Prepare for perhaps major decreases in ED pediatric volumes!
Steve Green, MD / Loma Linda University
Los Angeles Times 9/26/98
TRIAL VACCINE CUTS MENINGITIS AMONG CHILDREN
An experimental vaccine has proved 100% successful in preventing bacterial
meningitis and severe bloodstream infections in children under the age of
5, researchers said Friday in San Diego.
The vaccine against pneumococcal disease proved so effective that
researchers ended a three-year trial prematurely and immunized all of the
38,000 children being studied, a team from the Kaiser Permanente Vaccine
Study Center in Oakland told a meeting of the Interscience Conference on
Antimicrobial Agents and Chemotherapy.
"This is a big win for children," Dr. Jerome Klein of the Boston
University School of Medicine, a expert on pneumococcal disease.
"Meningitis will now bee an uncommon disease."
The vaccine could be widely available as early as next year.
Shinefield and Dr Steven Black enrolled more than 38,000 children in the
study at 23 Kaiser Permanente sites throughout Northern California. Half
got the new vaccine at the ages of 2 months, 4 11 months and 6 months,
while half got a placebo vaccine at similar intervals. Neither patients
nor physicians knew who received the actual vaccine.
By August, 22 children had developed pneumococcal bacteremia or meningitis.
When Shinefield and Black "broke the code" to learn which patients had
received vaccine, they found that all the cases were among the children
receiving a placebo. They immediately halted the trial and began
immunizing all the children.
Four more cases have subsequently been discovered, again among the placebo
group. The vaccine thus proved 100% effective.
"You don't see many vaccine trials where the results are that dramatic,"
But experts cautioned that the vaccine will not prevent all infections.
About 80 strains of the bacterium are known, and the vaccine protects only
against the seven most common strains. "It will have a substantial impact,
but it won't wipe out all pneumococcal disease," Klein said.
The vaccine's manufacturer, Wyeth Lederle Vaccines, said it would apply to
the Food and Drug Administration later this year for permission to market
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