Sexually transmitted diseases, vaccines

Stanbeny, L,R. and D. Bemsiein Sexually Transmitted Diseases Vaccines, Prevention and Control, Academic Press, Inc., San Diego, CA, 2000. 

Human papillomavirus (HPV) is the causative agent of virtually all cases of cervical cancer and one of the most common of the sexually transmitted diseases. Cervical cancer remains a main cause of cancer-related death in many developing countries. Current vaccines are too expensive... 

Medaglini, D., et al. 1997. Commensal bacteria as vectors for mucosal vaccines against sexually transmitted diseases Vaginal colonization with recombinant streptococci induces local and systemic antibodies in mice. Vaccine 15 1330. 

Pulmonary delivery could also be used for delivery of vaccines. In the United States alone, children endure as many as 14 vaccine injections by age 16 and that number is climbing as new research makes more vaccines available. The cost of a single injection can quadruple if the costs of equipment and personnel are included. Furthermore, fear of needles reduces compliance, thus the potential for an increased market share in this area. Inhaled vaccines may be used to prevent influenza, pneumonia, tuberculosis, measles, cytomegalovirus, asthma, and mucosal-entry diseases such as sexually transmitted diseases including HIV. 

Jacobs RJ, Meyerhoff AS. Cost-effectiveness of hepatitis A/B vaccine versus hepatitis B vaccine in public sexually transmitted disease clinics. Sex Transm Dis 2003 30 859-865. 

Little or no federal funding is provided to state and local health departments to support the surveillance of general communicable diseases. The ability of the states to support infectious disease surveillance has declined in recent years. A 1993 survey indicated that 12 states had no professional position dedicated to surveillance of foodbome and waterborne diseases (Osterholm et al., 1996). Although most states do have some infectious disease surveillance capacity, it is most often supported by categorical (i.e., disease-specific) funds, for example, Acquired Immune Deficiency Syndrome, vaccine-preventable diseases, sexually transmitted diseases. These funds generally cannot be used to support noncategorical communicable disease activities. 

Hepatitis B virus infects the liver and causes progressive liver disease and ultimately liver cancer. There are about 250 million sufferers worldwide. Unlike hepatitis A, which can be contracted from contaminated food, hepatitis B is predominantly maternally or sexually transmitted or is transmitted by intravenous dmg use. Infection can also arise from contact with physiological fluids and people working with these materials, e.g. in biochemistry lahs, would he advised to receive vaccination against it Hie first hepatitis B vaccines based on Dane partides were derived from plasma from human carriers of the disease, hut supply was limited hy the availability of such plasma. In addition, extensive processing of the material extracted from plasma was necessary to ensure its non-infectivity. From the point of view of patients, there was a rductance to accept a vaccine derived from human plasma. The hiotedmologicaUy prcxluced hepatitis B coat protein is now the most commonly used vaccine. 

The ability to assemble self-adjuvanting immunogens obviates the need for emulsification in traditional and often harmful oil based adjuvants and also allows different delivery routes to be accessed. The PamSCys peptide was equally effective when delivered by the intranasal route as when delivered parenterally (Fig.6). Furthermore, the PamSCys-peptide elicited IgA antibody forming cells in the lung and draining lymph nodes following intra-nasal administration. Clearly the ability to induce IgA has ramifications for vaccines that are required to induce mucosal immune responses such as those to prevent respiratory diseases as well as HIV and other sexually transmitted pathogens. The ability to deliver vaccines... 

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