Researcher studies why some vaccines may require a booster

ROCHESTER, N.Y. — Do all vaccines boost immunity for the same period of time? And, if not, when are additional “booster shots” needed to keep immunity strong? One researcher is looking for answers, the Rochester General Health System announced Nov. 27.

In this month's issue of Pediatrics, the Journal of the American Academy of Pediatrics, Michael Pichichero, director of the Rochester General Research Institute, studies the medical necessity for occasional booster shots to sustain immunity.

It is well known that a booster shot for tetanus is needed every 10 years to maintain immunity. But, what happens if you fail to get that booster?

"Fortunately, a patient has a window of opportunity to get a booster shot even after getting a dirty wound," Pichichero said. "In this case, the booster shot will take hold before the tetanus infection can establish itself. The problem is that this scenario is not true for all diseases."

In his published study, Pichichero, an authority on vaccines and vaccine-induced memory, discusses the effectiveness of booster vaccinations and disease progression.

"We found that for slow-moving infections like hepatitis, immune memory is activated within plenty of time to prevent the disease after a person has been vaccinated and booster vaccines are not needed," Pichichero said. "Other examples of vaccines that do not appear to require boosters because the pace of disease progression is slow include: polio, measles, mumps, and German measles."

The study found, however, that there are several newer vaccines that may require booster shots to remain effective during a lifetime, including vaccines for diphtheria, all three types of spinal meningitis caused by bacteria, and the new vaccine to prevent cervical cancer.

"Booster shots are needed in these cases because the disease progression is too fast for the memory response to occur in time."

Pichichero said, "Pediatricians and family doctors must begin to anticipate the need to provide booster vaccinations for several of the newer vaccines introduced in recent years.

"And, public health agencies, such as the Centers for Disease Control, must begin to consider the cost of booster shots as they calculate the cost-benefit of vaccines. Up to now, cost calculations for the introduction and public payment of meningitis vaccines and the cervical cancer vaccine have not included the need [and cost] of periodic boosters, nor the consequences of missed boosters with disease development later in life."

Pichichero acknowledged that only continued monitoring will determine whether he is correct in his assessment of the need for booster shots for certain diseases.

"We do not want to face a diphtheria epidemic in the U.S. as occurred in Russia a decade ago due to lack of boostering of adults."

Pichichero has ongoing support from the National Institutes of Health to study the prospects of an ear, sinus and bronchitis vaccine. He has also received financial support for his research from vaccine companies including GlaxoSmithKline, MedImmune, Sanofi Pasteur and Wyeth (now Pfizer).

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