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International Director
Bandim Health Project
Copenhagen C, Denmark
Peter Aaby
I am originally trained as a social anthropologist. Since 1978 I have built a large health and demographic surveillance system (HDSS) in Guinea-Bissau. In 1978, under-5 child mortality was 500/1000. Contrary to all expectations, the high case fatality in measles infection (21%) was not due to malnutrition but to the intensity of exposure as secondary case within the family. Intensity of exposure was subsequently shown to explain severity in many childhood infections including pertussis, chickenpox, polio and RSV. We were the first to introduce measles vaccine (MV) in Bissau in 1979. The first MV campaign reduced the overall child mortality level to one-third, an effect not explained by prevention of measles infection. This led to a series of discoveries contradicting the specific-disease-specific-vaccine paradigm. Vaccines affect general resistance/susceptibility to unrelated infections and these non-specific effects (NSEs) are more important for child survival than the specific preventive effects. A new paradigm emphasizing that the immune system is a learning entity, which can be boosted or misdirected is needed. So far, the live vaccines including BCG, measles vaccine, OPV, and vaccinia have been found to have strong beneficial NSEs. Unfortunately, non-live vaccine often misdirect the immune system leading to higher mortality, particularly for girls. This has been found for at least five non-live vaccines including DTP, IPV, HBV, Penta, and RTS,S malaria vaccine. Sequence of vaccinations, sex-differential effects, boosting and maternal priming are very important features of this new immune training paradigm. Pursuing this paradigm can lead to major reductions in child mortality in low-income countries and to health care cost-savings in rich countries.
I do not have any relevant financial / non-financial relationships with any proprietary interests.
Thursday, October 20, 2022
10:30 AM – 11:45 AM US ET
Thursday, October 20, 2022
11:20 AM – 11:45 AM US ET