Vaccine Update for Healthcare Providers

On the Bookshelf

"How the Immune System Works" by Lauren Sompayrac

In recent months, this column has contained reviews of books dedicated to bacteria and viruses. To complement these selections, we now review a book dedicated to explaining how our immune system deals with encounters by these and other aggressors. Published earlier this year in its fourth edition, “How the Immune System Works” by Lauren Sompayrac provides readers with a detailed look at the immune system, both what is known and what is not yet known, in an easy to understand and concise style.

Sompayrac sets up the discussion as a series of lectures for students and employs symbolism that is easily relatable when describing concepts and players of the immune system, such as describing the dendritic cell as the coach of the team and T helper cells as the quarterback.

Following an overview chapter, the lectures progress through details of the immune system related to:

The remaining chapters discuss concepts related to autoimmunity (avoiding it), immunological memory and vaccines before turning to examples in which the immune system fails, such as immunodeficiency and cancer. The book contains 15 lectures.

Resembling a workbook in format and containing only 141 pages, Sompayrac does not skimp on details, discussing cell surface molecules necessary for cell-to-cell interactions, roles of various cytokines, and the concepts of up and down regulation without overwhelming readers.

Those who have always wanted to better understand the immune system or students currently enrolled in immunology courses will appreciate Sompayrac’s efforts to describe this most complex subject in a succinct and easy-to-follow manner.

“How the Immune System Works” is available through Amazon.com and Barnes and Noble Booksellers.

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Vaccines, Sixth Edition

“Vaccines,” the premier text about vaccines edited by Stanley A. Plotkin, Walter A. Orenstein and Paul A. Offit, is now available in the sixth edition. Published by Elsevier Saunders, this new edition has 78 chapters, 1,550 pages and references for more than 20,000 scientific papers. One of the updated features includes access to a searchable online version using a unique activation code provided inside each copy of the book. In addition, each chapter shows only 10-12 of the most pertinent references and directs users to the online version for the complete list; thereby saving incredible numbers of pages and keeping the hard copy version full of facts on each page of this already thick text.

Sections are color-coded for the first time and include:

Of special note, should you find this comprehensive primer in your hands, take a moment to read the foreward by Bill Gates and the preface by Editor in Chief, Stanley A. Plotkin; both of whom speak directly to readers. Bill reminds readers of the importance of work in this field, especially during a time when “irresponsible claims and groundless rumors” are sometimes deemed as credible as facts, and Stanley fondly recalls the birth of this text as he bids readers a heartfelt farewell; this being the final edition in which he will be an editor. As anyone who uses this reference can tell you, we owe Dr. Plotkin a tremendous amount of gratitude for leaving everyone working in the field of vaccines with this exhaustive, non-replaceable resource.

The book is available from Amazon.com and Barnes & Noble.

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The Viral Storm: The Dawn of a New Pandemic Age by Nathan Wolfe

Author Nathan Wolfe is a virus hunter; he has spent his career trying to figure out ways to find the world’s newest viruses before they become a pandemic. Much like vaccines, when he and his colleagues are successful, chances are we don’t know about it.

In The Viral Storm: The Dawn of a New Pandemic Age, Wolfe uses the analogy of a storm to inform readers about the historical and relevant interactions between viruses and the world. Early chapters, grouped in the section “Gathering Clouds,” address how viruses fit into the biological structure and how they move from one species to another. Wolfe discusses hunting and the domestication of animals as historical events that played important roles in allowing microbes, such as viruses, the opportunity to access and adapt to humans.

Part two of the book, “The Tempest” focused on the ability of a microbe to cause a pandemic, defined by Wolfe as an infection that has spread to all continents. Wolfe explained that the stage was set for a pandemic to occur when travel became easier, faster and more frequent, and as modern medicine increasingly saved lives using techniques that provided “bridges” for microbes to cross into other species, such as transfusions, transplants and injections.

In part three, “The Forecast,” Wolfe focused on how modern technologies help us successfully counteract these potential threats. He discussed working with hunters in secluded corners of the world to get blood samples from animals that they find dead or that they kill, and he described how cell phones and GPS technology, even Internet searches, are helping microbe hunters understand what is happening in geographic regions in real-time. He discussed the importance of understanding which microbes are beneficial and how they may be employed to protect us from harmful ones. His final chapter, “The Last Plague,” nicely synthesized how understanding the history and embracing new technologies and ideas may one day allow us to “predict and prevent pandemics.”

The book is available from Amazon.com and Barnes and Noble.

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Your Baby’s Best Shot: Why Vaccines are Safe and Save Lives

Stacy Mintzer Herlihy and E. Allison Hagood’s recently published book, titled “Your Baby’s Best Shot: Why Vaccines are Safe and Save Lives,” is presented as a vaccine primer by parents for parents.

The authors’ heroic efforts cover all of the vaccine topics being discussed these days – vaccine ingredients, autism, too many vaccines, etc., and their voice is that of parents having a conversation on the sidelines or at the park. For example, in reference to websites with bad information they state “In our opinion, some websites that focus on vaccines are, quite honestly, simply awful. Such websites contain not only misleading information but also outright lies. We feel they deserve to be called out. So we’re doing just that. . . .Some of the instructions on these sites . . . can directly endanger your baby’s life if followed. If you choose to read the information on these websites, do so with extreme caution.” (p. 129)

The book is available at amazon.com and Barnes and Noble.com.

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"Bacteria: The Benign, the Bad, and the Beautiful " by Trudy M. Wassenaar

Did you know?

These facts along with introductions to the many types of bacteria with which we co-exist are shared in Trudy M. Wassenaar’s Bacteria: The Benign, the Bad, and the Beautiful. Recently published by Wiley-Blackwell, the goal of this book is to serve as an antidote to the negative press commonly directed at bacteria. While Wassenaar addresses some of the bacteria that pose a threat to human health, much of the book deals with aspects of bacteria that typically receive less attention. Because the book is meant for readers at various educational levels, the first few chapters address classification, reproduction and evolution, motility, and definitions of life. As Wassenaar continues, she gets into many interesting aspects of bacterial biology, including toxins, enzymes, genomics, and antibiotic resistance. Specific chapters related to marine microbiology, bacteria and their role in oil spills, bacteria and art, and extreme life provide descriptions of bacteria in unusual situations.

While the writing could be more succinct in places and offer a bit more clarity, the book provides readers with a nice compendium of what is known about bacteria and the directions research will likely move as we learn more about these creatures that live on us, in us and all around us. Bacteria: The Benign, the Bad, and the Beautiful is available at Amazon.com and Barnes and Noble.

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"If I Could Tell You" by Hannah Brown

Charlotte A. Moser, Assistant Director, Vaccine Education Center at The Children’s Hospital of Philadelphia

In this fictional work by Hannah Brown, four very different families deal with daily life having a child diagnosed with autism:

Although fictional, If I Could Tell You provides life-like characters with all of their imperfections dealing with real life issues related to living with autism. The stories show the breadth of responses to the diagnosis as well as to the approaches to treatment.

My personal preference would have been that no character thought vaccines were the cause of their child’s diagnosis and that mercury poisoning, big pharma motives and chelation therapy weren’t addressed; however, it is a reality that some parents believe this to be true, so I tried to read it with that in mind. Other parents and the therapist didn’t seem to agree with Talia, but no one took a strong vocal stand against her point of view. Talia’s son ended up in a coma as a result of one of his treatments but survived. Talia also recognized in the story that her son’s behavior was not improving with this therapy.

This book is an interesting read for anyone who works with family’s living with autism. It is available from Amazon.com and Barnes and Noble Booksellers.

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The Vaccine Handbook: A Practical Guide for Clinicians

You’ve heard of The Red Book, The Yellow Book, and The Pink Book, but do you know about The Purple Book?

The Purple Book, more formally, The Vaccine Handbook: A Practical Guide for Clinicians, is written by Gary Marshall, MD. In the recently published fourth edition, the book provides clinicians with everything they need to know related to vaccines. The information is presented in two main sections:

The general principles section includes eight chapters addressing topics related to vaccine science, infrastructure, practice and recommendations, safety and schedules. Tables and figures provide excellent visuals, such as:

The diseases and vaccines chapters are organized alphabetically by pathogen, and address the following aspects of the either the disease or the vaccine:

Each chapter also includes a summary table of the vaccines available including information such as type of vaccine, composition, dosing, public and private costs and much more.

The Purple Book packs a ton of information into an easy to carry format that won’t take much room on your desk or book shelf. It will quickly become one of your “go-to” sources when a vaccine question arises. The book is available from amazon.com or directly from the publisher.

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Two true stories provide insights into the lives of some children

Charlotte A. Moser, Assistant Director, Vaccine Education Center at The Children’s Hospital of Philadelphia

Neither book in this review will be found in the medical, or even public health, section of the bookstore, but both provide interesting snapshots into the complex childhoods some of today’s children face and how one person can impact change in those lives. Both “King Peggy” and “An Invisible Thread” are autobiographical in nature, co-authored by the women who affected the change.

King Peggy

“King Peggy,” by Peggielene Bartels and Eleanor Herman, tells the story of Peggielene Bartels, a Washington DC-based secretary at the Ghanaian Embassy who was named first woman king of Otuam, a town of about 7,000 people in Ghana, when her uncle died in 2008. The story follows Peggy through the first two years of her reign providing an inside look at the culture, characters, and living conditions of Otuam. Before she became king, the town had no running water and the children were often sent to get it, some carrying water up to six hours each day. There was no high school and most families couldn’t afford the school fees for the younger grades either. Using her salary as a secretary in the U.S. and collaborating with a nearby church, Peggy puts the needs of her people ahead of her own, bringing about positive change in the lives of all of her townspeople for generations. "King Peggy" is available from amazon.com and barnesandnoble.com.

An Invisible Thread

“An Invisible Thread,” by Laura Schroff and Alex Tresniowski, tells the story of what happened when Laura, a sales executive in New York City, stopped the day that Maurice, a then 11-year-old panhandler, asked her for spare change. Instead of offering her change and running on, she took him for dinner, and, therein, was born an unlikely friendship — and lives changed. Following Maurice provides an interesting snapshot of some of the difficulties faced each day by children living in the shadows of our cities. A quick read, the story reminds us all how simply taking an interest in the lives of those around us and trying to make them better can, in fact, make our own lives richer as well. "An Invisible Thread" is available from amazon.com and barnesandnoble.com.

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"Steve Jobs" and "Uncommon Friends"

Charlotte A. Moser, Assistant Director, Vaccine Education Center at The Children’s Hospital of Philadelphia

Walter Isaacson’s recently published biography, Steve Jobs, and James Newton’s Uncommon Friends, originally published in 1987, both tell the stories of famous businessmen. Newton was friend and business partner with historical giants including Thomas Edison, Henry Ford, Harvey Firestone, Alexis Carrel and Charles Lindbergh. While the personalities of the subjects and the time periods in which they lived differ, the books provided some interesting thematic similarities.

In their own ways, each believed in and practiced the notion “know what your customer needs.” Success wasn’t defined by the bottom line, but rather by the customers’ satisfaction. Steve Jobs learned a lot about running a company from Mike Markkula; and when Markkula penned Apple’s marketing philosophy, one of the main points was that they had to understand the needs of their customers (Isaacson, p. 78). Similarly, Newton points out that Edison’s primary goal was to “invent things the world needed.” (Newton, p. 102). Of course, one of Ford’s more famous quotes aligns with these sentiments as well, “If I had asked people what they wanted, they would have said faster horses.” 

All of these businessmen were described with characteristics that led them to persevere and work with others. At Apple, various mock-ups of new products were made of foam, so Jobs and colleagues could hold them, “play with them,” and work on details to improve the product. When he designed the building space, Jobs did so in such a way that employees had to interact with one another. Lindbergh and Carrel worked together on many versions of a perfusion pump, so that Carrel could study organs outside of the body. Edison held 1,093 patents for his inventions, yet he always talked about the importance of teamwork in his success. In essence, these men were all leaders. They used intuition, trial and error and team building to accomplish what they did.

While each had a unique personality and was driven to achieve his goals, they all took time to think. Ford and Jobs liked to walk while thinking or talking. Edison could be found at the dock, “fishing” even though he rarely baited his hook. Carrel summered on Saint-Gildas, an island in the English Channel.

Each of the men described in these two books changed the way we live today. While there is no one personality or road to success, these men were all innovative, driven and persistent — characteristics worthy of emulation by anyone.

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"Connected: "The Surprising Power of Our Social Networks and How They Shape Our Lives"

Charlotte A. Moser, Assistant Director, Vaccine Education Center at The Children’s Hospital of Philadelphia

 Although not recently published, Connected: The Surprising Power of Our Social Networks and How They Shape Our Lives, by Nicholas A. Christakis and James H. Fowler, provides a thoughtful narrative about the impact of social networks, particularly as we navigate new opportunities to communicate through social media.  

The study of social networks has shown that people are not only influenced by those with whom they directly communicate, but also by people connected to those with whom they communicate, or said another way, you are influenced not only by your friends, but also by your friends’ friends. Influence can take the form of actions, such as voting, but it can also influence health-related behaviors, such as eating (or over-eating) and getting immunized. Although vaccines are a very small part of the book, the authors discuss two studies in which vaccine uptake was influenced by social networks:  

The authors discuss findings related to the spread of anxiety, feelings and diseases throughout networks, and they describe mass psychogenic illness, a situation in which large numbers of people are affected when emotions spread from person to person.

In discussing social media, the authors describe four areas in which the advent of the Internet has changed social network interactions:  

The book concludes with a discussion of how being part of the whole inevitably leads to a loss of individuality, but how a better understanding of our place within networks will ultimately lead to a better understanding of ourselves as individuals.

Connected: The Surprising Power of Our Social Networks and How They Shape Our Lives is available from Amazon.com and Barnes and Noble booksellers.

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"Destiny of the Republic: A Tale of Madness, Medicine and the Murder of a President"

Charlotte A. Moser, Assistant Director, Vaccine Education Center at The Children’s Hospital of Philadelphia

One of the issues associated with vaccine acceptance today is the notion that parents do not recall a time when vaccine-preventable diseases were scary because prevention and treatment were limited. In the 1880s, U.S. President James Garfield was typical of parents from that era, having lost his oldest child to diphtheria and his youngest to pertussis. In Destiny of the Republic: A Tale of Madness, Medicine and the Murder of a President, Candice Millard successfully takes readers back to the time when the limits of medicine were, unfortunately, well understood through experience.

Using the story of James Garfield’s surprising nomination for U.S. President, short term in office, and untimely death, Millard chronicles Garfield’s demise following a gunshot wound that, even then, should not have been fatal.

In the 1880s most U.S. doctors did not support Joseph Lister’s notion surrounding the antiseptic treatment of wounds. Indeed, after Garfield was shot, about 10 physicians examined him on the floor of the railroad station by putting their fingers into the wound and trying to locate the bullet. The story of Garfield’s subsequent care and the self-appointed physician in charge, D. Willard Bliss, provides a rare glimpse into the practice of medicine at that time.

The definition of social responsibility provides another interesting contrast to today. At one point, shortly before Garfield’s death, he wanted to go near the sea. The story details extensive trip preparations including agreements with private homeowners along the way whose homes may have been needed if the President had to stop traveling, workers laying train tracks until dawn for the trip, and permission to go through people’s yards to do so. One woman was quoted saying, “I am willing that you should ruin my house, all I have — if it would help to save him.” (p.226) In the last leg of the trip, the train engine could not get up the hill to the cottage prepared for the President, so hundreds of observers in the crowd pushed the train up the hill.

Millard’s is a quick, easy-to-read account that will leave one reflecting on differences between society and medicine of today as compared to that of the past.

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