Free vaccines, anti-vaccine parents, and the role of obesity

Vaccines are one of the few medicines that cross all socio-economic and regional divides. They save an estimated 400 million lives per year and prevent disability in a further 750,000 children.

But they’re not without their critics and complications, and 2016 has embodied that tension.

On the one hand, the numbers are good. Global vaccine sales have maintained their upward trend, hitting $29.5 billion, according to Kalorama Information’s new Vaccines 2016 report. That figure represents an increase of $4.8 billion from 2014, driven by growth in all market segments.

The research firm also projected worldwide vaccine sales to increase 6-8 percent in the coming years, through the introduction of new products and the expanded use of existing vaccines and delivery systems.

Behind those number, however, politics and vaccines continue to collide in the U.S., and abroad, while the obesity epidemic further complicates the immunization equation.

Anti-vaccine movement gets a powerful new ally

The United States has retained its position as the largest market for vaccines, with total sales of $10 billion or 34.6 percent of the overall market, Kalorama’s report states.

Despite the numbers, the country remains uneasy about vaccines — a situation that could deteriorate in 2017. President-elect Donald Trump is set to take over the White House, a leader who has on many occasions met with anti-vaccine advocates or touted their message.

 

According to the new report, some 57.6 percent of vaccines worldwide are pediatric. It’s no surprise that many children want to escape a jab in the arm, but American parents are increasingly skeptical about the need for vaccines and the potential risks associated with them.

In August, a paper published in the journal Pediatrics found the number of U.S. pediatricians that had encountered parents refusing vaccines for their children had increased from 74.5 percent in 2006 to 87.0 percent in 2013.

While apathy is a major component, rumors that vaccines can cause autism persist. For Trump, the intense vaccine schedule outlined for U.S. children is of particular concern. Changing these guidelines could be on the President’s agenda in the next few years.

Are current vaccines strong enough?

Running counter to the anti-vaccine argument, ongoing research suggests current vaccines doses and schedules may not be serving obese patients.

The complex interaction of body fat and immunization was one of Kalorama’s top 5 vaccine trends from 2016. The research firm cited a study from Baylor College, which called into question the efficacy of standard 1-inch needles for patients with high body fat.

In a recent study of 22 obese teenagers conducted at Baylor College of Medicine in Texas, researchers found that the standard one-inch injection needle spurred only a weak response to hepatitis B vaccine while a 1.5 inch needle provided a higher antibody count. As longer needles are not routinely used for vaccinations and many healthcare professionals are not aware of the limitations of shorter needles, this presents a potentially significant public health risk due to the likelihood of similar limitations with other vaccines and rising rates of obesity.

Beyond vaccine delivery, obesity has also been shown to complicate the immune response over time. A team lead by Melinda Beck at the University of North Carolina’s Family Medicine Center studied the relationship between body mass index (BMI) and response to the influenza vaccine.

The researchers found individuals with a healthy BMI retained antibodies to the virus one year after vaccination. Their obese counterparts, on the other hand, had very few persist.

“If you’re obese and you’re vaccinated in September, maybe your antibodies have started dropping by the time you see flu in March,” Beck told the UNC publication endeavors. “So maybe you need to be vaccinated closer to when flu is actually circulating. Or maybe you need a stronger vaccine.”

More than two-thirds of Americans are now considered overweight or obese, underscoring the critical need for research in this area.

Doctors Without Borders rejects free vaccines

Far away from these first-world debates, Doctors Without Borders made headlines this year by rejecting 1 million vaccines donated by Pfizer.

In an open letter on the subject, posted Oct. 9, U.S. executive director Jason Cone said such gifts come with many strings attached, including where and when the vaccines can be used. He also argued that the donations help Big Pharma companies dodge the real issue of excessively high pricing. Pfizer and GlaxoSmithKline (GSK) have made billions in recent years maintaining an artificially high price for the vital pneumonia vaccine, Cone stated in his post.

The stand-off seems to have worked. In November, Pfizer announced a new program to reduce the price of its vaccines in emergency situations. It also pledged to donate the first year’s profits from the program to humanitarian organizations.

Photo: baona, Getty Images