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Vaccines

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  • The articles and short videos below show why vaccines do not protect and do cause damage and death to the vaccinated some are physiologically expressed as Autism, ADD, ADHD, MS, SIDS, Guillain-Barre syndrome (GBS), Allergies and autoimmune diseases and others hidden beneath the surface by ways of creating a weaker immune system making the Pt more susceptible to all disease. Read the articles so you will have a understanding of why vaccines do not work and are dangerous to all.
    It is very important to understand the immune system before you decide to bypass natures and GOD's natural defenses, the mucosa of the lungs, throat and nose, the stomach, and the skin with an assault on the immune system and body with untested chemicals, neurotoxins, DNA from caterpillars, DNA from dog Kidneys, DNA from aborted fetus tissue, additional contaminating viruses, live viruses that shed for up to 28 days causing others to become ill, protein from peanuts that are used as an excipient plays a major role in contributing to the serious peanut allergy epidemic in America and much, much more for you to learn and be aware of before you can say that you are fully informed.

    First of all, vaccine damage and death is much more common than 1:1,000,000 as you are told.
    A. http://articles.mercola.com/sites/articles/archive/2014/04/26/vaccines-adverse-reaction.aspx
    B. An article in JAMA estimated that 1:4000 will experience an adverse reaction, a lot more than the one in a million that is quoted or written.
    Reference: JAMA, June 19, 1999 vol. 281, no.21, pg.2132
    C. How Vaccines Harm Child Brain Development - Dr Russell Blaylock MD (neurosurgeon, researcher)
    http://www.youtube.com/watch?v=7QBcMYqlaDs#t=417 88 minutes
    D. How the studies that doctors site as evidence are skewed (lied about) in the pharmaceuticals favor and how vitamin D3 is much more effective against the Flu and Influenza like illness (ILI) than the Flu vaccine.
    http://www.youtube.com/watch?v=h-3yrrgkcLY&feature=youtube 8 minutes
    I go into 3 other ways that the pharmaceuticals twist and distort the truth in my power point below.

    It is very important to understand how the immune system works and why vaccines do not protect us and that the reasons for the massive decline of disease is due to sanitation, improved nutrition, clean drinking water, and washing hands. All these that we take for granted in the modern world the third world countries do not have and is the reason why disease persists on a larger scale. The billions we spend on vaccination will be much better served in sanitation, clean drinking water and food sustainability like culturing spirulina as is being done in Africa https://www.youtube.com/watch?v=CxSA5iiGgiY
    A. http://www.vaccinationcouncil.org/2011/06/10/basics-of-the-human-immune-system-prior-to-introduction-of-vaccines-are-vaccines-turning-our-children%E2%80%99s-immune-systems-inside-out/
    B. http://www.vaccinationcouncil.org/2011/06/21/risks-damage-basics-of-the-human-immune-system-prior-to-introduction-of-vaccines-are-vaccines-turning-our-childrens-immune-systems-inside-out-part-2/
    C. http://pathwaystofamilywellness.org/Informed-Choice/how-do-vaccines-work-immune-mechanisms-and-consequences.html
    D. http://www.vaccineriskawareness.com/Your-Immune-System-How-It-Works-And-How-Vaccines-Damage-It


    The 3 driving forces of vaccination are listed below with fear as a common denominator to vaccinate.

    1. The belief that polio and smallpox were eradicated is a major force in peoples belief system to subject themselves to vaccine damage and death. Listen to Dr.Suzanne Humphries presentation on
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  • Polio and how it was never eradicated but the diagnostics was changed with the stroke of a pen and was reclassified as transverse myelitis (which there are over 1,000 cases every year just of this one disease) and many other diseases. The horrible photos of the iron lung were replaced with the modern day ventilator and the ECMO http://www.dellchildrens.net/services_and_programs/ecmo/what_is_ecmo/how_does_ecmo The ventilator and ECMO do not stand out as much as the iron lung but they perform the same function, to aid the Pt (Patient) in breathing or to breath for the Pt.
    A. http://www.vaccinationcouncil.org/2013/02/15/dr-suzanne-humphries-discusses-vaccines-and-polio-video/
    B. Purchase “Dissolving Illusions, Disease,, Vaccination and the Forgotten History” 2013, for the most accurate history on vaccination by Dr. Suzanne Humphries. Great details on the history of Polio and other diseases and the lies that are the foundation of vaccination.
    http://www.vaccinationcouncil.org/books-and-media/
    C. Jabs, Jenner and Juggernauts: a Look at Vaccination By Jennifer Craig
    The lies behind small pox and Edward Jenners work
    http://www.vaccinationcouncil.org/books-and-media/
    D. Jenner and Vaccination: A Strange Chapter of Medical History By Charles Creighton
    http://www.vaccinationcouncil.org/books-and-media/

    2. The second driving force of vaccination is the myth of herd immunity and it is morally and ethically wrong not to vaccinate because of others weakened immune system. Herd immunity is only achieved by a community acquiring the disease naturally and passing on the antibodies in breast milk. Benefits are a lifelong immunity and a stronger immune system, two benefits that can not be achieved with vaccination.
    A. http://www.vaccinationcouncil.org/2012/07/05/herd-immunity-the-flawed-science-and-failures-of-mass-vaccination-suzanne-humphries-md-3/
    B. http://www.vaccinationcouncil.org/2012/02/18/the-deadly-impossibility-of-herd-immunity-through-vaccination-by-dr-russell-blaylock/

    3. The third driving force is the belief that vaccines will prevent the disease the Pt was vaccinated against.
    Short videos and articles of outbreaks within the the vaccinated (not protected as advertised) and caused by the vaccinated.
    A. http://experimentalvaccines.org/2014/03/31/new-york-measles-outbreak-90-vaccinated/
    B. http://experimentalvaccines.org/2014/04/03/ohio-mumps-outbreak-97-vaccinated/
    C. http://experimentalvaccines.org/2014/03/25/mumps-outbreak-involves-highly-vaccinated-students/
    D. http://experimentalvaccines.org/2014/01/31/cfr-council-on-fake-realities-vaccine-created-outbreaks-map/
    E. http://experimentalvaccines.org/2014/04/04/fda-vaccine-insert-lists-autism-as-adverse-reaction/
    F. http://experimentalvaccines.org/2013/10/09/91-fully-vaccinated-involved-in-pertussis-outbreak/

    G, 17 more vaccine failures
    http://vactruth.com/2013/02/23/17-examples-of-vaccine-failure/

    H. http://www.collective-evolution.com/2014/04/23/measles-outbreak-traced-to-fully-vaccinated-patient-for-first-time/

    After over 1,000 hours of research on my own I was compelled to create a source of factual information for those who want to learn more about the who, what, where, why and how of vaccination
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  • and become fully informed with a purpose to encourage independent research and critical thinking and not parrot what someone has heard all of their lives.
    A. I have many recommended books, DVD's, Documentaries and websites that you can learn from in my power point
    http://www.slideshare.net/db61/exposing-the-myth-of-vaccination-essential-information-you-need-to-know-to-be-fully-informed-30978670?qid=144d3297-fe17-4eb8-bd7d-d92656e9c477&v=default&b=&from_search=1
    B. A great place to start is at this website composed of physicians, read the articles and listen to their presentations
    http://www.vaccinationcouncil.org/start-here-2/
    C. Recommended Books and media
    http://www.vaccinationcouncil.org/books-and-media/

    D. Dr. Sherrie Tenpenny's Vaccine Research Library is a one-of-a-kind collection of over 6,000 medical and scientific studies revealing truth about vaccine dangers. The information has been amassed by sifting through tens of thousands of medical abstracts and full text articles hosted in Pubmed, Scholar, Quertle, Biomed Central and more. Complex information has been extracted from scientific journals such as Nature and Science, and from releases by the CDC, FDA, NIH, HHS, and Pharmcast. The evidence has been examined and categorized. The Vaccine Research Library is a no-nonsense, sobering collection of the actual clinical studies and papers telling “The Other Side of the Story.”
    http://tenpennyimc.com/2012/03/04/announcing-the-vaccine-research-library/
    D. Conflicts of interest. This is just the tip of the ice burg on this subject.
    http://www.cbsnews.com/news/how-independent-are-vaccine-defenders/
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  • Excellent presentation
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  • 1. WHAT YOU SHOULD HAVE READ BUT….2010 <ul><li>Vaccines </li></ul>University of Verona, Italy Attilio Boner
  • 2. generalità
  • 3. Ab titers against HBV mlU/mL Effect of Needle Length When Immunizing Obese Adolescents With Hepatitis B Vaccine Middleman Pediatrics 2010;125:e508 <ul><li>To determine whether use of a longer (1.5-in) rather than a standard (1-in) needle to penetrate the thicker deltoid fat pad among obese youth would result in higher antibody titers after immunization against hepatitis B virus. </li></ul>1-inch 1.5 inch 345.4 189.8 P=0.03 400 – 300 - 200 – 100 - 0 needle
  • 4. Ab titers against HBV mlU/mL Effect of Needle Length When Immunizing Obese Adolescents With Hepatitis B Vaccine Middleman Pediatrics 2010;125:e508 <ul><li>To determine whether use of a longer (1.5-in) rather than a standard (1-in) needle to penetrate the thicker deltoid fat pad among obese youth would result in higher antibody titers after immunization against hepatitis B virus. </li></ul>1-inch 1.5 inch 345.4 189.8 P=0.03 400 – 300 - 200 – 100 - 0 That needle length accounts for a significant portion of the discrepancy in immune response to HBV vaccine that is seen among those with obesity. needle
  • 5. The less abundant blood supply in adipose tissue results in a potential delay in vaccine antigen presentation to the B and T cells that are responsible for immune response; this delay may allow the protein antigens to be denatured by enzymes , resulting in a diminished immune response to vaccination. Effect of Needle Length When Immunizing Obese Adolescents With Hepatitis B Vaccine Middleman Pediatrics 2010;125:e508
  • 6. Eff ect of prophylactic paracetamol administration at time of vaccination on febrile reactions and antibody responses in children: two open-label, randomised controlled trials. Prymula Lancet 2009;374:1339 <ul><li>459 healthy infants </li></ul><ul><li>3 prophylactic paracetamol doses every 6–8 h in the first 24 h (n=226) or </li></ul><ul><li>no prophylactic paracetamol (n=233) after each vaccination </li></ul>% of children with temperature ≥ 38°C 80 – 70 – 60 – 50 – 40 – 30 – 20 – 10 – 0 42% 66% Paracetamol NO Paracetamol
  • 7. Eff ect of prophylactic paracetamol administration at time of vaccination on febrile reactions and antibody responses in children: two open-label, randomised controlled trials. Prymula Lancet 2009;374:1339 <ul><li>459 healthy infants </li></ul><ul><li>3 prophylactic paracetamol doses every 6–8 h in the first 24 h (n=226) or </li></ul><ul><li>no prophylactic paracetamol (n=233) after each vaccination </li></ul><ul><li>Antibody geometric mean (GMCs) concentrations were significantly lower in the prophylactic paracetamol group than in the no prophylactic paracetamol group after primary vaccination for all ten pneumococcal vaccine serotypes, antidiphtheria, antitetanus. </li></ul><ul><li>After boosting, lower antibody GMCs persisted in the prophylactic paracetamol group for antitetanus, </li></ul><ul><li>and all pneumococcal serotypes apart from 19F. </li></ul>
  • 8. Eff ect of prophylactic paracetamol administration at time of vaccination on febrile reactions and antibody responses in children: two open-label, randomised controlled trials. Prymula Lancet 2009;374:1339 <ul><li>459 healthy infants </li></ul><ul><li>3 prophylactic paracetamol doses every 6–8 h in the first 24 h (n=226) or </li></ul><ul><li>no prophylactic paracetamol (n=233) after each vaccination </li></ul><ul><li>Antibody geometric mean (GMCs) concentrations were significantly lower in the prophylactic paracetamol group than in the no prophylactic paracetamol group after primary vaccination for all ten pneumococcal vaccine serotypes, antidiphtheria, antitetanus. </li></ul><ul><li>After boosting, lower antibody GMCs persisted in the prophylactic paracetamol group for antitetanus, </li></ul><ul><li>and all pneumococcal serotypes apart from 19F. </li></ul>prophylactic administration of antipyretic drugs at the time of vaccination should not be routinely recommended since antibody responses to several vaccine antigens were reduced.
  • 9. influenza
  • 10. Impact of influenza vaccination on mortality risk among the elderly Groenwold ERJ 2009:34:56 <ul><li>Information on patients aged ≥65 yrs from the computerised Utrecht General Practitioner database on 8 influenza epidemic periods. </li></ul><ul><li>Adjustment for measured confounders using multivariable regression analysis. </li></ul>INFLUENZA VACCINATION 0.58 Or for Mortality Risk 1.0 – 0.9 – 0.8 – 0.7 – 0.6 – 0.5 – 0.4 – 0.3 – 0.2 – 0.1 – 0
  • 11. <30% >70% 2005 1995 <ul><li>177 120 patients with COPD (mean age 65 years). </li></ul><ul><li>Follow-up of 6.8 years. </li></ul>80 – 70 – 60 – 50 – 40 – 30 – 20 – 10 – 0 Vaccination rates against influenza in patients aged ≥ 60 years Influenza but not pneumococcal vaccination protects against all-cause mortality in patients with COPD Schembri Thorax 2009;64:567–572.
  • 12. >70% 2005 1995 <ul><li>177 120 patients with COPD (mean age 65 years). </li></ul><ul><li>Follow-up of 6.8 years. </li></ul>80 – 70 – 60 – 50 – 40 – 30 – 20 – 10 – 0 Influenza but not pneumococcal vaccination protects against all-cause mortality in patients with COPD Schembri Thorax 2009;64:567–572. Cumulative vaccination rate against pneumonia in patients aged ≥ 70 yrs 0%
  • 13. 0.59 0.97 1.0 – 0.5 – 0 During Outside influenza season For all-cause mortality the adjusted Relative Risks associated with influenza vaccination in patients not vaccinated against pneumonia Influenza but not pneumococcal vaccination protects against all-cause mortality in patients with COPD Schembri Thorax 2009;64:567–572. <ul><li>177 120 patients with COPD (mean age 65 years). </li></ul><ul><li>Follow-up of 6.8 years. </li></ul>
  • 14. 0.30 0.98 1.0 – 0.5 – 0 During Outside influenza season For all-cause mortality the adjusted Relative Risks associated with influenza vaccination in patients vaccinated against pneumonia Influenza but not pneumococcal vaccination protects against all-cause mortality in patients with COPD Schembri Thorax 2009;64:567–572. <ul><li>177 120 patients with COPD (mean age 65 years). </li></ul><ul><li>Follow-up of 6.8 years. </li></ul>
  • 15. Ovalbumin content in 2009 to 2010 seasonal and H1N1 monovalent influenza vaccines Waibel JACI 2010;125:749 <ul><li>For the 2009 to 2010 influenza season, 34 manufacturers in 19 countries are manufacturing influenza vaccines. </li></ul><ul><li>Because influenza vaccines are developed by inoculating embryonated chicken eggs with virus, the final product has always contained ovalbumin, which can pose a risk in children and adults with egg allergy. </li></ul><ul><li>All but 1 manufacturer for the 2009 to 2010 FDA-approved influenza vaccines state a maximum ovalbumin content of ≤1mg per dose ( ≤2mg/mL). </li></ul>
  • 16. Ovalbumin content in 2009 to 2010 seasonal and H1N1 monovalent influenza vaccines Waibel JACI 2010;125:749 <ul><li>For children and adults with egg allergy, 3 clinical courses are generally recommended: </li></ul><ul><li>vaccine avoidance, </li></ul><ul><li>vaccine skin testing with a 2-dose vaccine administration protocol, or </li></ul><ul><li>vaccine skin testing with a multidose graded vaccine administration protocol. Zeiger JACI 2002;110:834 </li></ul>
  • 17. Ovalbumin content in 2009 to 2010 seasonal and H1N1 monovalent influenza vaccines Waibel JACI 2010;125:749 <ul><li>For children and adults with egg allergy, 3 clinical courses are generally recommended: </li></ul><ul><li>vaccine avoidance, </li></ul><ul><li>vaccine skin testing with a 2-dose vaccine administration protocol, or </li></ul><ul><li>vaccine skin testing with a multidose graded vaccine administration protocol. Zeiger JACI 2002;110:834 </li></ul><ul><li>The 2-dose protocol 10% of the dose is given initially, and if there is no reaction in 30 minutes, the remaining 90% of the dose is given, with an additional observation period afterward. </li></ul>
  • 18. Ovalbumin content in 2009 to 2010 seasonal and H1N1 monovalent influenza vaccines Waibel JACI 2010;125:749 <ul><li>For children and adults with egg allergy, 3 clinical courses are generally recommended: </li></ul><ul><li>vaccine avoidance, </li></ul><ul><li>vaccine skin testing with a 2-dose vaccine administration protocol, or </li></ul><ul><li>vaccine skin testing with a multidose graded vaccine administration protocol. Zeiger JACI 2002;110:834 </li></ul>This was based on a single study demonstrating the safety of this approach with vaccines containing no more than 1.2 mg/mL ovalbumin in 83 children and adults with egg allergy. James J Pediatr 1998;133:624
  • 19. Ovalbumin content in 2009 to 2010 seasonal and H1N1 monovalent influenza vaccines Waibel JACI 2010;125:749
  • 20. Ovalbumin content in 2009 to 2010 seasonal and H1N1 monovalent influenza vaccines Waibel JACI 2010;125:749
  • 21. Ovalbumin content in 2009 to 2010 seasonal and H1N1 monovalent influenza vaccines Waibel JACI 2010;125:749 <ul><li>British Society of Allergy and Clinical Immunology recommends using only vaccines with a maximal egg content of 1.2µg/mL in patients with egg allergy. Nasser CAE 2009;39:1288 </li></ul><ul><li>The influenza vaccine administered to subjects with egg allergy in the 2-dose protocol described here had a maximum ovalbumin content of 1.2 µg/mL, and all subjects tolerated the entire dose. </li></ul><ul><li>Thus, one should consider administering any vaccine containing less than this amount to subjects with egg allergy as a single dose, without previous vaccine skin testing. </li></ul>
  • 22. Egg allergy and influenza vaccination Settipane Allergy Asthma Proc 2009;30:660 <ul><li>Batch-to-batch variability of egg content in extant influenza vaccines necessitates an informed and cautious approach to vaccination of an egg-allergic individual. </li></ul><ul><li>Due to denaturation of some egg proteins through heating, tolerance of “baked egg” products may not predict tolerance of “native egg” proteins present in the influenza vaccine. </li></ul><ul><li>Intradermal skin testing with influenza vaccine diluted 1:10 may be irritating to the skin and result in false positive results. </li></ul><ul><li>If skin test to the vaccine is positive, vaccination may still be cautiously administered, if necessary, in a graded-dose protocol, as presented herein. </li></ul><ul><li>Most patients with egg allergy are likely to develop egg tolerance by late childhood. </li></ul>
  • 23. Egg allergy and influenza vaccination Settipane Allergy Asthma Proc 2009;30:660 Il pdf è a pagamento
  • 24. pneumococco
  • 25. Increased risk of serious pneumococcal disease (SPD) in patients with atopic conditions other than asthma Jung JACI 2010:125:217 Background: We reported an increased risk of serious pneumococcal disease ( SPD ) among patients with asthma. It is not known whether this is true for patients with other atopic conditions. Objective: To determine the relationship between atopic conditions other than asthma and SPD.
  • 26. <ul><li>Between 1964 and 1983 174 serious pneumococcal disease (SPD) cases. </li></ul>ATOPIC CONDITIONS OTHER THAN ASTHMA 2.13 2.5 – 2.0 – 1.5 – 1.0 – 0.5 – 0 OR FOR SPD Increased risk of serious pneumococcal disease (SPD) in patients with atopic conditions other than asthma Jung JACI 2010:125:217 P=0.04
  • 27. <ul><li>Between 1964 and 1983 174 SPD cases. </li></ul>ATOPIC CONDITIONS OTHER THAN ASTHMA 2.13 2.5 – 2.0 – 1.5 – 1.0 – 0.5 – 0 OR FOR SPD Like asthma, other atopic conditions, particularly atopic dermatitis , are associated with an increased risk of SPD. Increased risk of serious pneumococcal disease (SPD) in patients with atopic conditions other than asthma Jung JACI 2010:125:217 P=0.04
  • 28. Burden of disease caused by Streptococcus pneumoniae in children younger than 5 years: global estimates O’Brien, Lancet 2010;375:893 <ul><li>Burden of pneumococcal pneumonia by applying the proportion of pneumonia cases caused by S pneumoniae </li></ul><ul><li>In 2000, about 14·5 million episodes of serious pneumococcal disease were estimated to occur </li></ul><ul><li>Pneumococcal disease caused about 826 000 deaths in children aged 1–59 months </li></ul>
  • 29. Burden of disease caused by Streptococcus pneumoniae in children younger than 5 years: global estimates O’Brien, Lancet 2010;375:893 <ul><li>Burden of pneumococcal pneumonia by applying the proportion of pneumonia cases caused by S pneumoniae </li></ul>Ten countries with the greatest number of pneumococcal deaths in children aged 1–59 months
  • 30. Invasive Pneumococcal Infections among Vaccinated Children in the United States Park J Pediatr 2010;156:478
  • 31. % breakthrough cases * 21% ( * % vaccine-type infection in a child who received at least one dose of PCV7) <ul><li>753 invasive infections </li></ul>25 – 20 – 10 – 5 – 0 Invasive Pneumococcal Infections among Vaccinated Children in the United States Park J Pediatr 2010;156:478 (155/753)
  • 32. % breakthrough cases * 21% ( * % vaccine-type infection in a child who received at least one dose of PCV7) <ul><li>753 invasive infections </li></ul>25 – 20 – 10 – 5 – 0 Invasive Pneumococcal Infections among Vaccinated Children in the United States Park J Pediatr 2010;156:478 (155/753) Predominantly caused by serotypes 6B (n = 50, 32%) and 19F (n = 45, 29%).
  • 33. % breakthrough cases * 21% ( * % vaccine-type infection in a child who received at least one dose of PCV7) <ul><li>753 invasive infections </li></ul>25 – 20 – 10 – 5 – 0 Invasive Pneumococcal Infections among Vaccinated Children in the United States Park J Pediatr 2010;156:478 (155/753) Proportion of breakthrough cases decreased with the increasing number of PCV7 doses received (P < .001, X2 for linear trend).
  • 34. % vaccine failures * 4% <ul><li>753 invasive infections </li></ul>Invasive Pneumococcal Infections among Vaccinated Children in the United States Park J Pediatr 2010;156:478 10 – 8 – 6 – 4 – 2 – 0 * Vaccine-type infection in a child who completed PCV7 vaccination
  • 35. % vaccine failures * 4% <ul><li>753 invasive infections </li></ul>Invasive Pneumococcal Infections among Vaccinated Children in the United States Park J Pediatr 2010;156:478 10 – 8 – 6 – 4 – 2 – 0 * Vaccine-type infection in a child who completed PCV7 vaccination Invasive pneumococcal were primarily caused by disease resulting from serotypes not covered with PCV7.
  • 36. Number of invasive pneumococcal infections (y-axis) in children among 8 children’s hospitals according to study years (x-axis) from 1994 to 2008. PCV7 was introduced in 2000. <ul><li>15-year prospective surveillance study of all invasive pneumococcal infections in children. </li></ul>Serotype 19A Is the Most Common Serotype Causing Invasive Pneumococcal Infections in Children Kaplan Pediatrics 2010;125:429
  • 37. Number of invasive pneumococcal isolates (y-axis) that were vaccine serotype, nonvaccine serotype, or 19A. Serotype 19A Is the Most Common Serotype Causing Invasive Pneumococcal Infections in Children Kaplan Pediatrics 2010;125:429 <ul><li>15-year prospective surveillance study of all invasive pneumococcal infections in children. </li></ul>
  • 38. Number of invasive pneumococcal isolates (y-axis) that were vaccine serotype, nonvaccine serotype, or 19A. Serotype 19A Is the Most Common Serotype Causing Invasive Pneumococcal Infections in Children Kaplan Pediatrics 2010;125:429 <ul><li>15-year prospective surveillance study of all invasive pneumococcal infections in children. </li></ul>The number of invasive pneumococcal infections in children has increased, primarily as a result of serotype 19A isolates , one third of which were resistant to multiple antibiotics in 2007 and 2008 .
  • 39. Proportion of isolates nonsusceptible (intermediate plus resistant) to clindamycin and erythromycin. Serotype 19A Is the Most Common Serotype Causing Invasive Pneumococcal Infections in Children Kaplan Pediatrics 2010;125:429 The number of invasive pneumococcal isolates per penicillin MIC for isolates in 2007 and 2008.
  • 40. Number of invasive pneumococcal isolates per ceftriaxone MIC for isolates in 2007 and 2008. Serotype 19A Is the Most Common Serotype Causing Invasive Pneumococcal Infections in Children Kaplan Pediatrics 2010;125:429 <ul><li>15-year prospective surveillance study of all invasive pneumococcal infections in children. </li></ul>
  • 41. 1) Currently, serotype 19A is the most common serotype for invasive disease in children . Serotype 19A also has become an important pneumococcal isolate causing otitis media and its complications such as mastoiditis. 2) In a multicenter study, pneumococcal pneumonia in children caused by isolates with penicillin MICs up to 4 µg/mL was treated successfully with intravenous penicillin or ampicillin. 3) For some patients with invasive infection, such as pneumonia or pleural empyema caused by a multidrug-resistant serotype 19A isolate, linezolid or perhaps a newer quinolone might be the only oral agents available for completing therapy. 4) Intravenous therapy with ceftriaxone and cefotaxime remains an appropriate treatment option for such patients as well. Serotype 19A Is the Most Common Serotype Causing Invasive Pneumococcal Infections in Children Kaplan Pediatrics 2010;125:429
  • 42. Continued Impact of Pneumococcal Conjugate Vaccine on Carriage in Young Children Susan Pediatrics 2009; 124:1 <ul><li>Nasopharyngeal specimens from children 3 months to <7 years of age during the winter seasons of 2000 –2001 and 2003–2004 and in 2006–2007. </li></ul>CARRIAGE OF NON-PCV7 SEROTYPE 2000-01 2003-04 2006-07 30 – 20 – 10 – 0 15% 19% 29%
  • 43. Continued Impact of Pneumococcal Conjugate Vaccine on Carriage in Young Children Susan Pediatrics 2009; 124:1 <ul><li>Nasopharyngeal specimens from children 3 months to <7 years of age during the winter seasons of 2000 –2001 and 2003–2004 and in 2006–2007. </li></ul>CARRIAGE OF NON-PCV7 SEROTYPE 2000-01 2003-04 2006-07 30 – 20 – 10 – 0 15% 19% 29% The relative contribution of several non-PCV7 serotypes, including 19A , 35B, and 23A, increased across sampling periods with greater proportions of penicillin non-susceptibility.
  • 44. New Vaccines Against Otitis Media: Projected Benefits and Cost-effectiveness O’ Brien Pediatrics 2009;123:1452 % acute otitis media episodes potentially prevented by <ul><li>Computerized model to compare the projected benefits and costs </li></ul><ul><li>The currently available 7-valent pneumococcal conjugate vaccine, </li></ul><ul><li>A candidate pneumococcal–nontypeable H influenzae vaccine </li></ul><ul><li>A hypothetical pneumococcal- nontypeable H influenzae –M oraxella vaccine, </li></ul><ul><li>No vaccination. </li></ul>6.4% 27% 31% 7-valent pneumococcal conjugate vaccine pneumococcal–nontypeable H Influenzae – Moraxella 50 – 40 – 30 – 20 – 10 – 0 pneumococcal–nontypeable H influenzae vaccine
  • 45. New Vaccines Against Otitis Media: Projected Benefits and Cost-effectiveness O’ Brien Pediatrics 2009;123:1452 % acute otitis media episodes potentially prevented by <ul><li>Computerized model to compare the projected benefits and costs </li></ul><ul><li>The currently available 7-valent pneumococcal conjugate vaccine, </li></ul><ul><li>A candidate pneumococcal–nontypeable H influenzae vaccine </li></ul><ul><li>A hypothetical pneumococcal- nontypeable H influenzae –M oraxella vaccine, </li></ul><ul><li>No vaccination. </li></ul>6.4% 27% 31% 7-valent pneumococcal conjugate vaccine pneumococcal–nontypeable H Influenzae – Moraxella 50 – 40 – 30 – 20 – 10 – 0 pneumococcal–nontypeable H influenzae vaccine New candidate vaccines against otitis media have the potential to prevent millions of disease episodes in the United States annually
  • 46. Pediatric parapneumonic pleural effusion:Epidemiology, clinical characteristics, and microbiological diagnosis Hernández-Bou Ped Pul 2009;44:1192 <ul><li>Prospective study of patients <18 years admitted for pneumonic pleural effusion (PPE) between September 2003 and December 2006. </li></ul>40 – 30 – 20 – 10 – 0 CASES PER 100,000 19.9 35.2 2004 2006      TO P      ABSTRACT     ME THODS     RE SULTS     DI SCUSSION     Su pport statement     St atement of interest     AC KNOWLEDGEMENTS     RE FERENCES      TO P      ABSTRACT     ME THODS     RE SULTS     DI SCUSSION     Su pport statement     St atement of interest     AC KNOWLEDGEMENTS     RE FERENCES
  • 47. Pediatric parapneumonic pleural effusion:Epidemiology, clinical characteristics, and microbiological diagnosis Hernández-Bou Ped Pul 2009;44:1192 <ul><li>Prospective study of patients <18 years admitted for pneumonic pleural effusion (PPE) between September 2003 and December 2006. </li></ul>40 – 30 – 20 – 10 – 0 CASES PER 100,000 19.9 35.2 2004 2006 <ul><li>S. pneumoniae was the main causal agent. </li></ul><ul><li>Non-vaccine serotypes (NVS) predominated (81.5%), and </li></ul><ul><li>serotype 1 was responsible for 38.5% of cases. </li></ul>      TO P      ABSTRACT     ME THODS     RE SULTS     DI SCUSSION     Su pport statement     St atement of interest     AC KNOWLEDGEMENTS     RE FERENCES      TO P      ABSTRACT     ME THODS     RE SULTS     DI SCUSSION     Su pport statement     St atement of interest     AC KNOWLEDGEMENTS     RE FERENCES
  • 48. <ul><li>Streptococcus pneumoniae continues to be the principal etiological agent of PPE in the pediatric population. </li></ul><ul><li>S. pneumoniae is divided into 91 serotypes, only a few of which are responsiblefor most cases of invasive </li></ul><ul><li>pneumococcaldisease (IPD). </li></ul><ul><li>Pneumococcal conjugate heptavalent vaccine (PCV-7) contains (4, 6B, 9V, 14, 18C, 19F, and 23F). </li></ul>Pediatric parapneumonic pleural effusion:Epidemiology, clinical characteristics, and microbiological diagnosis Hernández-Bou Ped Pul 2009;44:1192 Serotypes 1 and 19 A are the most frequent causes of PPE      TO P      ABSTRACT     ME THODS     RE SULTS     DI SCUSSION     Su pport statement     St atement of interest     AC KNOWLEDGEMENTS     RE FERENCES      TO P      ABSTRACT     ME THODS     RE SULTS     DI SCUSSION     Su pport statement     St atement of interest     AC KNOWLEDGEMENTS     RE FERENCES
  • 49. Empyema Hospitalizations Increased in US Children Despite Pneumococcal Conjugate Vaccine Li Pediatrics 2010;125:26 <ul><li>Hospitalizations of children ≤ 18 years associated with empyema in 1997, 2000, 2003, and 2006 </li></ul>% increase in empyema-associated hospitalization rate from 1997 to 2006 70% 70 – 60 – 50 – 40 – 30 – 20 – 10 – 0
  • 50. Empyema Hospitalizations Increased in US Children Despite Pneumococcal Conjugate Vaccine Li Pediatrics 2010;125:26 <ul><li>Hospitalizations of children ≤ 18 years associated with empyema in 1997, 2000, 2003, and 2006 </li></ul>% increase in empyema-associated hospitalization rate from 1997 to 2006 70% 70 – 60 – 50 – 40 – 30 – 20 – 10 – 0 The rate of invasive pneumococcal disease (pneumonia, sepsis, or meningitis caused by Streptococcus pneumoniae) decreased 50%, and t he rate of bacterial pneumonia decreased 13%.
  • 51. rotavirus
  • 52. Il pediatra ha la possibilità di programmare e proporre la strategia preventiva.
  • 53. Varicella
  • 54. papilloma
  • 55. Mothers’ Intention for Their Daughters and Themselves to Receive the Human Papillomavirus Vaccine: A National Study of Nurses Kahn Pediatrics 2009;123:1439 % of mother who intended to vaccinate a daughter <ul><li>10 521 mothers, all nurses, between June 2006 and February 2007 </li></ul>48% 68% 86% If she were 9 to 12 yr 100 – 90 – 80 – 70 – 60 – 50 – 40 – 30 – 20 – 10 – 0 If she were 13 to 15 yr If she were 16 to 18 yr of age
  • 56. Mothers’ Intention for Their Daughters and Themselves to Receive the Human Papillomavirus Vaccine: A National Study of Nurses Kahn Pediatrics 2009;123:1439 % of mother who intended to vaccinate a daughter <ul><li>10 521 mothers, all nurses, between June 2006 and February 2007 </li></ul>48% 68% 86% If she were 9 to 12 yr 100 – 90 – 80 – 70 – 60 – 50 – 40 – 30 – 20 – 10 – 0 If she were 13 to 15 yr If she were 16 to 18 yr of age mothers’ intention to vaccinate a daughter <13 years of age was contrasting with national recommendations to target 11- to 12-year-old girls for vaccination
  • 57. Sustained efficacy and immunogenicity of the human papillomavirus (HPV)-16/18 AS04-adjuvanted vaccine: analysis of a randomised placebo-controlled trial up to 6·4 years The GlaxoSmithKline Vaccine HPV-007 Study Group Lancet 2010 in press VACCINE EFFICACY AGAINST incident infection with HPV 16/18 95.3% <ul><li>Women aged 15–25 yrs HPV-16/18 seronegative </li></ul><ul><li>double-blind (n=1113; 560 vaccine group vs 553 placebo group) </li></ul><ul><li>6·4 years follow-up </li></ul>100 – 90 – 80 – 70 – 60 – 50 – 40 – 30 – 20 – 10 – 0
  • 58. 100% <ul><li>Women aged 15–25 yrs HPV-16/18 seronegative </li></ul><ul><li>double-blind (n=1113; 560 vaccine group vs 553 placebo group) </li></ul><ul><li>6·4 years follow-up </li></ul>100 – 90 – 80 – 70 – 60 – 50 – 40 – 30 – 20 – 10 – 0 VACCINE EFFICACY AGAINST 12 months persistent infection with HPV 16/18 Sustained efficacy and immunogenicity of the human papillomavirus (HPV)-16/18 AS04-adjuvanted vaccine: analysis of a randomised placebo-controlled trial up to 6·4 years The GlaxoSmithKline Vaccine HPV-007 Study Group Lancet 2010 in press
  • 59. 100% YES NO 72% lesions associated with HPV-16/18 100 – 90 – 80 – 70 – 60 – 50 – 40 – 30 – 20 – 10 – 0 <ul><li>Women aged 15–25 yrs HPV-16/18 seronegative </li></ul><ul><li>double-blind (n=1113; 560 vaccine group vs 553 placebo group) </li></ul><ul><li>6·4 years follow-up </li></ul>VACCINE EFFICACY AGAINST cervical intraepithelial neoplasia grade 2 and above (CIN2+) Sustained efficacy and immunogenicity of the human papillomavirus (HPV)-16/18 AS04-adjuvanted vaccine: analysis of a randomised placebo-controlled trial up to 6·4 years The GlaxoSmithKline Vaccine HPV-007 Study Group Lancet 2010 in press
  • 60. 100% YES NO 72% lesions associated with HPV-16/18 100 – 90 – 80 – 70 – 60 – 50 – 40 – 30 – 20 – 10 – 0 <ul><li>Women aged 15–25 yrs HPV-16/18 seronegative </li></ul><ul><li>double-blind (n=1113; 560 vaccine group vs 553 placebo group) </li></ul><ul><li>6·4 years follow-up </li></ul>VACCINE EFFICACY AGAINST cervical intraepithelial neoplasia grade 2 and above (CIN2+) Sustained efficacy and immunogenicity of the human papillomavirus (HPV)-16/18 AS04-adjuvanted vaccine: analysis of a randomised placebo-controlled trial up to 6·4 years The GlaxoSmithKline Vaccine HPV-007 Study Group Lancet 2010 in press Antibody concentrations remained 12-fold or more higher than after natural infection (both antigens) safety outcomes were similar
  • 61. Efficacy of human papillomavirus (HPV)-16/18 AS04-adjuvanted vaccine against cervical infection and precancer caused by oncogenic HPV types (PATRICIA): final analysis of a double-blind, randomised study in young women Paavonen LANCET 2009;374:301 70.2% <ul><li>Women (15–25 years) vaccinated at months 0, 1, and 6 (vaccine, n=8093; control, n=8069). </li></ul><ul><li>Mean follow-up 34·9 months after the third dose. </li></ul>80 – 70 – 60 – 50 – 40 – 30 – 20 – 10 – 0 In women receiving at least one vaccine dose w ith no evidence of oncogenic HPV infection at baseline VACCINE EFFICACY AGAINST cervical intraepithelial neoplasia 2+ (CIN2+)
  • 62. 70.2% <ul><li>Women (15–25 years) vaccinated at months 0, 1, and 6 (vaccine, n=8093; control, n=8069). </li></ul><ul><li>Mean follow-up 34·9 months after the third dose. </li></ul>80 – 70 – 60 – 50 – 40 – 30 – 20 – 10 – 0 VACCINE EFFICACY AGAINST cervical intraepithelial neoplasia 2+ (CIN2+) Individual cross-protection against CIN2+ associated with HPV-31, HPV-33, and HPV-45 was seen. Efficacy of human papillomavirus (HPV)-16/18 AS04-adjuvanted vaccine against cervical infection and precancer caused by oncogenic HPV types (PATRICIA): final analysis of a double-blind, randomised study in young women Paavonen LANCET 2009;374:301 In women receiving at least one vaccine dose w ith no evidence of oncogenic HPV infection at baseline
  • 63. Comparison of the immunogenicity and safety of Cervarix TM and Gardasil ® human papillomavirus cervical cancer vaccines in healthy women aged 18–45 years Einstein, Human Vaccines 2009;5: 705 Geometric mean titers of serum neutralizing antibodies fold higher after vaccination with Cervarix ™ compared with Gardasil ®, across all age strata. 2.3 9.1 6.8 4.8 HPV-16 HPV-18 10 – 9 – 8 – 7 – 6 – 5 – 4 – 3 – 2 – 1 – 0 <ul><li>Observer-blind study compared the prophylactic human HPV-vaccines, Cervarix ™(GlaxosmithKline) and Gardasil ® (Merck). </li></ul><ul><li>Immunogenicity and safety through 1 month after completion of the 3-dose vaccination course. </li></ul><ul><li>Women (n = 1106) stratified by age (18–26, 27–35, 36–45 yrs) and randomized (1:1) to receive Cervarix ™ (Months 0, 1, 6) or Gardasil ® (Months 0, 2, 6). </li></ul>
  • 64. <ul><li>Observer-blind study compared the prophylactic human HPV-vaccines, Cervarix ™(GlaxosmithKline) and Gardasil ® (Merck). </li></ul><ul><li>Immunogenicity and safety through 1 month after completion of the 3-dose vaccination course. </li></ul><ul><li>Women (n = 1106) stratified by age (18–26, 27–35, 36–45 yrs) and randomized (1:1) to receive Cervarix ™ (Months 0, 1, 6) or Gardasil ® (Months 0, 2, 6). </li></ul>Comparison of the immunogenicity and safety of Cervarix TM and Gardasil ® human papillomavirus cervical cancer vaccines in healthy women aged 18–45 years Einstein, Human Vaccines 2009;5: 705 Geometric mean titers of serum neutralizing antibodies fold higher after vaccination with Cervarix ™ compared with Gardasil ®, across all age strata. 2.3 9.1 6.8 4.8 HPV-16 HPV-18 10 – 9 – 8 – 7 – 6 – 5 – 4 – 3 – 2 – 1 – 0 Cervarix ™ induced significantly higher serum neutralizing antibody titers in all age strata (p<0.0001) .
  • 65. <ul><li>Observer-blind study compared the prophylactic human HPV-vaccines, Cervarix ™(GlaxosmithKline) and Gardasil ® (Merck). </li></ul><ul><li>Immunogenicity and safety through 1 month after completion of the 3-dose vaccination course. </li></ul><ul><li>Women (n = 1106) stratified by age (18–26, 27–35, 36–45 yrs) and randomized (1:1) to receive Cervarix ™ (Months 0, 1, 6) or Gardasil ® (Months 0, 2, 6). </li></ul>Comparison of the immunogenicity and safety of Cervarix TM and Gardasil ® human papillomavirus cervical cancer vaccines in healthy women aged 18–45 years Einstein, Human Vaccines 2009;5: 705 Geometric mean titers of serum neutralizing antibodies fold higher after vaccination with Cervarix ™ compared with Gardasil ®, across all age strata. 2.3 9.1 6.8 4.8 HPV-16 HPV-18 10 – 9 – 8 – 7 – 6 – 5 – 4 – 3 – 2 – 1 – 0 Specific memory B-cell frequencies were also higher after vaccination with Cervarix ™ compared with Gardasil ®.
  • 66. <ul><li>Observer-blind study compared the prophylactic human HPV-vaccines, Cervarix ™(GlaxosmithKline) and Gardasil ® (Merck). </li></ul><ul><li>Immunogenicity and safety through 1 month after completion of the 3-dose vaccination course. </li></ul><ul><li>Women (n = 1106) stratified by age (18–26, 27–35, 36–45 yrs) and randomized (1:1) to receive Cervarix ™ (Months 0, 1, 6) or Gardasil ® (Months 0, 2, 6). </li></ul>Comparison of the immunogenicity and safety of Cervarix TM and Gardasil ® human papillomavirus cervical cancer vaccines in healthy women aged 18–45 years Einstein, Human Vaccines 2009;5: 705 Geometric mean titers of serum neutralizing antibodies fold higher after vaccination with Cervarix ™ compared with Gardasil ®, across all age strata. 2.3 9.1 6.8 4.8 HPV-16 HPV-18 10 – 9 – 8 – 7 – 6 – 5 – 4 – 3 – 2 – 1 – 0 Although the importance of differences in magnitude of immune response between these vaccines is unknown, they may represent determinants of duration of protection against HPV-16/18.
  • 67. <ul><li>A process for the manufacture of a vaccine composition comprising the admixture of </li></ul><ul><li>an adjuvant composition comprising an immunostimulant which is 3-de-O-acylated monophosphoryl lipid A, adsorbed onto an aluminium salt particle , characterised in that not more than 20% by mass of the total material capable of adsorbing to the aluminium salt particle is an antigen, and </li></ul><ul><li>an antigen. </li></ul>AS04 -adjuvanted vaccine
  • 68. % serious adverse events <ul><li>A pooled analysis of the safety of the human papillomavirus (HPV)-16/18 AS04-adjuvanted cervical cancer vaccine Cervarix (GlaxoSmithKline) was performed in a cohort of almost 30,000 girls and women aged ≥10 years, 16,142 who received at least one dose of the HPV-16/18 vaccine and 13,811 who received one of three controls [Al(OH) 3 ] or hepatitis A vaccine. </li></ul>2.8% Cervarix 3.1% Controls Safety of human papillomavirus (HPV)-16/18 AS04-adjuvanted vaccine for cervical cancer prevention Descamps Human Vaccines 2009;5:332 4 – 3 – 2 – 1 – 0
  • 69. % new onset chronic autoimmune disease 0.4% Cervarix 0.3% Controls Safety of human papillomavirus (HPV)-16/18 AS04-adjuvanted vaccine for cervical cancer prevention Descamps Human Vaccines 2009;5:332 0.5 – 0.4 – 0.3 – 0.2 – 0.1 – 0 ns <ul><li>A pooled analysis of the safety of the human papillomavirus (HPV)-16/18 AS04-adjuvanted cervical cancer vaccine Cervarix (GlaxoSmithKline) was performed in a cohort of almost 30,000 girls and women aged ≥10 years, 16,142 who received at least one dose of the HPV-16/18 vaccine and 13,811 who received one of three controls [Al(OH) 3 ] or hepatitis A vaccine. </li></ul>
  • 70. Rates of autoimmune events <ul><li>Newly licensed vaccines against human papillomavirus (HPV) and hepatitis B (HBV) contain a novel Adjuvant System, AS04, composed of 3-O-desacyl-4’ monophosphoryl lipid A and aluminium salts. </li></ul><ul><li>To assess safety of AS04 adjuvanted vaccines with regard to potential autoimmune aetiology. </li></ul><ul><li>All randomised, controlled trials. </li></ul><ul><li>Individual data ( N = 68,512). </li></ul><ul><li>Mean follow-up of 21.4 months. </li></ul>0.5% Analysis of adverse events of potential autoimmune aetiology in a large integrated safety database of AS04 adjuvanted vaccines Verstraeten Vaccine 2008;26:6630 1.0 – 0.5 – 0 And did not differ between the AS04 and control groups
  • 71. Rates of autoimmune events <ul><li>Newly licensed vaccines against human papillomavirus (HPV) and hepatitis B (HBV) contain a novel Adjuvant System, AS04, composed of 3-O-desacyl-4’ monophosphoryl lipid A and aluminium salts. </li></ul><ul><li>To assess safety of AS04 adjuvanted vaccines with regard to potential autoimmune aetiology. </li></ul><ul><li>All randomised, controlled trials. </li></ul><ul><li>Individual data ( N = 68,512). </li></ul><ul><li>Mean follow-up of 21.4 months. </li></ul>0.5% 1.0 – 0.5 – 0 And did not differ between the AS04 and control groups This integrated analysis of over 68,000 participants who received AS04 adjuvanted vaccines or controls demonstrated a low rate of autoimmune disorders, without evidence of an increase in relative risk associated with AS04 adjuvanted vaccines. Analysis of adverse events of potential autoimmune aetiology in a large integrated safety database of AS04 adjuvanted vaccines Verstraeten Vaccine 2008;26:6630
  • 72. <ul><li>Both Cervarix and Gardasil provided more than 90% efficacy in preventing cervical intraepithelial neoplasia grade 2+ (CIN 2+) disease caused by HPV 16 and 18 in women 16–26 years who were seronegative and PCR-negative for HPV 16 and 18 at baseline. </li></ul><ul><li>Cervarix provides more than 75% efficacy in independent cross-protection against persistent HPV 31 and 45, and 47% efficacy against HPV 33; whereas Gardasil offers 50% efficacy only against persistent HPV 31. </li></ul><ul><li>Cervarix efficacy is documented to 6.4 years; Gardasil’s to 5 yrs. </li></ul><ul><li>Cervarix induces three to nine-fold higher peak-neutralizing antibody titers to HPV 16/18 than Gardasil, has significantly higher cervicovaginal mucus-neutralizing antibody presence than Gardasil, and significantly higher B memory cell response than Gardasil. </li></ul>Current prophylactic HPV vaccines and gynecologic premalignancies Harper Curr Opin Obstet and Gynecol 2009, 21:457–464
  • 73. <ul><li>Cervical screening programs offer secondary, not primary prevention. </li></ul><ul><li>Vaccination against the HPV, which is the major cause of cervical cancer, is a significant step forward. </li></ul><ul><li>Cross protection against oncogenic non-vaccine HPV types, in particular HPV-45, may be important in the prevention of cervical adenocarcinoma, which is currently not well served by screening. </li></ul>Human papillomavirus (HPV) vaccine: Cervarix Szarewski Expert Opin. Biol. Ther 2010 10(3):477-487

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