AIDS at 35: The Anniversary of the First Report on a Mysterious New Disease

mmwrOn June 5, 1981 — 35 years ago this Sunday — the Centers for Disease Control and Prevention published a report with an inauspicious title: “Pneumocystis Pneumonia — Los Angeles.” Nestled between pieces on dengue and measles, the article in the Morbidity and Mortality Weekly Report briefly described five patients, all young men from Los Angeles with cases of life-threatening pneumonia. While it didn’t immediately grab headlines, its publication represented a turning point in public health: the beginning of the AIDS era.

In another 35 years, will AIDS be a fading memory?

These patients’ pneumonia had been caused by a particular species of fungus, which back then was responsible for fewer than 100 pneumonia cases annually. Young, healthy people weren’t supposed to be vulnerable to this fungal infection, and the fact that men with no known risk factors were suddenly falling victim to it was a huge red flag that something strange was afoot.

The patients shared other characteristics as well, and at that point, scientists could only speculate what, if any, of these traits were associated with the strange new disease. All five patients were “active homosexuals,” were positive for cytomegalovirus (CMV), had yeast infections, ranged in age from 29 to 36, and used inhalant drugs (aka “poppers”). The CDC knew right away that this mysterious cluster of illnesses must have been caused by “a common exposure that predisposes individuals to opportunistic infections” — an observation that, in hindsight, was incredibly accurate, as HIV destroys the immune system and opens its host to normally rare infections. The editors posited that “some aspect of a homosexual lifestyle” might increase risk for this type of pneumonia — perhaps a sexually transmitted disease that somehow caused pneumonia. Continue reading

Gardasil and Mortality

womenVaccination is one of public health’s greatest achievements, but today’s sociopolitical climate promotes unfounded fears. In turn, this fear-mongering has led to outbreaks of otherwise rare infectious diseases, such as measles and whooping cough. Human papillomavirus (HPV) vaccines protect against two HPV strains that cause 70 percent of cervical cancers, which itself is the second-most common type of cancer in women worldwide. Immunization has the potential to eliminate these viral strains, which would save lives and reduce health care costs — but, unfortunately, vaccine horror stories are a dime a dozen on the Internet, and HPV vaccines like Gardasil are popular targets for vaccine opponents.

Of 57 million Gardasil doses given in the United States, 40 confirmed deaths have occurred in recipients. However, these deaths were not caused by vaccination.

There are many claims flying around that Gardasil causes serious side effects, including death. However, claims that Gardasil can lead to death aren’t supported by good evidence. Generally speaking, people who make these accusations obtain their information from a publicly accessible database called the Vaccine Adverse Event Reporting System (VAERS), which collects claims of adverse events from anyone — including health care providers, patients, or family members.

What is an adverse event?

Most people don’t realize that the phrase “adverse event” cannot be used interchangeably with the term “side effect.” An adverse event is something that occurs after a vaccination — such as a headache, seizure, depression, or death. It could happen one second after being injected with a vaccine or more than a year afterward. It could be a coincidence, or it might be caused by vaccination. For example, if two weeks after receiving a flu shot I get a headache, I could legitimately claim it is an “adverse event,” even if my headache had nothing to do with the shot. An adverse event is only called a side effect if it is found to have been caused by vaccination.

What is VAERS?

Despite its occasional misrepresentation in print media, social media, and the blogosphere, VAERS is not a source of information about verified side effects — it is a database of adverse events that have been self-reported by the public. Anyone can submit a report to VAERS — heck, I could claim that the flu shot gave me telekinetic powers in addition to that headache, and it would be recorded in the database. That doesn’t mean that you should worry about coming down with a nasty case of telekinesis after getting a flu shot at the corner drug store. Continue reading