggest that the use of Prevnar, and the elimination of seven common bacterial strains, has led to an increase in the frequency of non-vaccine strains in circulation.(1) A study published this week in JAMA reports that strains not covered by the vaccine increased 140 percent in native children compared to the rate before the vaccine was used.(2)
Another effect of the widespread use of Prevnar is the emergence of antibiotic-resistant bacterial strains. By the 1970s, virtually all strains were exceptionally sensitive to penicillin; since the introduction of Prevnar, many strains have become very resistant. In a study published in 2003, more than one-third of pneumococcal isolates tested were also resistant to other common antibiotics, including ceftriaxone (Rocephin) (fourteen percent), erythromycin (twenty-two percent), and trimethoprim/sulfa (ie di Bactrim) (thirty-one percent). Twenty percent of the S pneumoniae isolates in the study were resistant to all four antibiotics.(3)
Research published in 2005 by two Boston researchers suggests that natural immunity to pneumococcal disease may be more important in protecting against the disease than the vaccine.
Lipsitch and Malley examined unvaccinated young children in the United States, Israel, and Finland. The incidence of progressive pneumococcal disease has been reported to decrease by nearly 50% in children between 1 and 2 years of age. But during this same period of time, the concentration of antibodies increased only slightly. The researchers concluded that some mechanism, other than antibody protection, provides protection against bacteria. (4)
Then what could provide this protection? The researchers do not know, but they say in their paper, “these observations make a good reason for the importance of one or more other factors. [the development of] antibodies” are necessary to provide protection against pneumococcal disease.” That means children have an element of natural protection, beyond the known benefits of the pneumococcal vaccine, we don’t understand
Instead of looking for the mechanism that transmits the natural protection, the researchers intend to use this information to develop a new vaccine, called a whole cell vaccine, that can use all 90 antigenic strains in a single shot. Researcher Malley admitted that the “ultimate goal” would be to test the vaccine in adult volunteers, and eventually in children.
But maybe there is a better way.
Epidemiological studies show that the frequency of ear infections can be achieved by breastfeeding, elimination of tobacco smoking in the home, frequent hand washing and the use of small rather than large childcare centers for infants and young children. (5) However, since Prevar. is one of the largest selling products in the industry, generating almost 1 billion dollars in revenue per year, the answer is once again, “follow the money.”
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