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Week of February 15, 2010

Scholarship & Creative Work

Parent concerns hinder national H1N1 immunization efforts

In the last four months of 2009, nearly 240 children died in the United States from H1N1 flu — more than three times as many child deaths as in a typical non-H1N1 flu season.

Meanwhile, the H1N1 vaccine given to more than 60 million individuals since October has had a track record of safety in children comparable to the widely used and similarly manufactured seasonal flu vaccine.

But many parents’ views of H1N1 illness and vaccine safety may not match these national data. Results from the latest C.S. Mott Children’s Hospital National Poll on Children’s Health indicate that, while 55 percent of parents worry about the H1N1 illness for their children, 66 percent of parents worry about the safety of the H1N1 vaccine.

The poll found that 28 percent of parents worry more about H1N1 vaccine safety than about H1N1 illness. Among these parents, only 10 percent have had their children vaccinated against H1N1.

“Parents’ worries about H1N1 vaccination are natural for any new vaccine,” says Dr. Matthew Davis, director of the poll and associate professor of pediatrics and internal medicine in the Child Health Evaluation and Research Unit at the Medical School. “But in this case, what I have emphasized to my patients is that we are facing a type of flu that is much worse than usual for kids who get sick. The vaccine is made so similarly to seasonal flu vaccine that it’s not really unknown to us. The track record in the first 60 million people looks reassuring to me. So, in weighing the benefits and risks, it seems clear to me for kids that the benefits of H1N1 vaccination outweigh the risks.”

Vaccine development doubles over a decade, study finds

Despite manufacturer concerns about vaccine profitability in the past, new U-M research shows that the number of vaccines in development by manufacturers globally more than doubled to over 350 separate products from 1995-2008.

Over the same period, the number of organizations working on new vaccines also more than doubled, to almost 140 worldwide.

Those are the findings of new U-M research currently available online in the journal Vaccine.

“Vaccines have typically been seen by industry as having limited profit potential, compared with therapeutic drugs,” says Dr. Matthew Davis, associate professor of pediatrics and communicable diseases, and internal medicine, and lead author in the study. “But our study results indicate very strong growth in this industry, suggesting that vaccines are not only rewarding medically — they also are rewarding for the companies that develop them.”

In addition, Davis and his colleagues studied the vaccine development patterns of four major vaccine manufacturers active in the U.S. market during the study period. All four also had drug therapies they were developing at the same time. The researchers also found that three of the four companies markedly increased the share of their total pharmaceutical product portfolio dedicated to vaccine development during that period of time.

Additional U-M authors include Amy Butchart, Dianne Singer, John Wheeler, Angela Pok and Dr. Gary Freed.

State safety spending needs re-evaluation to reduce prison population

State policymakers must evaluate spending priorities involving public safety, including programs that assist former inmates with their re-entry into society, to reduce Michigan’s prison population, a new research at U-M indicates.

Focusing on state programs designed to reduce recidivism rates, such as the Michigan Prisoner ReEntry Initiative (MPRI) and the Justice Reinvestment Initiative, is one way to deter crime and ensure public safety, the research says.

High rates of offenders returning to prison and long prison stays both contribute to Michigan’s incarceration rate, according to a new research brief on prison population and corrections expenditures by the Center for Local, State and Urban Policy, which is located in the Gerald R. Ford School of Public Policy.

The center analyzed prison data from the 1960s to 2008. Michigan made substantial gains in crime reduction beginning in the mid-1980s, going from an index crime rate above that of neighboring states and higher than national index crime rate to a rate that is lower than most neighboring states and is lower than the national rate.

A main component of the current reform is MPRI, which focuses on identifying offenders’ risks and needs while in prison, upon reentry into the community and during the initial parole period. While it is too early to definitively report on the effectiveness of the MPRI, CLOSUP officials say descriptive data suggest it may have positive effects, reducing the number of offenders returning to prison and slowing the growth of the prison population.

Texas county teaches world about stroke through U-M research

The Brain Attack Surveillance in Corpus Christi (BASIC) project, led by U-M, has reached a 10-year mark in its work to expand what the world knows about the severity and treatment of stroke, particularly among Mexican Americans.

The Cardiovascular Center and the School of Public Health work with a 12-member field staff of local residents in Corpus Christi, Texas, where 6,911 strokes have occurred since the project began in 1999.

Strokes occur more commonly in Mexican Americans but researchers have learned the population survives stroke longer than non-Hispanic whites, and at great financial burden. Also, neighborhood factors, including air pollution and the density of fast food restaurants, are associated with an increased risk of stroke.

“The project has enjoyed tremendous collaboration and partnership with the Corpus Christi/Nueces County Health Department, both hospital systems, all local neurologists, the broader physician community, and most importantly the patients who have worked with us to help stroke patients around the world,” says Dr. Lewis Morgenstern, director of the U-M Stroke Program.

The study is still in its midst but has already produced results including:

• Stroke is treated more aggressively in men than women.

• Social factors, such as education, are associated with stroke risk in addition to conventional biologic risk factors like hypertension, diabetes, cigarette smoking and obesity.

• Risk of stroke following a transient ischemic attack, or mini stroke, is high and occurs early.

Findings from BASIC data have been reported at the 2009 International Stroke Conference and published in peer-reviewed journals including the Annals of Neurology.



Jeanne Mackey, senior performance support analyst, Information and Technology Services, on environmental activism: “What I love about the Transition Towns approach to a low-energy future is that it draws on our hopes more than our fears.”


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