Jump to content

1988 Tompkins Square Park riot and Vaccine: Difference between pages

Edit links
From Wikipedia, the free encyclopedia
(Difference between pages)
Content deleted Content added
VisualWikitext
→‎Background: somewhat rewritten, for clarity, accuracy, historical perspective, and to reduce copyvio concerns. Feedback/revision heartily encouraged!
 
copy edits; Wikifications; npoving; etc.
 
Line 1: Line 1:
{{otheruses}}
[[Image:SignTSP.jpg|thumb|right|400px|A city sign in the park commemorates the riots.]]
A '''vaccine''' is a biological preparation which is used to establish or improve immunity to a particular disease.
The '''Tompkins Square Park Police Riot''' occurred on [[August 6]]&ndash;[[August 7]] [[1988]] in [[New York City]]'s [[Tompkins Square Park]]. Groups of "drug pushers, homeless people and young people known as '[[skinheads]]'" had largely taken over the [[East Village, Manhattan|East Village]] park, but the neighborhood was divided about what, if anything, should be done about it.<ref name=Newsday1>Koch Suspends Park Curfew Following bloody clash in Tompkins Square, Manuel Perez-Rivas, [[Newsday]], August 8, 1988, NEWS; Pg. 5.</ref> The local governing body, [[Manhattan Community Board 3]], adopted a 1 a.m. curfew for the previously 24-hour park, in an attempt to bring it under control.<ref>{{cite news|first=Howard|last=Kurtz|title=Man Refuses to Surrender Film of Clash With Police|url=http://pqasb.pqarchiver.com/washingtonpost/access/73629298.html?dids=73629298:73629298&FMT=ABS&FMTS=ABS:FT&date=SEP+07%2C+1988&author=Howard+Kurtz&pub=The+Washington+Post&desc=Man+Refuses+to+Surrender+Film+of+Clash+With+Police%3B+New+Yorker+Jailed+on+Contempt+Charge&pqatl=google|work=The Washington Post|date=[[1988-09-07]]}}</ref> On July 31, a protest rally against the curfew saw several clashes between protesters and police<ref>{{cite news|first=Michael|last=Wines|title=Class Struggle Erupts Along Avenue B|url=http://select.nytimes.com/gst/abstract.html?res=FB0714FD3D550C738DDDA10894D0484D81|work=New York Times|date=[[1988-08-10]]}}</ref>.


Vaccines can be [[prophylaxis|prophylactic]] (e.g. to prevent or ameliorate the effects of a future [[infection]] by any natural or "wild" [[pathogen]]), or [[Drug therapy|therapeutic]] (e.g. vaccines against cancer are also being investigated; see [[cancer vaccine]]). Vaccines have become one of the most lucrative market segments in the [[pharmaceutical industry]].
Another rally was held on August 6. The police charged a crowd of protesters, and a riot ensued. Bystanders, activists, police officers, neighborhood residents and journalists were caught up in the violence<ref>{{cite news|url=http://www.villagevoice.com/specials/0543,50thsmith3,69281,31.html|title=Message in a Bottle: Homesteaders Rock the Lower East Side|accessdate=2007-06-04|first=RJ|last=Smith|date=[[1988-08-23]]|work=The Village Voice}}</ref>. Despite a brief lull in the fighting, the [[mêlée]] continued until 6 a.m. the next day. Mayor [[Ed Koch]] temporarily rescinded the curfew. The neighborhood, previously divided over how to deal with the park, was unanimous in its condemnation of the heavy-handed actions of the police.


The term "vaccine" derives from [[Edward Jenner]]'s 1796 use of [[cowpox]] ([[Latin]] ''variolæ vaccinæ'', adapted from the Latin ''vaccīn-us'', from ''vacca'' cow), which, when administered to [[human]]s, provided them protection against [[smallpox]].
Over 100 complaints of police brutality were lodged following the riot. Much blame was laid on poor police handling, and the commander of the precinct in charge was deprived of office for a year. In an editorial entitled ''[[Police riot|Yes, a Police Riot]]'', ''[[The New York Times]]'' commended Commissioner [[Benjamin Ward]] and the [[New York Police Department]] for their candor in a report that confirmed what ubiquitous media images made clear: the NYPD were responsible for inciting a riot.<ref>[http://select.nytimes.com/gst/abstract.html?res=FB0715FD385D0C758EDDA10894D0484D81&n=Top%2fReference%2fTimes%20Topics%2fSubjects%2fP%2fParks%20and%20Other%20Recreation%20Areas"Yes, a Police Riot,"] editorial of ''The New York Times'', [[August 26]] [[1988]], Section A; Page 30, Column 1; Editorial Desk</ref>


==History and outlook==
One of the concerns of the local community had been that the park was a gathering place for scores of drunken rock fans and their boisterous street parties. After the riot, on November 7, 2004, about 200 people gathered in Tompkins Square Park to attend a concert by the punk band Leftöver Crack. The concert has since become a yearly ritual to mark the 1988 riots.


The earliest vaccines were based on the concept of [[variolation]], originating in [[China]], in which a person is deliberately infected with a weak form of smallpox as a form of [[inoculation]]. Jenner realized that [[milkmaid]]s who had contact with cowpox did not get smallpox. The process of distributing and administrating vaccines is thus referred to as "[[vaccination]]". Jenner's work was continued by [[Louis Pasteur]] and others in the 19th century. Since vaccination against smallpox was much safer than smallpox inoculation, the latter fell into disuse and was eventually banned in England in 1849.
==Background==
[[Image:AlphabetCityStBrigids.JPG|thumb|right|[[Saint Brigid's Roman Catholic Church, New York|St. Brigid's Church]] on [[Avenue B]] overlooks Tompkins Square Park and allowed protesters to organize there. Its scheduled demolition is the subject of on-going litigation.]]
Since the [[Tompkins Square Riot (1874)|Tompkins Square Riot of 1874]], the park had been a symbolic place for the New York labor movement.<ref>{{cite book |title=Homesteading in New York City, 1978–1993: The Divided Heart of Loisaida |author=Hassell, Malve Von Hassell |publisher=Bergin & Garvey |year=1996 |pages=p. 44}}</ref>


The 19th and 20th centuries saw the introduction of several vaccines developed and introduced for prevention of a variety of [[infectious disease]]s. These included ]][[bacterial and [[Virus|viral]] diseases, but not (to date) any parasitic diseases.
By the summer of 1988 the East Village – and Tompkins Square Park in particular – had become a gathering place and home for the wayward and those on the verge of imminent collapse. Contingents of the homeless and rowdy youth had nearly taken over the park.


Pediatric vaccines dominate the vaccine market, but the adult vaccine market is expected to grow rapidly in coming years. Leading the way, products such as the [[HPV vaccine]] and related cancer prevention vaccines may garner a quarter of the global vaccine market by 2012.[http://www.pr.com/press-release/110403]
Neighborhood residents, voicing their preferences through at least four community organizations, had differing perspectives on the evolving nature of the park, and what actions should or should not be taken. The Avenue A Block Association (comprised of local businesses) demanded a curfew; Friends of Tompkins Square Park and political organizers on the poorer east side of the park preferred that curfew be imposed; and [[Manhattan Community Board 3]] tried to take the middle ground.<ref name="Purdham">{{cite news
|url=http://select.nytimes.com/gst/abstract.html?res=FB0711FC3A540C778DDDA10894D0484D81&n=Top%2fReference%2fTimes%20Topics%2fSubjects%2fP%2fParks%20and%20Other%20Recreation%20Areas
|title=Melee in Tompkins Sq. Park: Violence and Its Provocation
|first=Todd
|last=Purdham
|work=The New York Times
|date=[[August 14]] [[1988]]
|page=A1}}</ref>


On June 28, the Avenue A Block Association's board approved a report that included a recommendation of a 1 a.m. curfew. While there was some controversy about how well-informed the voting board members were, board manager Martha Danziger affirmed the validity of the decision.


{{Expand-section|date=August 2008}}
Park workers painted a warning on the ground days after the Association made its decision. On July 11 the police, under the direction of Captain Gerald McNamara of the 9th Precinct, confined homeless people to the park's southeast quadrant, and evicted all others. The closed the park down periodically over the next two weeks.<ref name="Purdham"/>


==The riot==
==Types==
[[Image:ReverseGeneticsFlu.jpg|thumbnail|300px|[[Avian Flu]] vaccine development by [[reverse genetics]] techniques.]]
===First signs of trouble===
Vaccines may be dead or inactivated organisms or purified products derived from them.
Though the park had already become a de facto homeless shelter and the general public virtually barred from using the park by anarchists supporting the rights of these homeless, some residents considered it an attempt to take the park away from the public. Protests were organized and a rally called for [[July 31]].<ref name="Purdham"/> That night, police entered the park for alleged noise complaints, and by the end of the call several people and six officers were treated for injuries and four men were arrested on charges of reckless endangerment and inciting to riot.<ref name="Lyle">[http://select.nytimes.com/gst/abstract.html?res=FB0711F63A5E0C728CDDA10894D0484D81&n=Top%2fReference%2fTimes%20Topics%2fSubjects%2fP%2fParks%20and%20Other%20Recreation%20Areas "Residents Clash With the Police In Village Park"] by Sarah Lyall, ''The New York Times'', [[August 1]] [[1988]], Section B; Page 3, Column 6; Metropolitan Desk </ref> Sarah Lewison, an eyewitness, said the protest was over rumors of a midnight curfew at the park and another witness, John McDermott, said the police provoked the melee.<ref name="Lyle"/> Angry organizers planned another rally for [[August 6]].<ref name="Purdham"/>


There are four types of traditional vaccines:<ref>[http://www.drspock.com/article/0,1510,4866,00.html]</ref>
===A rematch: August 6===
* Vaccines containing killed microorganisms - these are previously virulent micro-organisms which have been killed with chemicals or heat. Examples are vaccines against [[Influenza vaccine|flu]], [[cholera]], [[bubonic plague]], and [[hepatitis A]].
[[Image:Allen Ginsberg.jpg|thumb|125px|left|[[Allen Ginsberg]]was an eyewitness to the riots.]]The police were there to meet the protesters. "It's time to bring a little law and order back to the park and restore it to the legitimate members of the community," said Captain McNamara. He dismissed questions about the seemingly excessive police numbers. "We don't want to get into a situation where we under-police something like this and it turns into a fiasco."<ref name="Purdham"/>
* Vaccines containing live, [[attenuated virus]] microorganisms - these are live micro-organisms that have been cultivated under conditions that disable their virulent properties or which use closely-related but less dangerous organisms to produce a broad immune response. They typically provoke more durable immunological responses and are the preferred type for healthy adults. Examples include [[yellow fever]], [[measles]], [[rubella]], and [[mumps]]. The live [[tuberculosis]] vaccine is not the [[contagious]] strain, but a related strain called "[[Bacillus Calmette-Guérin|BCG]]"; it is used in the United States very infrequently.
* [[Toxoid]]s - these are inactivated toxic compounds in cases where these (rather than the micro-organism itself) cause illness. Examples of toxoid-based vaccines include [[tetanus]] and [[diphtheria]]. Not all toxoids are for micro-organisms; for example, Crotalis atrox toxoid is used to vaccinate dogs against rattlesnake bites.
* [[Subunit]] - rather than introducing an inactivated or attenuated micro-organism to an immune system (which would constitute a "whole-agent" vaccine), a fragment of it can create an immune response. Characteristic examples include the subunit vaccine against [[HBV]] that is composed of only the surface proteins of the virus (produced in [[yeast]]) and the [[virus-like particle]] (VLP) vaccine against [[human papillomavirus]] (HPV) that is composed of the viral major [[capsid]] protein.


A number of innovative vaccines are also in development and in use:
New York was in the midst of a record heat wave. Medical waste was washing ashore in a [[Syringe Tide]] and the beaches were closed. The city was on edge and tempers were running hot. In the midst of this, the park was turned into what Times reporter McFadden described as a bloody "war zone."<ref name="McFadden">[http://select.nytimes.com/gst/abstract.html?res=FB0716F9395F0C7B8CDDA10894D0484D81&n=Top%2fReference%2fTimes%20Topics%2fSubjects%2fP%2fParks%20and%20Other%20Recreation%20Areas"Park Curfew Protest Erupts Into a Battle And 38 Are Injured"] by Robert McFadden, The New York Times, August 7, 1988, Section B; Page 3, Column 6; Metropolitan Desk </ref> <p>
* [[Conjugate vaccine|Conjugate]] - certain bacteria have [[polysaccharide]] outer coats that are poorly immunogenic. By linking these outer coats to proteins (e.g. toxins), the [[immune system]] can be led to recognize the polysaccharide as if it were a protein antigen. This approach is used in the ''Haemophilus influenzae'' type B vaccine.
Around 23:30, 150 or 200 (police estimates were 700) protesters came through the [[St. Mark's Place]] entrance to the park, holding banners proclaiming ''Gentrification is Class War.''<ref name="Purdham"/> By the time dawn broke the next morning, thirty-eight people, including reporters and officers, suffered injuries; nine people were arrested on riot, assault and other charges; and six complaints of police brutality were logged with the [[Civilian Complaint Review Board]].<ref name="McFadden"/>
* [[Recombinant DNA|Recombinant]] Vector - by combining the physiology of one micro-organism and the [[DNA]] of the other, immunity can be created against diseases that have complex infection processes.
* [[DNA vaccination]] - in recent years a new type of vaccine, created from an infectious agent's DNA called ''DNA vaccination'', has been developed. It works by insertion (and [[Gene expression|expression]], triggering immune system recognition) into human or animal cells, of viral or bacterial DNA. Some cells of the immune system that recognize the proteins expressed will mount an attack against these proteins and cells expressing them. Because these cells live for a very long time, if the [[pathogen]] that normally expresses these proteins is encountered at a later time, they will be attacked instantly by the immune system. One advantage of DNA vaccines is that they are very easy to produce and store. As of 2006, DNA vaccination is still experimental.


While most vaccines are created using inactivated or attenuated compounds from micro-organisms, [[synthetic vaccine]]s are composed mainly or wholly of synthetic peptides, carbohydrates or antigens.
===Police actions===
[[Image:TompkinsChristadoraHouse.JPG|thumb|200px|Christadora House, for many the first sign of East Village [[gentrification]], and scene of the riot.]]Although bottles reportedly flew, it was the police who charged the crowd.<ref name="Purdham"/> Despite NYPD protestations that their actions were measured, "The police panicked and were beating up bystanders who had done nothing wrong and were just observing," said poet [[Allen Ginsberg]], a local resident and witness.<ref name="Purdham"/> Captain McNamara countered, "We did everything in our power not to provoke an incident. They didn't charge the crowd until the bricks and bottles started flying." New York Times photographer Angel Franco saw the police beat a couple who emerged from a grocery store; when he tried to take photographs, an officer clubbed him. A [[New York Daily News]] reporter, Natalie Byfield, was also clubbed on the head. Both were wearing press identity cards. Jeff Dean Kuipers, a reporter for [[Downtown magazine]], was clubbed after an officer told his African-American companion, Tisha Pryor, to "move along, you black [[nigger]] [[bitch]]."<ref name="Purdham"/> Kuipers told ''[[Newsday]]'' "[The police] ran into the crowds with horses. I saw residents pulled off their stoops . . . They cracked my friend's head open. It didn't matter if you were a journalist or a resident or a storekeeper."<ref name=Newsday1/>


Vaccines may be ''monovalent'' (also called ''univalent'') or ''multivalent'' (also called ''polyvalent''). A monovalent vaccine is designed to immunize against a single antigen or single microorganism.<ref>{{DorlandsDict|five/000067458.htm|Monovalent}}</ref> A multivalent or polyvalent vaccine is designed to immunize against two or more strains of the same microorganism, or against two or more microorganisms.<ref>[http://www.mercksource.com/pp/us/cns/cns_hl_dorlands.jspzQzpgzEzzSzppdocszSzuszSzcommonzSzdorlandszSzdorlandzSz000113928zPzhtm Polyvalent vaccine] at ''[[Dorlands Medical Dictionary]]''</ref>
Pryor is seen crying, with blood flowing down the back of her neck, in a videotape made by [[artist]] Clayton Patterson. Another video made by freelance cameraman Paul Garrin shows officers swinging clubs at him and slamming him against a wall. Mr. Fish, a travel promoter out for an evening on the town, attempted to hail a taxi on Avenue A near [[6th Street (Manhattan)|Sixth Street]] when he was suddenly struck on the head. "I was just standing there watching," he said. "The next thing that I remember is seeing the stick, and then a young woman who was helping me." Patterson's videotape showed that no officers helped Fish until an ambulance arrived. A police helicopter hovered over the scene, contributing to a sense of chaos.<ref name="Purdham"/>


==Developing immunity==
During a lull in the riot, a young officer on Patterson's video appealed for understanding from the protesters. He tried to calmly tell them how unhappy the police were with the assignment and its aftermath. "We've got cops back there in ambulances who've been hit." But the lull ended. Thirty to seventy protesters re-entered the park. A witness said the mob rammed a police barricade through the glass door of the Christodora House, a high-rise luxury building on Avenue B. They overturned planters and tore a lamp out of the wall, threatened residents and staff with bodily harm, and screamed and chanted "Die Yuppie Scum". At 6 a.m., the last protesters dispersed, vowing to demonstrate again.<ref name="Purdham"/>
The immune system recognizes vaccine agents as foreign, destroys them, and 'remembers' them. When the [[virulent]] version of an agent comes along the body recognises the protein coat on the virus, and thus is prepared to respond, by (1) neutralizing the target agent before it can enter cells, and (2) by recognizing and destroying infected cells before that agent can multiply to vast numbers.


Vaccines are widely credited with having contributed to the eradication of [[smallpox]], one of the most contagious and deadly diseases known to man. Other diseases such as [[rubella]], [[polio]], [[measles]], [[mumps]], [[chickenpox]], and [[typhoid]] are nowhere near as common as they were a hundred years ago. As long as the vast majority of people are vaccinated, it is much more difficult for an outbreak of disease to occur, let alone spread. This effect is called [[herd immunity]]. Polio, which is transmitted only between humans, is targeted by an extensive [[Polio eradication|eradication campaign]] that has seen endemic polio restricted to only parts of four countries.[http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5627a3.htm?s_cid=mm5627a3_e] The difficulty of reaching all children as well as cultural misunderstandings, however, have caused the anticipated eradication date to be missed several times.
When questioned about the brutality, Captain McNamara said, "It was a hot night. There was a lot of debris being thrown through the air. Obviously tempers flared. But all these allegations will be investigated."<ref name="Purdham"/> Mayor [[Ed Koch]] was forced to temporarily revoke the curfew.<ref>New York Drops Curfew, ''[[The Washington Post]]'', August 9, 1988, First Section, P. A6</ref>


==Aftermath==
==Schedule==
{{main|Vaccination schedule}}
Eventually the brutality complaints ballooned to over 100.<ref name="Purdham2">[http://select.nytimes.com/gst/abstract.html?res=F30A10F8395C0C758DDDAE0894DF494D81&n=Top%2fReference%2fTimes%20Topics%2fSubjects%2fP%2fParks%20and%20Other%20Recreation%20Areas"Findings on Tompkins Sq. Prompt 2 Police Supervisors to Lose Posts"] by Todd S. Purdham, ''The New York Times'', [[August 25]] [[1988]], Section A; Page 1, Column 2; Metropolitan Desk </ref> Video and images of "police officers striking demonstrators with nightsticks and kicking other apparently defenseless people while they were lying on the ground" were flashed continuously across the media. [[New York City Police Commissioner|New York Police Commissioner]] [[Benjamin Ward]] issued a scathing report laying the blame for the riot squarely on the precinct. The police actions were "not well planned, staffed, supervised or executed... which culminated in a riot." Ward announced the retirement of Deputy Chief Thomas J. Darcy, who was absent from the scene and derelict in his duties.<ref name="Purdham2"/> Deputy Inspector Joseph Wodarski, the senior officer at the scene in Darcy's absence, was not demoted but transferred from his prestigious post as commander of the Midtown South precinct to a "less sensitive" command. Captain McNamara, the lowest-ranking commander at the scene, was temporarily relieved of his post, but was allowed to resume command of the precinct the next year. Ward said that McNamara's actions were "not well planned, staffed, supervised or executed, [but he] acted in good faith and made judgments that were within the level of his experience," after Darcy and Wodarski failed to act.<ref name="Purdham2"/>
:''See also: [[Vaccination policy]]''


In order to provide best protection, children are recommended to receive vaccinations as soon as their immune systems are sufficiently developed to respond to particular vaccines, with additional 'booster' shots often required to achieve 'full immunity'. This has led to the development of complex [[vaccination schedule]]s. In the United States, the [[Advisory Committee on Immunization Practices]], which recommends schedule additions for the [[Center for Disease Control]], recommends routine vaccination of children against: [[hepatitis A]], [[hepatitis B]], [[polio]], [[mumps]], [[measles]], [[rubella]], [[diphtheria]], [[pertussis]], [[tetanus]], [[Haemophilus influenzae|HiB]], [[chicken pox]], [[rotavirus]], [[influenza]], [[meningococcal disease]] and [[pneumonia]]. The large number of vaccines and boosters recommended (up to 24 injections by age two) has led to problems with achieving full compliance. In order to combat declining compliance rates, various notification systems have been instituted and a number of combination injections are now marketed (e.g., [[Prevnar]] and [[ProQuad vaccine]]s), which provide protection against multiple diseases.
A city review of the riot turned up numerous problems with the police department's actions that night, including a failure to contact either Commissioner Ward or Mayor Koch.<ref name=LATimes>NYPD RIOT ACTION A FAR CRY FROM GLORY DAYS, John Goldman, Los Angeles Times August 12, 1988</ref> In the middle of the riot the commander left the scene to go to the bathroom at the station house, blocks from the fighting. The police helicopter used to illuminate the area only attracted bigger crowds. Critical rooftops were not secured and were used to throw bottles and debris at people on the street.<ref name=LATimes/> Ward said the mounted police were brought to the scene too soon and acted too rashly to confront protesters. A temporary headquarters was set up right in the middle of the park, causing officers unfamiliar with the East Village—who rushed to the scene from throughout the city—to push their way through demonstrators to reach it. Once at the headquarters, they found no high-ranking officer on duty.<ref name=LATimes/>


Besides recommendations for infant vaccinations and boosters, many specific vaccines are recommended at other ages or for repeated injections throughout life -- most commonly for measles, tetanus, influenza, and pneumonia. Pregnant women are often screened for continued resistance to rubella. The [[human papillomavirus]] vaccine is currently recommended in the U.S. and UK for ages 11–25. Vaccine recommendations for the elderly concentrate on pneumonia and influenza, which are more deadly to that group. In 2006, a vaccine was introduced against [[shingles]], a disease caused by the chicken pox virus, which usually affects the elderly.
===The city's reaction===
[[Image:Ed Koch 1978 flipped.jpg|thumb|Mayor Ed Koch]]Mayor Koch called the park a "cesspool" where "sandboxes are soiled with feces and urine."<ref name="Purdham3">[http://select.nytimes.com/gst/abstract.html?res=FB0714F63C5B0C738EDDA10894D0484D81&n=Top%2fReference%2fTimes%20Topics%2fSubjects%2fP%2fParks%20and%20Other%20Recreation%20Areas"A Playground 'Derelicts' Can't Enter,"] by Todd Purdham, ''The New York Times'', [[August 20]] [[1988]], Section 1; Page 31, Column 2; Metropolitan Desk</ref> Koch admitted he had not seen the feces and urine himself. "There are people, hundreds of them, I'm told, who park there all 24 hours a day, and obviously there are bodily needs."<ref name="Purdham3"/>
Hundreds of officers were called out on a steamy Saturday for the worst violence the city had seen in years, yet Koch did not know about it until the next day and said he did not speak to Ward about it until Monday.<ref name="Levine">"Koch's Verdict: Ward Not Guilty" by Richard Levine, ''The New York Times'', [[August 13]] [[1988]], Section 1; Page 30, Column 1; Metropolitan Desk</ref>


In [[Australia]], a massive increase in vaccination rates was observed when the federal government made certain benefits (such as the universal 'Family Allowance' welfare payments for parents of children) dependent upon vaccination compliance. As well, children were not allowed into school unless they were either vaccinated or their parents completed a statutory declaration refusing to immunize them, after discussion with a doctor, and other bureaucracy. (Similar school-entry vaccination regulations have been in place in some parts of [[Canada]] for several years.) It became easier and cheaper to vaccinate one's children than not to. When faced with the annoyance, many more casual objectors simply gave in.{{Fact|date=January 2008}}
[[Image:Ben Ward.jpg|thumb|left|Commissioner Benjamin Ward]]Ward himself had been the subject of controversy in the past, and the riot became a cause to reflect on the negative aspects of his record as Commissioner. After 10 people were shot in Brooklyn in 1984, nobody could find him for days.<ref name="Levine"/> He appeared drunk at a [[Patrolmen's Benevolent Association]] convention in 1984; under his watch in 1985, officers in [[Queens]] used stun guns on suspects and in 1986 Brooklyn police stole and sold drugs. He was lambasted in 1987 for telling [[African-American]] journalists that most crime in New York was committed by young black men and later told black ministers in reference to that remark, "our little secret is out." He told a woman who was scared about a series of [[rape]]s that she was the type of woman a rapist would go after.<ref name="Levine"/>


==Efficacy==<!-- This section is linked from [[Mumps]] -->
It was noted that Mayor Koch held steadfast in his support of Ward. Although Koch said he was "shocked" by the videotape of the police response, as he had done in the past he refused to utter a negative word about Ward. "The day I think that a commissioner, including a police commissioner, isn't as good as he should be to run whatever he's running, that's the day I will ask him to submit his resignation," said Koch. "I think Ben Ward will go down as one of the greatest police commissioners this city has ever had. Bob McGuire is the other, and I appointed both of them."<ref name="Levine"/> However, Koch's support eroded as evidence mounted that municipal disorganization and a lack of police leadership that night likely sparked the riots. "The film that I saw causes me to believe that there may have been an overreaction. I was not happy with what I saw on film. Those films were disturbing to me, and I think they disturbed Ben Ward as well."<ref name=Newsday2>Koch Changes Tune on Melee, Richard Esposito and Clara Hemphill, Newday, August 10, 1988, NEWS; Pg. 7</ref>
Vaccines do not guarantee complete protection from a disease. Sometimes this is because the host's immune system simply doesn't respond adequately or at all. This may be due to a lowered immunity in general (diabetes, steroid use, HIV infection) or because the host's immune system does not have a [[B cell]] capable of generating [[Antibody|antibodies]] to that [[antigen]].


Even if the host develops antibodies, the human immune system is not perfect and in any case the immune system might still not be able to defeat the infection.
Two officers were charged with use of excessive force. Officer Karen Connelly was accused of using her nightstick "wrongfully and without just cause" to strike a civilian, and Philip O'Reilly, who was accused of interfering with Times photographer Franco, and of using his nightstick to injure Franco's hand.<ref name=Lyall>"More Officers May Be Facing Charges," by Sarah Lyall, The New York Times, [[August 25]] [[1988]], Section B; Page 6, Column 1; Metropolitan Desk</ref> The [[Civilian Complaint Review Board]] recommended the officers be charged, and Commissioner Ward endorsed the recommendations.<ref name=Lyall/>


[[Immunologic adjuvant|Adjuvant]]s are typically used to boost immune response. Adjuvants are sometimes called the ''dirty little secret'' of vaccines [http://www.thescientist.com/article/display/39377/] in the scientific community, as not much is known about how adjuvants work. Most often aluminium adjuvants are used, but adjuvants like [[squalene]] are also used in some vaccines and more vaccines with squalene and phosphate adjuvants are being tested.
===Neighborhood reactions===
The [[vaccine efficacy|efficacy]] or performance of the vaccine is dependent on a number of factors:
A neighborhood divided over their feelings about police were united against their aggression. "The streets were full of people who I see coming out of their houses every morning with briefcases...I mean people who work on [[Wall Street]], and they're standing in the street screaming 'Kill the pigs!'" said Phil Van Aver, a member of [[Manhattan Community Board 3]].<ref name="Purdham"/> Board 3 and the nonprofit social service organizations supported the goal of clearing Tompkins Square Park of the drug dealers, drunks, addicts and anti-social elements that considered it home.<ref name="Johnson">[http://select.nytimes.com/gst/abstract.html?res=FB0716FD345A0C708DDDA10894D0484D81&n=Top%2fReference%2fTimes%20Topics%2fSubjects%2fP%2fParks%20and%20Other%20Recreation%20Areas "The Talk of the East Village; A Neighborhood of Vigorous Opinions,"] by Kirk Johnson, ''[[The New York Times]]'', [[August 13]] [[1988]], Section 1; Page 29, Column 2; Metropolitan Desk</ref> Instead, the [[police riot]] ripped open old wounds about brutality and the neighborhood's housing problem many longtime residents faced.<ref name="Johnson"/> "The police, by acting in the brutal fashion that they did, managed to link a small group of crazies to the legitimate sentiments of opposition to gentrification," said Valerio Orselli, director of the Cooper Square Committee, a nonprofit housing group. "Now the issue has become police brutality, not housing. It's set everyone back."<ref name="Johnson"/>
* the disease itself (for some diseases vaccination performs better than for other diseases)
* the strain of vaccine (some vaccinations are for different strains of the disease) [http://bmj.bmjjournals.com/cgi/content/full/319/7206/352]
* whether one kept to the timetable for the vaccinations (''see [[Vaccination schedule]]'')
* some individuals are 'non-responders' to certain vaccines, meaning that they do not generate antibodies even after being vaccinated correctly
* other factors such as ethnicity or genetic predisposition


When a vaccinated individual does develop the disease vaccinated against, the disease is likely to be milder than without vaccination.
Many people relished the neighborhood as a home for society's [[outcasts]]. Getrude Briggs, owner of East [[7th Street]] store ''Books 'n' Things'', and a resident of forty-one years: "Of course [the East Village] still attracts a lot of freaks, because it's still a place you can be free. For a lot of kids, coming here is a way to get away from the choking atmosphere of [[suburbia]]."<ref name="Johnson"/> Thirty year resident Barbara Shawm protested the East Village's dangerous reputation: "A 90-pound woman can easily fend off a [[drifter|down-and-outer]] or an [[addict]]. They're not dangerous. It's more dangerous [[Upper West Side|uptown]] - what people do to each other in [[elevators]]."<ref name="Johnson"/>


The following are important considerations in the effectiveness of a vaccination program:{{Fact|date=January 2008}}
==Music and the riots==
# careful modelling to anticipate the impact that an immunisation campaign will have on the epidemiology of the disease in the medium to long term.
According to Times reporter Todd Purdham, the clash had its roots in music.<ref name="Purdham"/> The park was a gathering place for scores of drunken rock fans and their boisterous street parties. The raucous affairs would rage through the night and they divided the community. News articles about the riots described some of the music groups who were involved in the melée . [[The New York Times]] quoted a handbill for The Backyards, a band looking for a drummer: "Must be dedicated, hard-hitting, in it for life. Willing to die naked in an alley for your anti-art. Outcasts and social rejects preferred but not essential."<ref name="Johnson"/> The [[anarchist]] rock band [[Missing Foundation]] were active in the riots and their logo—an overturned [[martini glass]] and "1988 - 1933"—was found everywhere on the walls of the East Village. The band's singer, [[Pete Missing]], sang through a bullhorn and claimed industrial society was on the verge of collapse and that a police state was imminent. The overturned glass signified the band's slogan "the party's over," and the dates an allusion to the year the [[Nazism|Nazis]] took over the [[Weimar Republic]].<ref name="Johnson"/>
# ongoing surveillance for the relevant disease following introduction of a new vaccine and
# maintaining high immunisation rates, even when a disease has become rare.


In 1958, there were 763,094 cases of measles and 552 deaths in the [[United States]].<ref name="pmid15106120">{{cite journal |author=Orenstein WA, Papania MJ, Wharton ME |title=Measles elimination in the United States |journal=J. Infect. Dis. |volume=189 Suppl 1 |issue= |pages=S1–3 |year=2004 |month=May |pmid=15106120 |doi= |url=http://www.journals.uchicago.edu/cgi-bin/resolve?JID20785}}</ref><ref name="pmid18463608">{{cite journal |author= |title=Measles--United States, January 1-April 25, 2008 |journal=MMWR Morb. Mortal. Wkly. Rep. |volume=57 |issue=18 |pages=494–8 |year=2008 |month=May |pmid=18463608 |doi= |url=http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5718a5.htm}}</ref> With the help of new vaccines, the number of cases dropped to fewer than 150 per year (median of 56).<ref name="pmid18463608"/> In early 2008, there were 64 suspected cases of measles. 54 out of 64 infections were acquired outside of the United States, and 63 of 64 either had never been vaccinated against measles, or were uncertain whether they had been vaccinated.<ref name="pmid18463608"/>
===Riot anniversary concerts===

On [[November 7]], [[2004]], about 200 people gathered in [[Tompkins Square Park]] to attend a concert by the punk band [[Leftöver Crack]]. The concert has become a yearly ritual to mark the 1988 riots. According to the NYPD, when officers attempted an arrest for an open container of alcohol, concertgoers "surrounded and assaulted" the officers. Six arrests were made on charges including assault inciting to [[riot]]. "It was a confrontation obviously. I don’t know if 'riot' is the right word", said Detective Gifford, a Police Department spokesperson. Reportedly, some of the [[punk subculture|punks]] spit upon and jumped on officers. [[Beer]] bottles were thown, causing some in the crowd to pour beer over fellow concertgoers.<ref>[[The Villager]], [http://www.thevillager.com/villager_80/punksclashwithpolice.html ''Punks clash with police''], November 10–16, 2004.</ref> On [[August 9]] [[2006]], Leftöver Crack again played the riot anniversary concert. A fight broke out in a [[mosh pit]].<ref>[[The Villager]], [http://www.thevillager.com/villager_171/leftovercrackfires.html ''[[Leftöver Crack]] fires up punks''], [[August 9]] [[August 15]] [[2006]].</ref>
==Types of vaccine developments==
{{Unreferencedsection|date=June 2008}}

* ''Rational attenuation'': Specific modifications or deletions of genes that confer virulence substantially reduces or removes the pathogenicity of the microbe while still allowing an immune response to be generated. This type of rational attenuation can be viewed as creating a "live" attenuated vaccine.

* ''Vector-mediated subunit delivery'': Introducing a non-infectious, non-pathogenic subunit into a live vector can prompt an immune response without presence of the pathogen. This is called ''vector-mediated subunit delivery''. For example, rabies surface protein gene has been inserted into vaccinia virus.

* ''[[Virus-like particle]]s'': [[Capsid]] proteins of icosahedral viruses assemble without the presence of a genome. These virus-like particles are antigenically authentic, but non-infectious. This has been used for HPV-16 and HPV-18 vaccines.

==Controversy==
[[Image:The cow pock.jpg|thumb|[[James Gillray]], ''The Cow-Pock—or—the Wonderful Effects of the New Inoculation!'' (1802)]]
{{main|Vaccine controversy}}

Opposition to vaccination, from a wide array of vaccine critics, has existed since the earliest vaccination campaigns.<ref name=wolfesharp>{{cite journal |author= Wolfe R, Sharp L |title= Anti-vaccinationists past and present |journal=BMJ |volume=325 |issue=7361 |pages=430–2 |year=2002 |pmid=12193361 |doi=10.1136/bmj.325.7361.430 |url=http://bmj.bmjjournals.com/cgi/content/full/325/7361/430}}</ref> Disputes have arisen over the morality, [[ethics]], [[Efficacy|effectiveness]], and safety of vaccination. The mainstream medical opinion is that the benefits of preventing suffering and death from serious [[infectious disease]]s greatly outweigh the [[vaccine injury]] risks of [[adverse effect]]s following [[immunization]].<ref name=BH>{{cite journal |journal= Curr Opin Infect Dis |year=2007 |volume=20 |issue=3 |pages=237–46 |title= Adverse events following immunization: perception and evidence |author= Bonhoeffer J, Heininger U |doi=10.1097/QCO.0b013e32811ebfb0 |pmid=17471032}}</ref><ref name=Cochrane>{{cite journal |doi=10.1002/14651858.CD004407.pub2 |pmid=16235361 |title= Vaccines for measles, mumps and rubella in children |author=Demicheli V, Jefferson T, Rivetti A, Price D |journal= Cochrane Database Syst Rev |year=2005 |volume=19 |issue=4 |laysummary=http://www.cochrane.org/press/MMR_final.pdf |laydate=2005-10-19 |laysource=Cochrane press release (PDF)}}</ref> Some vaccination critics say that vaccines are ineffective against disease<ref name=Halvorsen>{{cite book |author= Halvorsen R |title= The Truth about Vaccines |publisher= Gibson Square |date=2007 |isbn=9781903933923}}</ref> or that vaccine safety studies are inadequate.<ref name=Cochrane/><ref name=Halvorsen/> Some religious groups oppose vaccination as a matter of [[doctrine]],<ref name=White>{{cite book |chapter= Theological opposition to inoculation, vaccination, and the use of anæsthetics |title= A History of the Warfare of Science with Theology in Christendom |author= White AD |location= New York |publisher=Appleton |year=1896 |chapterurl=http://abob.libs.uga.edu/bobk/whitem10.html |accessdate=2007-08-17}}</ref> and some political groups oppose mandatory vaccination on the grounds of [[Liberty|individual liberty]].<ref name=wolfesharp/>

==Economics of development==
One challenge in vaccine development is economic: many of the diseases most demanding a vaccine, including [[HIV]], [[malaria]] and [[tuberculosis]], exist principally in poor countries. Pharmaceutical firms and [[biotechnology]] companies have little incentive to develop vaccines for these diseases, because there is little profit potential. Even in more affluent countries, financial returns are often minimal, and the financial risks are great.<ref name='market_return'>{{cite news | first=Jesse L. | last=Goodman | coauthors= | title=Statement of Jesse L. Goodman, M.D., M.P.H. Director, Center for Biologics, Evaluation and Research Before the Committee on Energy and Commerce United States House of Representatives | date=2005-05-04 | publisher= | url =http://www.fda.gov/ola/2005/influenza0504.html | work = | pages = | accessdate = 2008-06-15 | language = }}</ref>

Most vaccine development to date has relied on 'push' funding by government, universities and non-profit organizations.{{Fact|date=June 2008}} Many vaccines have been highly cost effective and beneficial for [[public health]].<ref name='market_return' /> The number of vaccines actually administered has risen dramatically in recent decades. This increase, particularly in the number of different vaccines administered to children before entry into schools, may be due to government mandates and support, rather than economic incentive.{{Fact|date=June 2008}}

Many researchers and policymakers are calling for a different approach, using 'pull' mechanisms to motivate industry. Mechanisms such as prizes, tax credits, or [[advance market commitments]] could ensure a financial return to firms that successfully developed a HIV vaccine. If the policy were well-designed, it might also ensure people have access to a vaccine if and when it is developed.{{Fact|date=June 2008}}

==Intellectual property==
[[Intellectual property]] can also be viewed as an obstacle to the development of new vaccines. Because of the weak protection offered through the [[patent]] of the final product, the protection of the innovation regarding vaccines is often made through the [[patent]] of processes used on the development of new vaccines as well as the protection of [[secrecy]].<ref>{{cite journal |author= Hardman Reis T |title= The role of intellectual property in the global challenge for immunization |journal= J World Intellect Prop |date=2006 |volume=9 |issue=4 |pages=413–25 |doi=10.1111/j.1422-2213.2006.00284.x}}</ref>

==Preservatives==
Many vaccines need preservatives to prevent serious adverse effects such as the ''[[Staphylococcus]]'' infection that, in one 1928 incident, killed twelve of 21 children inoculated with a [[diphtheria]] vaccine that lacked a preservative.<ref>{{cite web |date=2007-09-06 |url=http://www.fda.gov/cber/vaccine/thimerosal.htm |accessdate=2007-10-01 |title= Thimerosal in vaccines |publisher= Center for Biologics Evaluation and Research, U.S. Food and Drug Administration}}</ref> Several preservatives are available, including [[thiomersal]], [[2-phenoxyethanol]], and [[formaldehyde]]. Thiomersal is more effective against bacteria, has better shelf life, and improves vaccine stability, potency, and safety, but in the U.S., the [[European Union]], and a few other affluent countries, it is no longer used as a preservative in childhood vaccines, as a precautionary measure due to its [[Ethylmercury|mercury]] content.<ref>{{cite journal |journal= Drug Saf |date=2005 |volume=28 |issue=2 |pages=89–101 |title= Thiomersal in vaccines: balancing the risk of adverse effects with the risk of vaccine-preventable disease |author= Bigham M, Copes R |pmid=15691220 |doi= 10.2165/00002018-200528020-00001}}</ref> [[Thiomersal controversy|Controversial claims]] have been made that thiomersal contributes to [[autism]]; scientific evidence support these claims have generally dismissed as unconvincing by most medical authorities.<ref>{{cite journal |journal= N Engl J Med |year=2007 |volume=357 |issue=13 |pages=1278–9 |title= Thimerosal and vaccines—a cautionary tale |author= [[Paul Offit|Offit PA]] |doi=10.1056/NEJMp078187 |pmid=17898096 |url=http://content.nejm.org/cgi/content/full/357/13/1278}}</ref>

==Delivery systems==
There are several new delivery systems in development, which will hopefully make vaccines more efficient to deliver. Possible methods include [[liposome]]s and ''ISCOM''<ref>[http://www.cababstractsplus.org/google/abstract.asp?AcNo=20043185919 Advanced Drug Delivery Reviews, 2004 (Vol. 56) (No. 10) 1367-1382] Morein, B., Hu KeFei, Abusugra, I</ref> (immune stimulating complex).

===Plasmids===
The use of [[plasmid]]s has been validated in preclinical studies as a protective vaccine strategy for cancer and infectious diseases. However, the crossover application into human studies has been met with poor results based on the inability to provide clinically relevant benefit. The overall efficacy of plasmid DNA immunization depends on increasing the plasmid's immunogenicity while also correcting for factors involved in the specific activation of immune effector cells.<ref name= Lowe>{{cite book |chapterurl=http://www.horizonpress.com/pla|author= Lowe et al|year=2008|chapter=Plasmid DNA as Prophylactic and Therapeutic vaccines for Cancer and Infectious Diseases|title=Plasmids: Current Research and Future Trends|publisher=Caister Academic Press|id=[http://www.horizonpress.com/pla ISBN 978-1-904455-35-6]}}</ref>

==Use in nonhumans==
{{Seealso|Influenza vaccine#Flu vaccine for nonhumans|Vaccination of dogs}}

Vaccinations of animals are used both to prevent their contracting diseases and to prevent transmission of disease to humans. Both animals kept as pets and animals raised as livestock are routinely vaccinated. In some instances, wild populations may be vaccinated. This is sometimes accomplished with vaccine-laced food spread in a disease-prone area and has been used to attempt to control [[rabies]] in [[raccoon]]s.

Where rabies occurs, rabies vaccination of dogs may be required by law. Other canine vaccines include [[canine distemper]], [[canine parvovirus]], [[canine hepatitis virus]], [[adenovirus-2]], [[leptospirosis]], [[bordatella]], [[canine parainfluenza virus]], and [[Lyme disease]] among others.


==See also==
==See also==
<div style="-moz-column-count:3; column-count:3;">
*[[Alphabet City]]
*[[List of riots]]
* [[Influenza vaccine]]
*[[Protest]]
* [[Immune system]]
* [[OPV AIDS hypothesis]], a refuted hypothesis that the AIDS pandemic emerged from polio vaccine manufacture.
* [[Immunology]]
* [[Immunization]]
* [[Inoculation]]
* [[Bacterin]]
* [[TA-CD]], a vaccine which negates the effects of [[cocaine]]
* [[Jim (horse)|The Horse Named Jim]]
* [[Virosomes]]
* [[Vaccination]]
* [[List of vaccine topics]]
* [[Reverse vaccinology]]
</div>


==References==
==References==
{{reflist|2}}
{{reflist|2}}

==Further reading==
* {{cite book |author=Patterson, Clayton |title=Captured: A Film & Video History of the Lower East Side |publisher=Seven Stories Press |year=2005 |id=ISBN 1583226745}}
* {{cite book |author=Patterson, Clayton |title=Resistance: A Radical Political and Social History of the Lower East Side |publisher=Seven Stories Press |year=2007 |id=ISBN 1583227458}}


==External links==
==External links==
* {{dmoz|Health/Pharmacy/Drugs_and_Medications/Vaccines_and_Antisera|Vaccines and Antisera}}
*[http://www.nycgovparks.org/sub_your_park/historical_signs/hs_historical_sign.php?id=12589 New York City Parks and Recreation Department entry for Tompkins Square Park].
* {{cite web |title=Immunization |url=http://www.nlm.nih.gov/medlineplus/immunization.html |date=2007-12-27 |accessdate=2008-01-14 |work=MedlinePlus |publisher= U.S. National Library of Medicine}}
*[http://www.upress.umn.edu/sles/Chapter8/ch8-1.html Extract of a book mentioning the riot].
* [http://www.violinet.org/ VIOLIN]: Vaccine Investigation and Online Information Network
*[http://query.nytimes.com/gst/fullpage.html?res=950DEFDE1239F930A35756C0A96F948260 NY Times news report the day after the riot].

{{Vaccines}}
{{Major Drug Groups}}

[[Category:Virology]]
[[Category:Vaccination]]
[[Category:Infectious diseases]]
[[Category:Microbiology]]
[[Category:Immunology]]


{{Link FA|vi}}
[[Category:History of New York City]]
[[ar:تطعيم]]
[[Category:Human rights abuses]]
[[gn:Tasymombiaha]]
[[Category:Riots and civil unrest in the United States]]
[[ca:Vacuna]]
[[Category:New York City Police Department]]
[[cs:Vakcína]]
[[Category:1988 in the United States]]
[[da:Vaccination]]
[[Category:Alleged brutality by the New York City Police Department]]
[[de:Impfstoff]]
[[es:Vacuna]]
[[eo:Vakcino]]
[[fa:واکسن]]
[[fr:Vaccination]]
[[fur:Vacine]]
[[ko:백신]]
[[id:Vaksin]]
[[it:Vaccino]]
[[he:חיסון]]
[[nl:Vaccin]]
[[ja:ワクチン]]
[[no:Vaksine]]
[[nn:Vaksine]]
[[pl:Szczepionka]]
[[pt:Vacina]]
[[ro:Vaccin]]
[[ru:Вакцина]]
[[sk:Očkovanie]]
[[sl:Cepivo]]
[[fi:Rokotus]]
[[te:టీకా]]
[[th:วัคซีน]]
[[vi:Vắc-xin]]
[[uk:Вакцина]]
[[zh:疫苗]]

Revision as of 19:08, 12 October 2008

For other uses, see Vaccine (disambiguation).

A vaccine is a biological preparation which is used to establish or improve immunity to a particular disease.

Vaccines can be prophylactic (e.g. to prevent or ameliorate the effects of a future infection by any natural or "wild" pathogen), or therapeutic (e.g. vaccines against cancer are also being investigated; see cancer vaccine). Vaccines have become one of the most lucrative market segments in the pharmaceutical industry.

The term "vaccine" derives from Edward Jenner's 1796 use of cowpox (Latin variolæ vaccinæ, adapted from the Latin vaccīn-us, from vacca cow), which, when administered to humans, provided them protection against smallpox.

History and outlook

The earliest vaccines were based on the concept of variolation, originating in China, in which a person is deliberately infected with a weak form of smallpox as a form of inoculation. Jenner realized that milkmaids who had contact with cowpox did not get smallpox. The process of distributing and administrating vaccines is thus referred to as "vaccination". Jenner's work was continued by Louis Pasteur and others in the 19th century. Since vaccination against smallpox was much safer than smallpox inoculation, the latter fell into disuse and was eventually banned in England in 1849.

The 19th and 20th centuries saw the introduction of several vaccines developed and introduced for prevention of a variety of infectious diseases. These included ]][[bacterial and viral diseases, but not (to date) any parasitic diseases.

Pediatric vaccines dominate the vaccine market, but the adult vaccine market is expected to grow rapidly in coming years. Leading the way, products such as the HPV vaccine and related cancer prevention vaccines may garner a quarter of the global vaccine market by 2012.[2]


Types

Avian Flu vaccine development by reverse genetics techniques.

Vaccines may be dead or inactivated organisms or purified products derived from them.

There are four types of traditional vaccines:[1]

  • Vaccines containing killed microorganisms - these are previously virulent micro-organisms which have been killed with chemicals or heat. Examples are vaccines against flu, cholera, bubonic plague, and hepatitis A.
  • Vaccines containing live, attenuated virus microorganisms - these are live micro-organisms that have been cultivated under conditions that disable their virulent properties or which use closely-related but less dangerous organisms to produce a broad immune response. They typically provoke more durable immunological responses and are the preferred type for healthy adults. Examples include yellow fever, measles, rubella, and mumps. The live tuberculosis vaccine is not the contagious strain, but a related strain called "BCG"; it is used in the United States very infrequently.
  • Toxoids - these are inactivated toxic compounds in cases where these (rather than the micro-organism itself) cause illness. Examples of toxoid-based vaccines include tetanus and diphtheria. Not all toxoids are for micro-organisms; for example, Crotalis atrox toxoid is used to vaccinate dogs against rattlesnake bites.
  • Subunit - rather than introducing an inactivated or attenuated micro-organism to an immune system (which would constitute a "whole-agent" vaccine), a fragment of it can create an immune response. Characteristic examples include the subunit vaccine against HBV that is composed of only the surface proteins of the virus (produced in yeast) and the virus-like particle (VLP) vaccine against human papillomavirus (HPV) that is composed of the viral major capsid protein.

A number of innovative vaccines are also in development and in use:

  • Conjugate - certain bacteria have polysaccharide outer coats that are poorly immunogenic. By linking these outer coats to proteins (e.g. toxins), the immune system can be led to recognize the polysaccharide as if it were a protein antigen. This approach is used in the Haemophilus influenzae type B vaccine.
  • Recombinant Vector - by combining the physiology of one micro-organism and the DNA of the other, immunity can be created against diseases that have complex infection processes.
  • DNA vaccination - in recent years a new type of vaccine, created from an infectious agent's DNA called DNA vaccination, has been developed. It works by insertion (and expression, triggering immune system recognition) into human or animal cells, of viral or bacterial DNA. Some cells of the immune system that recognize the proteins expressed will mount an attack against these proteins and cells expressing them. Because these cells live for a very long time, if the pathogen that normally expresses these proteins is encountered at a later time, they will be attacked instantly by the immune system. One advantage of DNA vaccines is that they are very easy to produce and store. As of 2006, DNA vaccination is still experimental.

While most vaccines are created using inactivated or attenuated compounds from micro-organisms, synthetic vaccines are composed mainly or wholly of synthetic peptides, carbohydrates or antigens.

Vaccines may be monovalent (also called univalent) or multivalent (also called polyvalent). A monovalent vaccine is designed to immunize against a single antigen or single microorganism.[2] A multivalent or polyvalent vaccine is designed to immunize against two or more strains of the same microorganism, or against two or more microorganisms.[3]

Developing immunity

The immune system recognizes vaccine agents as foreign, destroys them, and 'remembers' them. When the virulent version of an agent comes along the body recognises the protein coat on the virus, and thus is prepared to respond, by (1) neutralizing the target agent before it can enter cells, and (2) by recognizing and destroying infected cells before that agent can multiply to vast numbers.

Vaccines are widely credited with having contributed to the eradication of smallpox, one of the most contagious and deadly diseases known to man. Other diseases such as rubella, polio, measles, mumps, chickenpox, and typhoid are nowhere near as common as they were a hundred years ago. As long as the vast majority of people are vaccinated, it is much more difficult for an outbreak of disease to occur, let alone spread. This effect is called herd immunity. Polio, which is transmitted only between humans, is targeted by an extensive eradication campaign that has seen endemic polio restricted to only parts of four countries.[3] The difficulty of reaching all children as well as cultural misunderstandings, however, have caused the anticipated eradication date to be missed several times.

Schedule

Main article: Vaccination schedule
See also: Vaccination policy

In order to provide best protection, children are recommended to receive vaccinations as soon as their immune systems are sufficiently developed to respond to particular vaccines, with additional 'booster' shots often required to achieve 'full immunity'. This has led to the development of complex vaccination schedules. In the United States, the Advisory Committee on Immunization Practices, which recommends schedule additions for the Center for Disease Control, recommends routine vaccination of children against: hepatitis A, hepatitis B, polio, mumps, measles, rubella, diphtheria, pertussis, tetanus, HiB, chicken pox, rotavirus, influenza, meningococcal disease and pneumonia. The large number of vaccines and boosters recommended (up to 24 injections by age two) has led to problems with achieving full compliance. In order to combat declining compliance rates, various notification systems have been instituted and a number of combination injections are now marketed (e.g., Prevnar and ProQuad vaccines), which provide protection against multiple diseases.

Besides recommendations for infant vaccinations and boosters, many specific vaccines are recommended at other ages or for repeated injections throughout life -- most commonly for measles, tetanus, influenza, and pneumonia. Pregnant women are often screened for continued resistance to rubella. The human papillomavirus vaccine is currently recommended in the U.S. and UK for ages 11–25. Vaccine recommendations for the elderly concentrate on pneumonia and influenza, which are more deadly to that group. In 2006, a vaccine was introduced against shingles, a disease caused by the chicken pox virus, which usually affects the elderly.

In Australia, a massive increase in vaccination rates was observed when the federal government made certain benefits (such as the universal 'Family Allowance' welfare payments for parents of children) dependent upon vaccination compliance. As well, children were not allowed into school unless they were either vaccinated or their parents completed a statutory declaration refusing to immunize them, after discussion with a doctor, and other bureaucracy. (Similar school-entry vaccination regulations have been in place in some parts of Canada for several years.) It became easier and cheaper to vaccinate one's children than not to. When faced with the annoyance, many more casual objectors simply gave in.[citation needed]

Efficacy

Vaccines do not guarantee complete protection from a disease. Sometimes this is because the host's immune system simply doesn't respond adequately or at all. This may be due to a lowered immunity in general (diabetes, steroid use, HIV infection) or because the host's immune system does not have a B cell capable of generating antibodies to that antigen.

Even if the host develops antibodies, the human immune system is not perfect and in any case the immune system might still not be able to defeat the infection.

Adjuvants are typically used to boost immune response. Adjuvants are sometimes called the dirty little secret of vaccines [4] in the scientific community, as not much is known about how adjuvants work. Most often aluminium adjuvants are used, but adjuvants like squalene are also used in some vaccines and more vaccines with squalene and phosphate adjuvants are being tested. The efficacy or performance of the vaccine is dependent on a number of factors:

  • the disease itself (for some diseases vaccination performs better than for other diseases)
  • the strain of vaccine (some vaccinations are for different strains of the disease) [5]
  • whether one kept to the timetable for the vaccinations (see Vaccination schedule)
  • some individuals are 'non-responders' to certain vaccines, meaning that they do not generate antibodies even after being vaccinated correctly
  • other factors such as ethnicity or genetic predisposition

When a vaccinated individual does develop the disease vaccinated against, the disease is likely to be milder than without vaccination.

The following are important considerations in the effectiveness of a vaccination program:[citation needed]

  1. careful modelling to anticipate the impact that an immunisation campaign will have on the epidemiology of the disease in the medium to long term.
  2. ongoing surveillance for the relevant disease following introduction of a new vaccine and
  3. maintaining high immunisation rates, even when a disease has become rare.

In 1958, there were 763,094 cases of measles and 552 deaths in the United States.[4][5] With the help of new vaccines, the number of cases dropped to fewer than 150 per year (median of 56).[5] In early 2008, there were 64 suspected cases of measles. 54 out of 64 infections were acquired outside of the United States, and 63 of 64 either had never been vaccinated against measles, or were uncertain whether they had been vaccinated.[5]

Types of vaccine developments

  • Rational attenuation: Specific modifications or deletions of genes that confer virulence substantially reduces or removes the pathogenicity of the microbe while still allowing an immune response to be generated. This type of rational attenuation can be viewed as creating a "live" attenuated vaccine.
  • Vector-mediated subunit delivery: Introducing a non-infectious, non-pathogenic subunit into a live vector can prompt an immune response without presence of the pathogen. This is called vector-mediated subunit delivery. For example, rabies surface protein gene has been inserted into vaccinia virus.
  • Virus-like particles: Capsid proteins of icosahedral viruses assemble without the presence of a genome. These virus-like particles are antigenically authentic, but non-infectious. This has been used for HPV-16 and HPV-18 vaccines.

Controversy

James Gillray, The Cow-Pock—or—the Wonderful Effects of the New Inoculation! (1802)
Main article: Vaccine controversy

Opposition to vaccination, from a wide array of vaccine critics, has existed since the earliest vaccination campaigns.[6] Disputes have arisen over the morality, ethics, effectiveness, and safety of vaccination. The mainstream medical opinion is that the benefits of preventing suffering and death from serious infectious diseases greatly outweigh the vaccine injury risks of adverse effects following immunization.[7][8] Some vaccination critics say that vaccines are ineffective against disease[9] or that vaccine safety studies are inadequate.[8][9] Some religious groups oppose vaccination as a matter of doctrine,[10] and some political groups oppose mandatory vaccination on the grounds of individual liberty.[6]

Economics of development

One challenge in vaccine development is economic: many of the diseases most demanding a vaccine, including HIV, malaria and tuberculosis, exist principally in poor countries. Pharmaceutical firms and biotechnology companies have little incentive to develop vaccines for these diseases, because there is little profit potential. Even in more affluent countries, financial returns are often minimal, and the financial risks are great.[11]

Most vaccine development to date has relied on 'push' funding by government, universities and non-profit organizations.[citation needed] Many vaccines have been highly cost effective and beneficial for public health.[11] The number of vaccines actually administered has risen dramatically in recent decades. This increase, particularly in the number of different vaccines administered to children before entry into schools, may be due to government mandates and support, rather than economic incentive.[citation needed]

Many researchers and policymakers are calling for a different approach, using 'pull' mechanisms to motivate industry. Mechanisms such as prizes, tax credits, or advance market commitments could ensure a financial return to firms that successfully developed a HIV vaccine. If the policy were well-designed, it might also ensure people have access to a vaccine if and when it is developed.[citation needed]

Intellectual property

Intellectual property can also be viewed as an obstacle to the development of new vaccines. Because of the weak protection offered through the patent of the final product, the protection of the innovation regarding vaccines is often made through the patent of processes used on the development of new vaccines as well as the protection of secrecy.[12]

Preservatives

Many vaccines need preservatives to prevent serious adverse effects such as the Staphylococcus infection that, in one 1928 incident, killed twelve of 21 children inoculated with a diphtheria vaccine that lacked a preservative.[13] Several preservatives are available, including thiomersal, 2-phenoxyethanol, and formaldehyde. Thiomersal is more effective against bacteria, has better shelf life, and improves vaccine stability, potency, and safety, but in the U.S., the European Union, and a few other affluent countries, it is no longer used as a preservative in childhood vaccines, as a precautionary measure due to its mercury content.[14] Controversial claims have been made that thiomersal contributes to autism; scientific evidence support these claims have generally dismissed as unconvincing by most medical authorities.[15]

Delivery systems

There are several new delivery systems in development, which will hopefully make vaccines more efficient to deliver. Possible methods include liposomes and ISCOM[16] (immune stimulating complex).

Plasmids

The use of plasmids has been validated in preclinical studies as a protective vaccine strategy for cancer and infectious diseases. However, the crossover application into human studies has been met with poor results based on the inability to provide clinically relevant benefit. The overall efficacy of plasmid DNA immunization depends on increasing the plasmid's immunogenicity while also correcting for factors involved in the specific activation of immune effector cells.[17]

Use in nonhumans

See also: Influenza vaccine § Flu vaccine for nonhumans, and Vaccination of dogs

Vaccinations of animals are used both to prevent their contracting diseases and to prevent transmission of disease to humans. Both animals kept as pets and animals raised as livestock are routinely vaccinated. In some instances, wild populations may be vaccinated. This is sometimes accomplished with vaccine-laced food spread in a disease-prone area and has been used to attempt to control rabies in raccoons.

Where rabies occurs, rabies vaccination of dogs may be required by law. Other canine vaccines include canine distemper, canine parvovirus, canine hepatitis virus, adenovirus-2, leptospirosis, bordatella, canine parainfluenza virus, and Lyme disease among others.

See also

References

  1. ^ [1]
  2. ^ "Monovalent" at Dorland's Medical Dictionary
  3. ^ Polyvalent vaccine at Dorlands Medical Dictionary
  4. ^ Orenstein WA, Papania MJ, Wharton ME (2004). "Measles elimination in the United States". J. Infect. Dis. 189 Suppl 1: S1–3. PMID 15106120. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
  5. ^ a b c "Measles--United States, January 1-April 25, 2008". MMWR Morb. Mortal. Wkly. Rep. 57 (18): 494–8. 2008. PMID 18463608. {{cite journal}}: Unknown parameter |month= ignored (help)
  6. ^ a b Wolfe R, Sharp L (2002). "Anti-vaccinationists past and present". BMJ. 325 (7361): 430–2. doi:10.1136/bmj.325.7361.430. PMID 12193361.
  7. ^ Bonhoeffer J, Heininger U (2007). "Adverse events following immunization: perception and evidence". Curr Opin Infect Dis. 20 (3): 237–46. doi:10.1097/QCO.0b013e32811ebfb0. PMID 17471032.
  8. ^ a b Demicheli V, Jefferson T, Rivetti A, Price D (2005). "Vaccines for measles, mumps and rubella in children". Cochrane Database Syst Rev. 19 (4). doi:10.1002/14651858.CD004407.pub2. PMID 16235361. {{cite journal}}: Unknown parameter |laydate= ignored (help); Unknown parameter |laysource= ignored (help); Unknown parameter |laysummary= ignored (help)CS1 maint: multiple names: authors list (link)
  9. ^ a b Halvorsen R (2007). The Truth about Vaccines. Gibson Square. ISBN 9781903933923.
  10. ^ White AD (1896). "Theological opposition to inoculation, vaccination, and the use of anæsthetics". A History of the Warfare of Science with Theology in Christendom. New York: Appleton. {{cite book}}: |access-date= requires |url= (help); External link in |chapterurl= (help); Unknown parameter |chapterurl= ignored (|chapter-url= suggested) (help)
  11. ^ a b Goodman, Jesse L. (2005-05-04). "Statement of Jesse L. Goodman, M.D., M.P.H. Director, Center for Biologics, Evaluation and Research Before the Committee on Energy and Commerce United States House of Representatives". Retrieved 2008-06-15. {{cite news}}: Cite has empty unknown parameter: |coauthors= (help)
  12. ^ Hardman Reis T (2006). "The role of intellectual property in the global challenge for immunization". J World Intellect Prop. 9 (4): 413–25. doi:10.1111/j.1422-2213.2006.00284.x.
  13. ^ "Thimerosal in vaccines". Center for Biologics Evaluation and Research, U.S. Food and Drug Administration. 2007-09-06. Retrieved 2007-10-01.
  14. ^ Bigham M, Copes R (2005). "Thiomersal in vaccines: balancing the risk of adverse effects with the risk of vaccine-preventable disease". Drug Saf. 28 (2): 89–101. doi:10.2165/00002018-200528020-00001. PMID 15691220.
  15. ^ Offit PA (2007). "Thimerosal and vaccines—a cautionary tale". N Engl J Med. 357 (13): 1278–9. doi:10.1056/NEJMp078187. PMID 17898096.
  16. ^ Advanced Drug Delivery Reviews, 2004 (Vol. 56) (No. 10) 1367-1382 Morein, B., Hu KeFei, Abusugra, I
  17. ^ Lowe; et al. (2008). "Plasmid DNA as Prophylactic and Therapeutic vaccines for Cancer and Infectious Diseases". Plasmids: Current Research and Future Trends. Caister Academic Press. ISBN 978-1-904455-35-6. {{cite book}}: Explicit use of et al. in: |author= (help); External link in |chapterurl= (help); Unknown parameter |chapterurl= ignored (|chapter-url= suggested) (help)

External links

Template:Link FA

Retrieved from "https://en.wikipedia.org/w/index.php?title=1988_Tompkins_Square_Park_riot&oldid=244825261"