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PBS NewsHour

How long-lasting is promising Ebola vaccine protection?

A nurse holds a syringe containing an experimental Ebola virus vaccine during
         a media visit at the Lausanne University Hospital (CHUV) in Lausanne November 4, 2014. A trial is being conducted with a vaccine
         from GlaxoSmithKline among 120 healthy volunteers with support from the World Health Organization (WHO). The participants
         will be monitored for six months to determine both the safety and efficiency of the vaccine in the fight against the worst
         outbreak of Ebola on record which has killed nearly 5,000 people.   REUTERS/Denis Balibouse (SWITZERLAND  - Tags: HEALTH SCIENCE
         TECHNOLOGY)   - RTR4CSBP

Watch Video | Listen to the Audio

JUDY WOODRUFF: Now a potentially exciting development in the search for an Ebola vaccine, and to Hari Sreenivasan.

HARI SREENIVASAN: Results of a clinical trial conducted in the West African country of Guinea and published today in the medical journal “Lancet” found an experimental vaccine was 75 percent to 100 percent effective in blocking new infections of the Ebola virus.

The trial involved more than 7,000 people, over 3,500 of whom were vaccinated. Guinea is one of three West African countries that marked the epicenter of the 2014 Ebola outbreak that killed more than 10,000 people.

For more on efforts to create a vaccine and on this trial, I am joined by Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases at the National Institutes of Health.

So, you have got — there are several different companies and people working on vaccines, including a member of your team, but today we hear words like game-changer, you know, these are significant results. Why was this so important?

DR. ANTHONY FAUCI, National Institutes of Health: Well, it’s significant because of the outcome of the trial. It showed rather impressive results.

Now, it was done under very difficult circumstances, so that’s really very important. It was done right during the intensity of the outbreak itself. And the data that have been released today show that the results are really quite favorable. There is still a lot of work to be done to determine, in fact, if this protection against Ebola is durable, mainly that it can last for several months, because we certainly would like to have this available for future outbreaks.

And, inevitably, there will be future outbreaks of Ebola. So this is an important step in our armamentarium of preventing Ebola infection, in addition to the public health measures that you do to prevent infection.

HARI SREENIVASAN: But what did they do? How did they figure out that this is effective?

DR. ANTHONY FAUCI: Well, it was a very interesting design to the study.

It’s called a ring vaccination study, ring meaning you create a ring around an index case of when someone gets infected, and you vaccinate the contacts of that person and the contacts of the contacts. But the thing about the ring study is that it was randomized, so when they identified a case of Ebola, they had two rings, one in which got vaccinated immediately, and one which got vaccinated 21 days afterward.

And then they compared the number of infections in those who were vaccinated immediately vs. those who had a delay of 21 days, and the results were rather impressive, because the number of Ebola infections in the people who were vaccinated immediately was zero, and the number of infections for those who had vaccination on a delayed basis was 17.

Now, relatively speaking, this is an interim analysis of results, but it’s still rather impressive. Now we’re going to have to look at the details of the data to really delve into what it means. But having said that, it’s important that the results came out this way.

HARI SREENIVASAN: This is — you alluded to this earlier. This is in the middle of an epidemic. This isn’t our kind of definition of a gold standard of a clinical trial, where you give some people medicine and some people a placebo, because I would imagine it’s almost unethical to not give someone a medication when you see people dying within days of having the virus.

DR. ANTHONY FAUCI: Well, I wouldn’t say it’s unethical. But it’s difficult to do in situations like that.

But if you don’t know what works, and you do a controlled trial, then you get informed consent about how you’re going to do the trial, and then it really is quite ethical. So — but I think that this design was an interesting, novel design. It’s fashioned after the design of how we approached smallpox and the elimination of smallpox.

It was a creative design that was done under difficult circumstances.

HARI SREENIVASAN: When people think of vaccines, they also think of things that actually have the virus in it. Did this vaccine have Ebola in it?

DR. ANTHONY FAUCI: No, it didn’t. It had a protein of Ebola.

So let me explain what it is. A virus was used called vesicular stomatitis virus, which is a virus that infects animals. It rarely infects humans. And what the virus was is, you took one gene of Ebola and inserted it into this other virus, and then injected this other virus into the vaccine recipients.

Once it got in them, it started making the Ebola protein, so none of the individuals got the Ebola virus itself. They got the protein of Ebola that was given to them through this vector or this carrier virus.

HARI SREENIVASAN: All right, Dr. Anthony Fauci from the National Institutes of Health, thanks so much for joining us.

DR. ANTHONY FAUCI: Good to be with you.

The post How long-lasting is promising Ebola vaccine protection? appeared first on PBS NewsHour.

First-ever Ebola vaccine shows ‘promise’ — now what?

The World Health Organization ran clinical trials for an Ebola virus vaccine in Guinea. The storage devices shown here
         use jet fuel to keep the vaccines at a temperature of minus 60 degrees Celsius. Photo by S. Hawkey/WHO

The World Health Organization ran clinical trials for an Ebola virus vaccine in Guinea. The storage devices shown here use jet fuel to keep the vaccines at a temperature of minus 60 degrees Celsius. Photo by S. Hawkey/WHO

A vaccine for the Ebola virus – the first of its kind in the disease’s 40-year recorded history – shows promise in trials in Guinea, according to a report released Friday in the medical journal Lancet.

“It could be a game-changer, because previously there was nothing against Ebola,” Dr. Marie-Paule Kieny, assistant director-general for health systems and innovation at the World Health Organization, told reporters in Geneva. It’s “promising” but results still need to be confirmed by the scientific community, she said.

Doctors Without Borders, which helped run the trials in Guinea, called it a “breakthrough.”

“Too many people have been dying from this extremely deadly disease, and it has been very frustrating for healthcare workers to feel so powerless against it. More data is needed to tell us how efficacious this preventive tool actually is, but this is a unique breakthrough,” the group’s Medical Director Bertrand Draguez said in a statement.

An all-out search for a vaccine was launched after a widespread Ebola outbreak hit West Africa. The disease, which surged in the spring of 2014 primarily in Guinea, Liberia and Sierra Leone, has infected about 27,800 people and killed 11,300, according to the World Health Organization’s latest figures.

The new vaccine, called VSV-EBOV, was first discovered by the public health agency of Canada. Drug manufacturer Merck has acquired the rights to develop it.

In trials that started in Guinea in March 2015, the vaccine was tested in “rings” of people in contact with those infected with Ebola, Kieny said.

Some rings of people were vaccinated immediately. Other rings of contacts were vaccinated three weeks later, and the results of both groups were compared.

In the rings that were vaccinated immediately, none of the 2,014 people in the trial developed the disease after 10 days of being vaccinated.

Of the 2,380 people in the control group — those who had the delayed vaccine — 16 developed Ebola.

The vaccine appears to be so effective that WHO is going to stop delaying the vaccinations, as it was doing in the control groups, and will start vaccinating children and young adults in light of the new data, Kieny said.

The vaccine still needs to be registered, which will take a few weeks or months, but the hope is the vaccine will be stockpiled and ready to use the next time there is an Ebola outbreak, she said. “Not if, when, there will be a new outbreak, because there is no doubt there will be new outbreaks.”

Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases at the National Institutes of Health, describes the significance of the findings on Friday’s PBS NewsHour. You can watch the show on our Ustream channel at 6 p.m. ET  or check your local listings.

The post First-ever Ebola vaccine shows ‘promise’ — now what? appeared first on PBS NewsHour.

Quiz: How much do you know about long-term care at hospitals?

Yoga is for any
         age

Odds are, you have been to a hospital at some point in your life. Did you know, though, that many hospitals do more than just care for very ill patients? We looked at some examples in the Washington area, offered in this report from Kaiser Health News, of how hospitals offer special services for seniors. Take this quiz to see how much you really know about the role hospitals can play in long-term care.

The post Quiz: How much do you know about long-term care at hospitals? appeared first on PBS NewsHour.

Why the anti-HIV pill is a hard sell to the Latino community

Louis Arevalo holds his Truvada pills. The drug Truvada, used to halt HIV infection, has been shown to be over 90 percent
         effective when used correctly. Photo by Heidi de Marco/KHN

Louis Arevalo holds his Truvada pills. The drug Truvada, used to halt HIV infection, has been shown to be over 90 percent effective when used correctly. Photo by Heidi de Marco/KHN

LOS ANGELES – Late on a Friday night at The New Jalisco Bar downtown, a drag show featuring dancers dressed in sequined leotards and feathered headdresses had drawn a crowd — most of them gay Latino men.

Inside the bar and out, three health workers chatted with customers, casually asking questions: Do you know about the HIV prevention pill? Would you consider taking it? A few men said they had never heard of it. Others simply said it wasn’t for them.

“It hasn’t really hit the Latino community yet,” Jesse Hinostroza, an HIV prevention specialist with AltaMed health clinics, said while sitting at a table with a bowl of condoms and a stack of bilingual pamphlets about the pill. “They aren’t educated about it.”

In California, New York, Texas and elsewhere, health workers are trying to get more high-risk Latino men to use the drug, Truvada. The medication, which is used for “Pre-Exposure Prophylaxis” or PrEP, was approved by the FDA in 2012 for HIV prevention and has been shown to be more than 90 percent effective when used correctly. But health workers are encountering barriers among many Latinos.

Among them are a lack of knowledge about the drug and the stigma attached to sleeping with men or perceived promiscuity. Many Latinos also have concerns about costs and side effects.

AltaMed is conducting HIV prevention outreach at several Latino gay bars in Los Angeles area. Photo by Heidi de Marco/KHN

AltaMed is conducting HIV prevention outreach at several Latino gay bars in Los Angeles area. Photo by Heidi de Marco/KHN


“Even for people who have heard about it, that makes them reluctant to use or hesitant to even inquire about it,” said Phillip Schnarrs, assistant professor of health promotion at the University of Texas at San Antonio and research director for the Austin PrEP Access Project.

Schnarrs, who is conducting a study with gay and bisexual Latino men in Texas, said 58 percent of those surveyed see themselves as good candidates for PrEP, compared to 82 percent of non-Hispanic whites, according to preliminary data.

In an ongoing study of 20 Latino gay couples in New York City, 37 of the 40 people had never heard about PrEP when interviewed last year, said Omar Martinez, assistant professor of social work at the Temple University College of Public Health.

Martinez said doctors and health workers need to focus on reaching young minority men at highest risk of getting HIV and transmitting it to others, including those who don’t regularly use condoms. “We need to do something,” he said. “And PrEP may be the solution.”

Latinos are disproportionately affected by HIV. They make up about 21 percent of new infections nationally, though they represented about 17 percent of the population, according to the U.S. Centers for Disease Control and Prevention. Latinos are also more likely than non-Hispanic whites and blacks to get diagnosed later in the course of their illness, raising the risks to their health and the likelihood of transmission to others.

At the same time, Latinos are less likely than non-Hispanic whites to be insured or have a regular doctor, although the Affordable Care Act has helped reduce that gap.

In California, health workers are trying to get more high-risk Latino men to use the drug, Truvada. AltaMed Health Services
         offered free HIV tests at The New Jalisco Bar in downtown Los Angeles on July 10, 2015. Photos by Heidi de Marco/KHN

In California, health workers are trying to get more high-risk Latino men to use the drug, Truvada. AltaMed Health Services offered free HIV tests at The New Jalisco Bar in downtown Los Angeles on July 10, 2015. Photos by Heidi de Marco/KHN


Truvada can cost up to $1,300 a month. Most insurance companies and Medicaid programs are covering at least part of that, and many local governments are also covering the pill for uninsured residents. But the high sticker price can dampen interest among patients.

Truvada, which blocks the virus from spreading in the body, is helping to significantly reduce new infections, said Robert Grant, a professor at UC San Francisco School of Medicine who leads research on PrEP’s effectiveness.

But the pill does not protect against other sexually transmitted diseases, requires daily use and can cause side effects in some patients, including kidney problems.

“It is a very valuable option, but it is only one option,” Grant said. “Condoms are still very important part of a sexual health strategy.”

As customers at the New Jalisco Bar danced to traditional Mexican music beneath a disco ball and rainbow lights, Jaime Cardenas conducted HIV tests in a mobile unit parked in front. Anyone who tested on the spot received a free drink coupon, courtesy of AltaMed and the bar.

One of the first to agree was Erik Quezada, a counselor at a Los Angeles high school.

Cardenas drew a few drops of blood from Erik Quezada’s finger for the rapid test. Within minutes, Cardenas gave him the good news: He didn’t have HIV. Cardenas quickly followed up with information about the HIV prevention pill.

“One way you can prevent yourself from acquiring HIV is by taking PrEP,” Cardenas said, offering to take down Quezada’s number so the clinic could call him later.

Quezada, 35, responded that he had heard it was like the birth control pill for gay people. He agreed to be contacted but quickly added, “I don’t know I would ever sign up for it.”

Erik Quezada, 35, says he has heard Truvada is like the birth-control pill for gay people. Quezada, a counselor at a
         Los Angeles high school, says he’s not sure he would sign up for it. Photo by Heidi de Marco/KHN

Erik Quezada, 35, says he has heard Truvada is like the birth-control pill for gay people. Quezada, a counselor at a Los Angeles high school, says he’s not sure he would sign up for it. Photo by Heidi de Marco/KHN


Others were even less interested. Jose Arriola, 25, a self-described “diva,” said he didn’t want to take any medication. “It’s better to use condoms,” he said, sitting by his boyfriend at the bar.

A short video produced by AltaMed played between acts. The video featured different Latino men getting dressed: a cowboy for a night out, a day laborer for work, a buff young man for the gym. Each took the HIV-prevention pill as part of their routine. At the end of each segment, one word popped up on the screen: listo, or ready.

“We are really trying to project the message that taking PrEP can be a normal part of your everyday life,” said Dr. Scott Kim, medical director of HIV Services for AltaMed, which runs more than 40 health clinics in Southern California.

That, he hopes, will reduce stigma. Kim said health workers need to be more creative in places like East Los Angeles, where many gay and bisexual Latinos are still in the closet and aren’t getting information through traditional health-care sources. Talking about PrEP at a doctor’s office may not be as effective as doing so on social media, by text message or in a bar, he said. “There are a lot of social obstacles and challenges we have to negotiate here because it’s harder to be out,” Kim said.

AltaMed’s efforts are being paid for by Gilead, the pharmaceutical company that makes Truvada. The goal of its $80,000 grant is to help 100 high-risk gay Latino men throughout Los Angeles County get prescriptions for PrEP. The grant pays for the outreach but does not cover the cost of the medication.

Since the project began late last month, about half a dozen patients have received prescriptions. Hinostroza of AltaMed said there is more interest and more knowledge in gay-friendly Hollywood and West Hollywood. “But for East Los Angeles, where we are, it’s a struggle,” she said.

Louis Arevalo, 27, is a college student and AltaMed patient who lives in Los Angeles. He said he decided to go on the medication last month after getting scared when a condom broke. He said he uses condoms regularly and gets HIV-tested every three months, but the medication is “an extra layer of protection.”

“I’m not as anxious anymore,” he said.

But Arevalo said he understands the stigma that might prevent others from taking the drug. For years, he said, he has hidden his boyfriends from his mother, an immigrant from El Salvador. Arevalo said her church pastor repeatedly has said that homosexuality is a sin. “It’s just part of the culture, and it’s the religion,” he said.

Louis Arevalo, 27, says he decided to go on the medication last month after getting scared when a condom broke. The college
         student from Los Angeles says he uses the pill as an extra layer of protection. Photo by Heidi de Marco/KHN

Louis Arevalo, 27, says he decided to go on the medication last month after getting scared when a condom broke. The college student from Los Angeles says he uses the pill as an extra layer of protection. Photo by Heidi de Marco/KHN


AltaMed’s efforts are just one part of a larger effort to get the word out about Truvada. The nonprofit Latino Commission on AIDS, based in New York, also recently started a campaign in five cities — Long Beach, Calif.; New York City; Chicago; Miami; and San Juan, Puerto Rico.

Gustavo Morales, the commission’s director of access to care services, said now is the time to educate people about PrEP — lest too many people form negative opinions about it and health workers become “like salmon swimming against the current.”

Morales said patients aren’t the only ones who need more information. When he decided to go on PrEP late last year, he went to two different doctors who didn’t know about Truvada. A third asked him why he wanted to poison himself. Finally, he got a prescription from an HIV specialist.

“I was definitely disappointed,” said Morales. “There is a lot of work that still has to be done.”

Kaiser Health News is an editorially independent program of the Henry J. Kaiser Family Foundation, a nonprofit, nonpartisan health policy research and communication organization not affiliated with Kaiser Permanente. Jay Hancock contributed to this report. Blue Shield of California Foundation helps fund KHN coverage in California.

The post Why the anti-HIV pill is a hard sell to the Latino community appeared first on PBS NewsHour.