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In this issue we encounter provocative notions about personalized medicine applied to vaccines.
How provocative? Where else can you get both a reference to Sansabelt slacks and to the "trickle-in" theory of medical advancement?
Oh, Yes! The Coming Age of Vaccinomics
By Dale Dauten, Syndicated Columnist
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If you haven't been talking about "vaccinomics" already, you will be, and the first thing is to pronounce it correctly: it's not said like "economics" or "Trump-onomics" ; rather, it's pronounced like "genomics," with a long "O" as in "Oh, yes! Welcome to "VAX-a-NO-mics."
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Recently I spoke with an evangelist for personalized medicine, Dr. Walter Dehority, Pediatric
Infectious Disease specialist and Associate Professor with the University of New Mexico Health
Sciences Center. Todd Watkins of STC tells me that those who heard his 2014 presentation on the future of vaccinations are still talking about it.
PERSONALIZED MEDICINE VS. THE SANSABELT
To start, Dr. Dehority explained why we should care about the vaccination version of personalized medicine:
"The easiest way to start thinking about personalized medicine is to think about pharmacogenomics, and how we could match dosages of drugs to patients. Right now, a 70 year-old woman who weighs 40 kilos (about 88 pounds) and a 25 year-old lineman for the Dallas Cowboys are both going to get the same dosage; that is, the 'adult dosage.' That's 'the Sansabelt Approach.' Instead of creating a custom suit, you just let one size fit all."
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For those of you who don't recall Sansbelt, that was a brand name for men's slacks with an elastic waist that eliminated the need for a belt - sans a belt... get it?
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WHY VACCINOMICS MATTERS... What Would You Do?
Here's an interesting policy dilemma posed by Dr. Dehority:
Standard protocol is to give children two doses of the measles vaccine, once at age one, then again at four. Dr. Dehority says, "Most people assume that the second dose is a 'booster' shot, but it isn't. Turns out that about five percent of children do not develop an immunity with the first shot, and so all children, including the 95% who have immunity, get the second dose."
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Here's the policy issue -- which of conclusions about the measles vaccine would you choose?
- Hey, 95% is great. Declare victory, because that's plenty good enough.
- We'll ask all parents to have their children tested for immunity, and that way we can identify the 5% and only give a second dose to those who need it.
- We can't get all children tested, and while 95% is good, it's not good enough. With a second vaccine we can get much closer to full coverage, so we'll require two doses and protect nearly everyone.
Well, we know that the current choice is #3. But some day we may have a fourth choice - using genetic profiling to identify those children who won't get immunity with the standard first dose, and then customize their vaccine dose and schedule.
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Or, another example of the need for vaccinomics...
There's a current outbreak of mumps in Arkansas, mostly among college-age kids. A fair percentage of those kids received the recommended vaccines. Dr. Dehority says, "What probably has happened with the vaccinated kids is that the immunity wasn't sustained. And there's probably a genetic underpinning. If we could identify the genetics, then we could deal with the lack of immunity, maybe added another dose before college."
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Dr. Dehority with his daughters
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WHY NOT NOW?
So, vaccinomics sounds great, right? Even inevitable. Dr. Dehority says, "When people hear about the benefits, they say, 'Awesome, let's do it!' And, while it is theoretically possible, it is impossible to overstate how complicated this is."
Speaking of complicated, Dr. Dehority has a mind-numbing flowchart of the human immune system. I started to insert it here, but feared people might spot it and give up reading.
THE "TRICKLE-IN" OF MEDICAL ADVANCEMENT
It's the complexity of the immune system, with its thousands of genes, that has Dr. Dehority convinced that vaccinomics will arrive slowly, vaccine by vaccine: "There will eventually be a breakthrough - there are researchers out there who will come up with a way to apply genomics to a specific immunization - it might be measles or whooping cough or something else, we can't really say. That will be the start; then, maybe three years later there will be another one, maybe for hepatitis, then a year after that perhaps it will be for flu. We don't know the order, but it's likely they will trickle in."
How long will it take? Well, breakthroughs don't have a schedule. However, given the momentum behind personalized medicine, we can be certain that we'll be hearing much more about vaccinomics.
Let's end with a quote from the man who coined the term "vaccinomics," Dr. Gregory Poland of the Mayo Clinic's Vaccine Research Group. He told Scientific American,
"There has been a deep schism between people who believe in vaccines and people who don't, and what's interesting is that both groups are highly attracted to this work we're doing." And, "We'll actually be able to predict whether you need a vaccine, how many doses you need, and whether you're likely to have a serious side effect. The power of this for human health is undeniable."
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Are you an Immunization Ambassador yet!?!
Click
here to learn more!
We're spreading our message worldwide. After seeing our materials, the Puerto Rican Health Department called us to help spread the word about vaccines. We've created a Go Fund Me to send the 50,000 bumper stickers they requested. Please check out
this link
if you would like to donate towards the cause and help the people of Puerto Rico.
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In Other News
If you got your flu shot, check to see if it showed up in your online record. If you don't have an account yet, make one TODAY at MyIR!
It's Cervical Cancer Awareness Month so here are a few good resources to learn more about HPV and the vaccine to prevent it:
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From the University of Minnesota, a webinar called "Why is Our Attitude Toward the HPV Vaccination Different From Other Vaccines?" explaining best practices for HPV vaccination recommendations on January 31, 2017 from 12pm-1pm. Register here.
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The Human Papilloma Virus HPV may be the most widespread, misunderstood and potentially dangerous epidemic that most people hardly know anything about. Worldwide, cervical cancer kills over 250,000 women every year. In Someone You Love, meet five unforgettable women whose lives have been changed forever and even interrupted by this deadly virus.
- Interested in hosting your own screening of Someone You Love? Click here to learn more
- Check out this cool UK based foundation that supports women who have been affected by cervical cancer
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See You There?
Care Pharmacy, February 3rd-5th, Williamsburg Lodge, MD
NACDS Regional, February 5th-7th, Palm Beach, FL
AIM, February 7th-9th, Charleston, SC
HIMMS, February 19th-23rd, Orlando, FL
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Join the celebration of ideas and the people who have them...
At STC, we believe in sharing innovative ideas. If you have ideas for better data around immunizations, or for thought-leaders we could profile, please pass them along...
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Mike Popovich, Publisher
Dale Dauten & Lara Popovich, Editors
Jacob Groom|Marketing
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