Vaccines, Autism, and “Blue Marble” Health - immune.org.nz Global challenges for... ·...

Vaccines, Autism, and“Blue Marble” HealthPeter Hotez, M.D., Ph.D.

Texas Children’s Hospital EndowedChair in Tropical Pediatrics

Dean, National School of Tropical Medicine at Baylor College of Medicine

US Science Envoy

@PeterHotez

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Houston, Texas

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Global health & disease in the 2020s

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New World Order‐The term "new world order" has been used to refer to any new period of history evidencing a dramatic change in world political thought and the balance of power.

‐Post WWI League of Nations

‐Post WWII United Nations

‐Cold War

‐Current New World Order•Anti-science•Regional Conflicts•Climate Change•US/UK Retreat from Globalization, China’s neo-Silk Road, & Blue Marble Health

https://en.wikipedia.org/wiki/Balance_of_power_in_international_relations

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The Global Burden of Disease 1990-2013

Expanded use of vaccines• 83% reduction in measles deaths• 82% reduction in tetanus deaths• 57% reduction in diphtheria/pertussis deaths• 45% reduction in Hib deaths

Development new vaccines• Pneumococcal disease (36% reduction in deaths)• Rotavirus (63% reduction in deaths)

2.5 million childhood lives saved through these initiatives

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http://www.google.com/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&uact=8&ved=0CAcQjRxqFQoTCLOi4eWz9MYCFQRbkgodaesNcQ&url=http://benjaminstudebaker.com/2015/01/29/its-time-for-the-state-to-put-an-end-to-the-anti-vaccination-movement/&ei=64SyVfOANoS2yQTp1reIBw&bvm=bv.98717601,bs.1,d.cGU&psig=AFQjCNExtIqPu6Gs1JbfyXVN8_jukVKoWQ&ust=1437849095259852

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Personal belief exemptions and Texas

http://www.google.com/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&uact=8&ved=0CAcQjRxqFQoTCM74kKOSiMcCFcMRkgod-VQAog&url=http://www.mysanantonio.com/news/local/article/DSHS-More-than-38-000-Texas-students-opted-out-6064490.php&ei=IN68Vc7oIcOjyAT5qYGQCg&bvm=bv.99261572,d.aWw&psig=AFQjCNEKu34Dsu3eO-tDmmBrAmF834QI5Q&ust=1438527385518438

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• Texas ranks at the bottom of fully immunized children• 45,000 Personal Belief Exemptions in Texas

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Measles outbreak Twin Cities MN

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Nation of Islam and Antivaccine

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Is Vaccine Hesitancy Expanding Nationally?

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State Vaccine Exemptions

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The Neurobiology of Autism

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Larson H et al EBioMedicine 2016 12, 295-301DOI: (10.1016/j.ebiom.2016.08.042)

Globalization of Vaccine Hesitancy

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How the Anti‐Vaxxers are Winning

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New survey findings: ResearchAmerica

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New Vaccines for 21st Century Neglected diseases

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Texas Children’s Hospital Center for Vaccine Development

• Built structure

• Launched Hookworm Program

2000 to

2004

• Expanded Hookworm Program

• SchistoProgram

• Relocated to TMC

2004 to

2011

• Added 7 additional programs

• Expansion of capabilities

2011 to

2015

http://www.google.com/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&uact=8&ved=0CAcQjRw&url=http://www.fiskcorp.com/fisk-houston.htm&ei=MEsEVezuFbWOsQS-loFA&bvm=bv.88198703,d.cWc&psig=AFQjCNG4c63EKgC5NWZW0YkDnPmba5WZqw&ust=1426431144648437

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Rino Rappuoli: Reverse Vaccinology

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Reverse vaccinology as a ‘holy grail’ for complex eukaryotic organisms

‐Large genomes of similar complexity to human genome

‐Inadequacy of bacterial expression systems for eukaryotic antigens

‐Low throughput not high throughput

‐Deficiencies in animal models

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Vaccine TargetingHookworm and Schistosomiasis Co-Infections

A MULTIVALENTVACCINE TARGETING HOOKWORM + SCHISTO

membrane1 2 3 4

C

GC

C C

C

G/A G/A

E/Q

E/Q

G/A

K

G/A F/Y

GC

E/Q

P

W/F/Y

EC‐1

EC‐2

http://www.google.com/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&docid=t0X9HoQ2SL-H0M&tbnid=WAWPfqHdLXJa1M:&ved=0CAUQjRw&url=http://www.nature.com/nrmicro/journal/v8/n11/full/nrmicro2438.html&ei=8WhZUuDbJYv89gSOtICQDQ&bvm=bv.53899372,d.eWU&psig=AFQjCNGNsbYjm4wGUQy21VHjOWrcenZHMg&ust=1381673968995641

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Three Major Drivers of 21st Century NTDs

• Health system collapse

Conflict

• Blue Marble Health

Poverty• Poverty• Conflict

Climate

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BLUE MARBLE HEALTH: The Poor Living Among the Wealthy (G20 + Nigeria)

WHO + GBD 2013• 73-78% Leprosy• 61-78% Chagas• 60-61% Dengue• 57-60% TB• 45-67% VL• 50-52% Helminths

• STH• Schistosomiasis• Lymphatic

Filariasis• Onchocerciasis

G20 + Nigeria = 54% Populationand 86% Global Economy

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US Gulf Coast: America’s Underbelly• NTDs

‐ Toxocariasis 2.2 M

‐ Trichomoniasis 1.4 M

‐ Chagas disease 58,000

‐ WNV 8,365

‐ Typhus 1,762

‐ Leprosy

‐ Dengue, Zika, chik

‐ Cysticercosis

• 21st Century Forces‐Poverty

‐Climate Change

‐Urbanization

‐Human migrations

‐Transportation

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Therapeutic Chagas Disease Vaccine

Increased Ag‐specific IFNγDecreased T. cruzi burdenDecreased Cardiac fibrosis

Experimental Chagas disease vaccine improvesCardiac Echocardiography function

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CONFLICT & POLITICAL DESTABILIZATION:

• Measles/Polio• Leishmaniasis• Schistosomiasis• Brucellosis• MERS CoV• Dengue and RVF• Malaria/TB• Cholera

ISIS-occupied Syria, Iraq, Libya, Yemen

http://www.google.com/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&uact=8&ved=0CAcQjRxqFQoTCM6BzJm2zMgCFQorHgodEhMALg&url=http://muslimvillage.com/2015/04/17/76953/strong-isis-libya/&bvm=bv.105454873,d.dmo&psig=AFQjCNHX6zKAgajhNXrP4LsyyuEVTXLBDA&ust=1445271350088086

http://www.google.com/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&uact=8&ved=0CAcQjRxqFQoTCJH_jdm2zMgCFYYWHgodKosNNQ&url=http://www.iranreview.org/content/Documents/Is-Iraq-Bound-for-the-Same-Destiny-as-Syria-.htm&bvm=bv.105454873,d.dmo&psig=AFQjCNFJCDUuiCW_bf-0ZO6qhOdbNW7vLw&ust=1445271651116350

https://www.google.com/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&uact=8&ved=0CAcQjRxqFQoTCIL0ya-6zMgCFYN1HgodWzkKqg&url=https://markdowe1.wordpress.com/2015/08/09/saudi-arabias-new-tactic-in-yemen-is-a-risky-military-gamble/&psig=AFQjCNE01rrpm83CWTLkC2i9EqqwgI9xAQ&ust=1445272652321896

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Leishmaniasis Vaccine• Bivalent recombinant vaccine

‐ NH36‐ Sandfly antigens: LJM19 LJM143‐ GLA or CpG

https://www.google.com/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&uact=8&ved=0CAcQjRxqFQoTCMrv-4CUiMcCFQUSkgoddCICTg&url=https://www.bcm.edu/people/view/b25405bc-ffed-11e2-be68-080027880ca6&ei=8d-8VYqzL4WkyAT0xIjwBA&bvm=bv.99261572,d.aWw&psig=AFQjCNFunsF9j0WAHFH9ShVBvqabY48OyA&ust=1438527855041204

http://www.google.com/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&uact=8&ved=0CAcQjRxqFQoTCO_H77mZiMcCFY8KkgodXBkOvQ&url=http://nihrecord.nih.gov/newsletters/2010/04_02_2010/milestones.htm&ei=p-W8Va_YEY-VyATcsrjoCw&bvm=bv.99261572,d.aWw&psig=AFQjCNFP16fRwid-0Bab09uO8pQsclHwIw&ust=1438529306640725

http://www.google.com/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&uact=8&ved=0CAcQjRxqFQoTCPuFytGZiMcCFUQNkgodujcAFg&url=http://www.itg.be/internet/colloq2012/theme%204%20-%20adaptation%20of%20pathogens%20to%20invertebrate%20hosts.html&ei=2eW8Vbs1xJrIBLrvgLAB&bvm=bv.99261572,d.aWw&psig=AFQjCNE2BGfWqxG6XX-Gfm1ApKUfEM9jyw&ust=1438529366253888

https://www.bcm.edu/people/view/b15d0272-ffed-11e2-be68-080027880ca6

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Coronaviruses

• 3 groups of coronaviruses. MERS‐CoV is the 6th new type of coronavirus like SARS‐CoV.

• SARS‐CoV and MERS‐CoV are β coronaviruses.

• MERS‐CoV was first identified in 2012, and causes increased cases of infections in humans and camels.

SARS‐CoV

MERS‐CoV

Coronavirus

MERS-CoV

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U.S. Science Envoy Program

http://www.google.com/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&uact=8&ved=0CAcQjRw&url=http://www.chuckgallagher.com/ethical-considerations-state-department/department-of-state-logo/&ei=QyikVNrQNIyMyATrkICgAw&bvm=bv.82001339,d.aWw&psig=AFQjCNHOYBA5_9D18mPX_pwrzldL0kKUrA&ust=1420130731914369

http://www.google.com/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&uact=8&ved=0CAcQjRw&url=http://library.uthscsa.edu/2013/02/white-house-announces-policy-of-open-access-to-results-of-federally-funded-research/&ei=bSikVNn4HZGdyQSz34KYAw&bvm=bv.82001339,d.aWw&psig=AFQjCNG1DLqJlHior79VsQnduQIZyu1eJA&ust=1420130784193308

http://www.google.com/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&uact=8&ved=0CAcQjRw&url=http://www.csee.umbc.edu/2013/02/jobs-summer-internships-at-white-house-ostp/&ei=hSikVPq8HI_4yAS38ILICw&bvm=bv.82001339,d.aWw&psig=AFQjCNG1DLqJlHior79VsQnduQIZyu1eJA&ust=1420130784193308

http://www.google.com/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&uact=8&ved=0CAcQjRw&url=http://www.moroccoworldnews.com/2014/03/124815/a-lot-of-hope-pinned-on-second-moroccan-us-business-development-conference-bouaida/&ei=3yikVN_KLMiVyASQwoCgAw&bvm=bv.82001339,d.aWw&psig=AFQjCNEAljl9UhuMoGvIqozBlg-Ni3OOsg&ust=1420130879767579

http://www.google.com/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&uact=8&ved=0CAcQjRw&url=http://americanbedu.com/2010/08/page/4/&ei=BymkVO-SMsKhyASAkYGgAw&bvm=bv.82001339,d.aWw&psig=AFQjCNEzilj_moeVyxzyYozxl9tMPoUM4Q&ust=1420130938113343

http://www.google.com/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&uact=8&ved=&url=http://www.amchamtunisia.org.tn/us-tunisia-relation-publications&ei=QZKyVcTkL4q4ogSN3Ir4AQ&bvm=bv.98717601,d.cGU&psig=AFQjCNE_FN57PEE3I0pujFjxHoEVECfGcQ&ust=1437852610284778

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