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Meghan Blackham
Dr. Paul Anderson
Eng 1010-03
19 July 2015
Rhetorical Analysis
Are You Safe?
Introduction
Growing up my mother had a tendency to be a hypochondriac when it came
to my sisters and mine health. If we started to get sick she would give us medicine
and if it got worse by the next day or two, we were in the doctor’s office
immediately. She wanted us to be as healthy as possible. So, when we were due for
vaccinations, there was no hesitation for my mother to take us in. Then, having a
degree in Biology I have taken many health science courses where vaccination have
been a major topic. There are still concerns about adverse effects, which can be
caused by administration of the vaccine. In the academic journal “Controlling
Infectious Diseases through Vaccination” found in the EBSCO database, the author,
Lorne A. Babiuk, examines vaccines and solutions for better and safer vaccines to
explain why immunization is key in preventing and controlling infectious diseases.
The article was published in the Clinical and Investigative Medicine volume 37 in
2014 for an audience that would contain scholars and those in the medical field.
About the Article
Babiuk is a Canadian scientist who specializes in immunology, pathogenesis,
virology and vaccinology. As the Vice President of Research at the University of
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Alberta, he gives an in-depth, fairly easy to follow explanations of what vaccines
contain and how they work. Vaccinations have become a significant issue of topic
due to the recent Ebola and re-emergence of the measles outbreak. Babiuk tries to
inform and educate his audience as well as including disadvantages he has found. He
composes possible solutions for vaccines to be safer and cheaper to allow for
greater immunization. Babiuk also gives examples illustrating the economical
impact vaccines have had and actions being taken to control transmission of
diseases between species. He is aware of the present controversy with the concerns
that anti-vaccinators have and states that “any missteps” (para. 10) of future
vaccines can lead to a greater controversy.
My Thesis
I believe Babiuk gives substantial examples of vaccines and their importance to
control infectious diseases as well as educate the audience of their function. To
better understand this issue, it is important to provide background information for
my audience.
Background
As stated previously, I have a Biology degree and I learned that vaccines are a
preparation of microbial antigens that induce an active and protective immunity.
Edward Jenner is accredited for being the founder of the first vaccine in 1798 for
small pox. Then, Louis Pasteur and his coworkers followed Jenner’s studies and
developed vaccines for chicken cholera, anthrax and rabies. As years have gone on,
we have developed many more vaccines for diseases such as Hepatitis A and B,
measles and common vaccines such as the flu vaccines. In each vaccine, it may
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consist of whole cells from the disease that are modified or even DNA from the virus.
In the United States we also mix in the adjuvant aluminum to increase the body’s
immune response to the specific vaccine. The last important detail is that when 90%
or more of the population is vaccinated, it establishes a herd immunity (immunity to
a virus/disease in a population) and controls infectious diseases from spreading.
This allows safety for individuals who may not be able to be vaccinated due to
adverse affects that they have. If herd immunity is reached, those who absolutely
cannot be vaccinated are safe as if they were vaccinated.
Body: Analysis
Statistical Evidence
The main strategy that Babiuk uses throughout this article to persuade and
communicate to the audience is logos. Logos is a Greek term used to describe facts
and figures to support the author’s claim. Using logos as a strategy enhances the
author’s ethos (credibility) when they use credible sources to get their information.
Logos can take several forms depending on the discipline or field of the author and
in this particular example, Babiuk, will be using logos in the form of statistics.
Examples of this strategy includes, “Indeed, every year infectious diseases cost the
global economy billions of dollars in losses and are responsible for approximately
one-third of all human deaths” as stated by Babiuk (para. 1). Babiuk supports this
statement of the economical impact by giving statistics of two examples: small pox
and poliovirus. He writes, “Prior to the global eradication of small pox through
vaccination, 2 million people died of the disease each year….poliovirus wherein it is
estimated that over 8 million people have been spared from paralysis since the polio
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eradication program was initiated” (para. 3). Along with those statistics, Babiuk
adds, “global effort to eradicate this disease [small pox] has not only eliminated
death due to this disease but dramatically reduced continuing health care costs”
(para. 3) He continues that with the polio virus, “This affects not only the individuals
that would have been paralyzed but also their families and caregivers” (para. 3). By
giving statistics of deaths from small pox and those who were not paralyzed by the
poliovirus accomplishes the author’s strategy of logos. He wanted to inform the
audience just how many were affected and how medical costs play a role in these
tragic diseases. This strategy gives examples that help the audience to visualize how
vaccines have saved lives and the economical impact it has had. Babiuk uses this
strategy in hopes that others may see the importance of using vaccines to control
infectious diseases like that of polio and small pox within humans. This then leads
into Babiuk’s next concern, which is transmission; the concern is not from human to
human but from animal to human.
Animal Vaccinations
Babiuk continues his use of logos but this time suggesting a link between
animal vaccinations and the role they play in controlling transmission and infections
to humans. For instance, he writes, “approximately thirty new emerging or reemerging diseases recorded in the last thirty years. The majority of these emerging
diseases are zoonotic (over 70%) causing even greater challenges to their control in
humans and animals” (para. 1). Zoonotic diseases are diseases that exist in animals
and can infect humans, making it more difficult to control and eradicate the disease.
Babiuk informs his readers that steps are being taken to immunize animals because
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“vaccinating cattle against [such diseases as] brucellosis prevents transmission of
this disease to humans…[and that] vaccinating cattle against E. coli…[can] reduce
shedding from animals into the environment. [Thus, the] vaccination [of animals]
dramatically reduces the opportunity for human infection…” (para. 2). He also adds
that there are studies being done to immunize animals against the West Nile Virus
(WNV) to decrease its circulation in the environment. In doing so, it allows for
“reducing the chances of infection of the vector (mosquito) and subsequent
transmission to humans” (para. 2). Being residents of Utah, the first cases appeared
here in August 2003. We learn that there are currently four cases of non-human
WNV here in Utah. In 2012, the Centers for Disease Control and Prevention received
reports of 5,674 WNV cases causing major illness (West Nile Virus, CDC). By
understanding that these viruses cause serious illness, or even death, in many
people in the United States, Babiuk plants in the minds of his readers the
importance of animal vaccinations to prevent such diseases1. By using statistics,
Babiuk establishes the soundness of his claim of the importance of both human and
animal vaccinations. The audience may have just learned that vaccinations are not
only important for humans but animals as well. This strategy was used as a tool for
raising awareness and convincing the audience about how vaccinations can prevent
transmission of animal diseases to humans. Therefore, Babiuk achieves his purpose
with his readers and supports his claim that vaccinations, human or animal, can help
control infectious diseases.
1
See CDC report
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Live Vaccines
Last of all, Babiuk uses the strategy of logos in the form of expert opinion
when educating the audience about the two different types of vaccines, which are:
live attenuated and killed vaccines. Live attenuated vaccines “results in mutations in
the pathogen such that it can still replicate…but is crippled sufficiently that it cannot
cause disease” (para. 4). Babiuk continues, “it produces all or most of the antigens,
which are then recognized by the immune system…acting as a natural infection
without inducing disease” (para.4). However, Babiuk informs us that there is a
disadvantage because the strain of the disease contained in the vaccine is live, it
does have the risk of being able to mutate into an active form of the disease (para.
4). With that concern, Babiuk writes of possible solutions for safer live vaccines. By
“using genetic engineering, it has been possible to delete virulence genes from
various pathogens: this results in production of safer vaccines since it is almost
impossible for a virus to regenerate a deleted gene” (para. 5). In addition Babiuk
states, “additional advantage of these gene-deleted vaccines is that one can use the
deletion site to insert gene coding for protective antigens from other infectious
agents” (para. 5).
Killed Vaccines
Next, Babiuk looks at killed vaccines, which are the majority of vaccines that
we use today. In his article Babiuk uses the influenza virus and Hepatitis B as
examples for his break down of what it contains and how it functions. He states,
“one can clone the protective components…In these cases, the protective proteins
are not only cloned but assembled into virus-like particles that present the epitopes
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in an extremely effective format for recognition by the immune system” (para. 7).
Just like that of live vaccines, Babiuk adds in the disadvantages of killed vaccines
“for effective immunity to be induced, adjuvants are required. Until recently, the
main adjuvant…was alum” (para.8). This is a disadvantage because alum initiates a
specific immune response not like that of the virus, “reducing the effectiveness of
vaccines” with certain components. Along with that disadvantage is that these killed
vaccines are more expensive, making it difficult for some people and nations to
afford them. Have no fear though, Babiuk writes of a solution that is being formed
where new adjuvants or combinations of adjuvants are being used. He writes that
the advantages of these new adjuvants and combinations allows for “dramatic
increase in immune responses…induces long-term memory, requiring only a single
dose of the vaccine…[and] extremely critical in the developing world, where
multiple vaccinations for a single disease are not feasible” (para. 9).
As Babiuk educates his readers of the different types of vaccines, the
audience is able to understand how the vaccines are supposed to work. Many people
know the basics about vaccines: we are supposed to have them and it creates
immunity. However, there is a fear of what we are really being injected with. Babiuk
understands that fear and guides us through what they contain and their purpose.
He also wrote of the disadvantages of each and action being taken to make them
safer. With Babiuk informing us of the disadvantages, we can feel that he is being
objective and giving us all the necessary information. He also references all
academic journals in his article, which adds ethos to his writing. Ethos is the
strategy that appeals to the authority or credibility of the author. As Babiuk writes
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and references expert opinions, he accomplishes his strategy of logos because the
audience is better educated on vaccines by a credible source. With the audience
being better educated, it is easier to understand why vaccines are important for
controlling infectious diseases. We can also look forward to a brighter future of safer
vaccines. Unfortunately, there is still a fear of what needs to be done when a new
disease arises causing a pandemic and we have no vaccine for it.
Outbreaks
Logos is used throughout the article as Babiuk’s choice of strategy to appeal
to the audience. However, he does add in one more strategy that grabs the attention
of the audience. The strategy he uses is pathos. Pathos is the Greek term of the
strategy to appeal to the emotions of the audience. It can take the form of
metaphors, similes, and a passionate delivery or in this case, associate the claim to a
national/global event that many people know or have heard of. Babiuk reminds the
audience of the recent outbreaks of H1N1 (swine flu) and Ebola. Babiuk discusses
how using a more effective adjuvant or combination is more advantage when new
pandemics arise. He states, “When the H1N1 potential pandemic was feared, the
vaccine companies could produce only approximately one tenth of the required
vaccine…reducing the amount of antigen required [due to using a more effective
adjuvant], the entire population could be immunized with the quantity of vaccine
available” (para. 10). Using a new adjuvant can have many benefits but also
produces risks if such vaccine is introduced too early in the fact that they have not
been licensed yet. Using such a vaccine with an unlicensed adjuvant like that for
H1N1 may be the approach used in “outbreaks such as Ebola, or other future
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outbreaks, where no licensed vaccine is available but the opportunity exists to
curtail the rapid spread of the infection with limited quantities of potential vaccines”
(para. 10). Fear has been a driving factor in the medical field to establish vaccines
for such diseases. By reminding the audience of H1N1 and Ebola, it appeals to their
emotions and reminds them of the fears that were worldwide when these diseases
broke out. As scientists continue to research and develop vaccines, it is crucial for
populations to take heed and vaccinate themselves to aid in preventing
transmission of diseases and prevent future outbreaks.
Conclusion
I believe Babiuk gives substantial examples of vaccines and their importance
to control infectious diseases as well as educate the audience of their function.
Having studied in the field of Biology, it is frightening to know that one little;
microscopic virus can cause a disease that can devastate millions. Individuals
believe it is their right or freedom whether to vaccinate or not vaccinate themselves
or their children. If a population does not reach herd immunity, it puts all
individuals at risk. Babiuk gives evidence why it is so important to control infectious
diseases through vaccines but if people do not research or take the medical advice to
be vaccinated, more outbreaks will occur. If less and less people are not being
vaccinated because it is their right, more severe outbreaks will occur and we may no
longer be able to control infectious diseases which will result in tragic
consequences.
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Appendix
The article “Controlling Infectious Diseases through Vaccination” by Lorne A.
Babiuk:
HENRY FRIESEN AWARD LECTURE
© 2012 CIM Clin Invest Med • Vol 37, no 6, December 2014 E409
Correspondence to:
Lorne A. Babiuk, O.C., SOM, PhD, DSc, FRSC
Vice-President (Research) University of Alberta
2-51 South Academic Building (SAB)
Edmonton, Alberta, Canada T6G 2G7
Email: lorne.babiuk@ualberta.ca
Clin Invest Med 2014; 37 (6): E409-E413.
Infectious diseases continue to cause significant morbidity and mortality in both
animals and humans. Indeed, every year infectious diseases cost the global economy billions
of dollars in losses and are responsible for approximately one-third of all human deaths.
These deaths occur from routine infections, hospital acquired infections (approximately
100,000 deaths occur annually in North America due to hospital-acquired infections),
occasional pandemics or regional outbreaks. The most recent regional outbreak is Ebola in
West Africa. This infection has caused significant challenges for the regional health care
community and has had a global impact. The challenge in the control of infectious diseases
is not only due to routine infections but also to the continued emergence and reemergence
of infectious diseases. These new threats occur on a regular basis with approximately thirty
new emerging or reemerging diseases recorded in the last thirty years. The majority of
these emerging diseases are zoonotic (over 70%) causing even greater challenges to their
control in humans and animals.
Current control of infectious diseases relies primarily on antimicrobial compounds
or vaccinations. Although many infectious diseases have been controlled with antimicrobial
treatment, the continued increase in resistance to antimicrobial agents is a constant
challenge. The rapid increases in multi-drug resistant bacteria, including mycobacteria, are
posing huge challenges to their control(1, 2). The recent successes in using multiple drugs for
controlling HIV (3) and, more recently, success with controlling Hepatitis C (4) are welcome
developments but concerns continue regarding the development of drug resistance to
viruses and bacteria. Unfortunately, the cost of these drugs can be prohibitive for use in all
environments; including for patients in the developing world and for many animal species.
Furthermore, in many cases, we do not have antimicrobial agents for many parasitic
infections. The alternative to antimicrobials is the use of vaccines to both break the cycle of
infection, by reducing the number of susceptible individuals in the environment (herd
immunity) as well as protecting individuals should they be exposed to the infectious agents.
These vaccines can be used to control outbreaks within a particular species, human to
human transmission or be used in one species to prevent infection in another species. The
best example of such a vaccine is where animals are immunized to prevent infection in
humans from a zoonotic infection; for example, vaccinating cattle against brucellosis
prevents transmission of this disease to humans (5). Another example is vaccinating cattle
against E. coli 0157:H7 to reduce shedding from animals into the environment. This
vaccination dramatically reduces the opportunity for human infection, which is caused
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either by drinking contaminated water or eating contaminated food (6). Recently, the
concept of “One Health” has been advocated to demonstrate the connection between animal
infectious diseases and those in humans. Immunizing animals against West Nile virus
reduces the level of West Nile virus circulating in the environment, thereby reducing the
chances of infection of the vector (mosquito) and subsequent transmission to humans. A
concerted effort to not only vaccinate humans but also develop a global strategy for linking
animal vaccination with human vaccination is required. This coordinated effort has a great
potential to reduce both animal as well as human infection.
Possibly the two best examples of the economic impact of vaccination on society is
that of small pox and polio virus. Prior to the global eradication of small pox through
vaccination, 2 million people died of the disease each year. The global effort to eradicate this
disease has not only eliminated death due to this disease but dramatically reduced
continuing health care costs. The second example is polio virus wherein it is estimated that
over 8 million people have been spared from paralysis since the polio eradication program
was initiated. This affects not only the individuals that would have been paralyzed but also
their families and caregivers.
Historically, there were two types of vaccines: 1) killed vaccines; and, 2) live
attenuated vaccines. Live attenuation is achieved by in vitro passage, which results in
mutations in the pathogen such that it can still replicate in vivo but is crippled sufficiently
that it cannot cause disease. Since the agent replicates in vivo, it produces all or most of the
antigens, which are then recognized by the immune system. This induction of both humoral
and cellular immunity is sufficient such that when the individual is later exposed to a field
strain of the pathogen, the immune response will limit the degree of replication and provide
protection. The advantage of these live attenuated vaccines is that they can be delivered
either systemically or via the mucosal
route, acting as a natural infection without inducing disease. The advantage of mucosal
delivery is that delivery by this route induces both mucosal and systemic immunity. Since
most pathogens enter via the mucosal route, the agent is neutralized even before it gets
established if the individual has mucosal immunity. This is not the case with systemicallydelivered killed vaccines that generally only induce systemic immunity. Examples of oral
vaccines, which induce mucosal immunity, include rotavirus and polio virus vaccines (7, 8).
The disadvantage of live vaccines is that, since they are live, they carry the risk of being able
to back mutate in vivo, resulting in the probability of shedding virulent pathogens into the
environment. The best example is polio virus where attenuation occurs due to a single
mutation in the virus. During replication in the intestine of the human, the virus back
mutates resulting in the shedding of a virulent virus into the environment (8). Furthermore,
if this mutation occurs very quickly prior to induction of immunity in the vaccinated
individual, the vaccine may also suffer from effects of polio. It is for this reason that it is
recommended that the live oral polio vaccines are only used in regions where there is a
large amount of wild virus circulating. This approach provides rapid coverage of the
population to reduce the viral load in the environment and then use killed virus to “mop up”
any residual virus in the community.
More recently, using genetic engineering, it has been possible to delete virulence
genes from various pathogens: this results in production of safer vaccines since it is almost
impossible for a virus to regenerate a deleted gene during replication. Using such genedeleted viruses not only capitalizes on the increased safety but it enables modulation of the
degree of attenuation, which is more difficult with conventional attenuation. In addition,
one can develop companion diagnostics to differentiate vaccinated individuals from those
who have been exposed to virulent field strains of virus. This is especially useful in livestock
vaccines used by countries trying to eradicate a pathogen from its borders. The best
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example is the vaccine for bovine herpes virus where a gene coding for a glycoprotein
attenuates the virus (9). Animals treated with the vaccine do not induce antibodies to the
gene-deleted component (gE). These animals can be differentiated from those that were
exposed to field strains of virus and may be carrying the virus in a latent state in their
bodies. If a country wants to eradicate the disease, they can cull the latent carrier animals
and eventually establish herpes virus-free herds. These vaccines are called DIVA vaccines
(DIVA = Differentiating Infected from Vaccinated Animals) and are useful for overcoming
non-tariff trade barriers for livestock movement (10). An additional advantage of these genedeleted vaccines is that one can use the deletion site to insert gene coding for protective
antigens from other infectious agents. The best example of this is the insertion of the rabies
virus glycoprotein into a pox virus (11). This vaccine, which has the added advantage of
thermal stability, has been incorporated into baits that are dropped from airplanes into
areas where wildlife such as foxes eat the bait and are thus immunized against rabies virus.
Such an approach not only eradicates rabies virus in wildlife but it eliminates spread to
domestic animals and subsequently to people. We are currently developing a pox-based
vaccine for cattle, sheep and goats to not only protect these animals from the devastating
pox viruses that infect them but also to protect animals against other infections by
incorporating other genes into the pox viruses. More specifically, we are inserting genes
from Rift Valley fever into the animal pox viruses, which will reduce not only Rift Valley
fever in animals but reduce transmission to humans.
A second approach to modulating virulence is to modify the virulence genes
involved in virus replication. The best example is influenza virus. Since the hemaglutinin
needs to be cleaved to allow infection of cells, it is possible to alter the cleavage site such
that it can only be cleaved by specific cleavage enzymes. Normally, the hemaglutinin protein
is cleaved by proteolytic enzymes such as trypsin, which are present in the respiratory tract.
Changing the composition of the cleavage site so that it can no longer be recognized by
trypsin will inhibit its replication in the natural host; however, if the cleavage site is
changed to be cleaved by elastase, an enzyme not present in the normal animal respiratory
tract, the virus can still be grown in vitro in the presence of elastase and then be used to
vaccinate animals intra-nasally. The virus can infect cells in the respiratory tract, because
the hemaglutinin has been cleaved with elastase and it can induce a full range of antigens,
which induce mucosal and systemic immunity. Since the virus can only go through a single
replication cycle, it is an abortive infection; this ensures vaccine safety. This vaccine has
been shown to give much broader immunity and protection against homologous and even
heterologous influenza virus, which is significantly broader than that provided by
conventional kill vaccines containing only the hemaglutinin and neuraminadase (12).
Killed vaccines comprise the majority of vaccines used today. These can be whole
organisms, which are inactivated through various means or individual components. The
critical concern with inactivation is ensuring that the inactivation process does not alter the
critical epitopes involved in inducing protective immunity. Alternatively, the vaccine may
only contain individual purified components that are known to induce protective immunity.
Such vaccines are often more expensive than live vaccines. Possibly the best example of a
killed vaccine is influenza, which contains hemaglutinin and neuraminidase that are
purified from the virus. As a third option, one can clone the protective components, as is
done with Hepatitis B or human papilloma virus (13, 14). In these cases, the protective
proteins are not only cloned but assembled into virus-like particles that present the
epitopes in an extremely effective format for recognition by the immune system. These
virus-like particles have been shown to be extremely effective since they are delivered to
the immune system in a natural configuration.
Unfortunately, with all killed vaccines, for effective immunity to be induced,
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adjuvants are required. Until recently, the main adjuvant licensed for use in vaccines was
alum. This adjuvant has a drawback in that it focuses the immune response to a Th2-like
immune response, reducing the effectiveness of vaccines for pathogens requiring Th1 or cell
mediated immunity for protection. More recently, as we become more knowledgeable
regarding the constellation of events occurring during immune induction, people have
begun using novel adjuvants and adjuvant combinations to drive the required immune
effector cells. The advantage of these new adjuvant combinations is that some of them can
be used to deliver vaccines not only systemically but also via mucosal routes. This
overcomes some of the earlier limitations of killed vaccines where alum was the adjuvant of
choice and the only delivery route was systemic.
The key to effective adjuvants is to create a cytokine microenvironment that attracts
the correct cells to the site of vaccine delivery and to expand the appropriate cells to induce
the correct immune response. One such combination adjuvant encompasses
polyphosphazenes, which induce cytokines in their own right but also act as vehicles for
mucosal delivery when formulated into micro particles, in combination with a toll-like
receptor (CpG or poly IC) and a host defence peptide (15). This triple adjuvant combination
allows not only a dramatic increase in immune responses, both humoral and cell mediated,
but also induces long-term memory, requiring only a single dose of the vaccine. This is
extremely critical in the developing world, where multiple vaccinations for a single disease
are often not feasible. In addition to providing a single shot vaccine, the ability to deliver the
vaccine as micro-particles to mucosal services reduces both the trauma of vaccination via
needles as well as the need for needles. Since needles are an expensive component of the
delivery process, there have been reports of needle reuse to reduce costs, resulting in the
spread of disease. An additional advantage of this adjuvant combination is the adjuvant
induces a balanced immune response in all ages of individuals; ranging from neonates to
elderly. This observation is critical since both age extremes – very young (neonates) and
elderly - respond differently to vaccination than do young adults. This vaccine combination
has recently been tested in respiratory syncytial (RSV) virus and in neonatal pertussis
vaccines. Early attempts to deliver an RSV vaccine using alum resulted in a skewed Th2-like
response, in that when vaccinated individuals were subsequently exposed to field strains of
virus, they were not protected but actually suffered more severe disease and even death
due to enhanced IgE responses. The triple adjuvant combination vaccine with RSV shifts the
immune response to a more balanced response, eliminating the allergic IgE response and
secretion of eotaxin components (16). This results in very few clinical signs and in rapid
clearance of the virus. This triple adjuvant can not only be used for development of new
vaccines but has also shown to be effective when added to existing vaccines. The first
vaccine in which this adjuvant was used with was Hepatitis B (15). Currently, Hepatitis B
vaccination requires three doses for effective long-term immunity. The current cost of the
three dose vaccine is over $200. Unfortunately, this cost is prohibitive in the developing
world where annual incomes in low and middle income countries can be in the $1,000 per
year range. Used in a triple adjuvant combination, excellent long-term immunity could be
induced with a single dose. More importantly, the dose of antigen could be reduced by at
least ten-fold (antigen spearing) thereby further reducing the cost of the vaccine. The low
cost of production of the vaccine by regional vaccine manufacturers, such as the Serum
Institute of India, and the requirement of only a single dose make this type of vaccine very
economical to deliver to the world’s most vulnerable populations.
Another advantage of using more effective adjuvants can be envisaged during new
pandemics. When the H1N1 potential pandemic was feared, the vaccine companies could
produce only approximately one tenth of the required vaccine. By reducing the amount of
antigen required, the entire population could be immunized with the quantity of vaccine
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available. This approach might even be deployed in outbreaks such as Ebola, or other future
outbreaks, where no licensed vaccine is available but the opportunity exists to curtail the
rapid spread of the infection with limited quantities of potential vaccines. Clearly, in these
situations, use of unlicensed vaccines would require significant discussions regarding the
ethical considerations and potential risks and benefits before embarking on the roll out of
the vaccine for emergency use. Hopefully, the lessons that have been learned, and are still
being learned, from Ebola, Nepa and other unique outbreaks, will form the foundation for
such discussions and decisions should these be required. These decisions must be made
with a full appreciation of the potential benefits and risk of early introduction of such
vaccines. This is especially important not only for the safety and wellbeing of the at-risk
population but also as not to inflame the anti-vaccine debate. All the evidence to date
demonstrates that the regulatory environment is exceptional for licensing safe vaccines and
that the vaccines have saved millions of lives, yet the strong anti-vaccine lobby has captured
the attention of many people including the media who continues to propagate the fear of
vaccines. Any missteps in the introduction of such vaccines could add to this controversy
and decisions about their use must be taken cautiously.
In summary, vaccination using conventional approaches has been extremely
effective. Building on the hundred plus years of great success in vaccination, we now have
additional tools to add to our armamentarium. Better understanding of the host immune
system, the role of virulence genes and protective antigens from various pathogens,
combined with molecular biology to attenuate pathogens or clone protective antigens for
combination with novel delivery systems, provides confidence that safer and better
vaccines will be developed in the future to further reduce morbidity and mortality due to
infectious diseases. Although many challenges still exist in the development of vaccines
against agents with complex life cycles and with host interactions, such as HIV, the majority
of devastating diseases should be at least controlled by immunization in the future, even if
eradication is not possible.
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Babiuk. Controlling Infectious Diseases through Vaccination
© 2012 CIM Clin Invest Med • Vol 37, no 6, December 2014 E413
Centers for Disease Control and Prevention.
http://www.cdc.gov/westnile/
The author also adds that studies are being done to immunize animals against the
West Nile Virus (WNV) to decrease its circulation in the environment. In doing so, it allows
for “reducing the chances of infection of the vector (mosquito) and subsequent transmission
to humans” (para. 2). Readers are probably familiar with the fact that although the virus is
or was more commonly found in Africa, West Asia, and the Middle East; it is now here in the
United States having first appeared in 1999. Closer to home, the virus is also here in Utah as
the first cases appeared here in August 2003. We all know that West Nile disease is an
ongoing issue here in Utah each summer season as several cases is reported each season
and it receives some media attention. From the Centers for Disease Control and Prevention,
we learn that there are currently four cases of non-human WNV presently here in Utah (all
in Weber county). And since the most common way to get infected is through the bite of a
mosquito, and even though most people, 70-80%, who become infected with the virus do
not develop any symptoms) those that do have the virus can show signs of headache, body
aches, join pains, vomiting, diarrhea, or rash. Thankfully, less than 1% of people infected
will develop a serious neurologic illness, like meningitis or encephalitis, or the less severe
acute flaccid paralysis. But, someone here in Utah, perhaps Salt Lake County, will develop on
of these serious illnesses, and therefore we can only hope it will not be one of us! But, this is
not to say that there will not be another serious outbreak like that in 2012. In 2012, the CDC
Blackham 16
received reports of 5,780 nationally notifiable arboviral disease cases (excluding dengue).
Of these, there was a large multistate outbreak of WNV disease, which accounted for 5,674
(98%) of reported cases; the highest number reported since 2003 (CDC). By pointing out
that arboviruses continue to cause serious illness in substantial numbers of persons in the
U.S., even death in some, the author plants in the minds of his readers the importance of
animal vaccinations to prevent such diseases. And so, through the use of statistics the
author establishes the soundness of his thesis [i.e. of the importance of both human and
animal vaccinations]. Some readers may even learn that vaccinations are not only important
for humans, but animals as well. This strategy is therefore both a tool for raising awareness
and convincing the audience about how vaccinations can prevent e transmission of animal
diseases to humans. It therefore helps Babiuk achieve his purpose with his readers and
supports his theses that vaccinations, whether human or animal, can help control infectious
diseases.
Blackham 17
Works Cited
Babiuk, Lorne A. "Controlling Infectious Diseases Through Vaccination." Clinical
& Investigative Medicine 37.6 (2014): E409-E413. Academic Search Complete.
Web. 3 July 2015.
"West Nile Virus." Centers for Disease Control and Prevention. Centers for Disease
Control and Prevention, 09 June 2015. Web. 16 July 2015.