Vaccines have been so successful at preventing deaths from infectious disease that most people don't realize scientists are constantly working to improve them. Researchers like UC Davis' Dean Blumberg, a pediatric infectious- disease specialist, are busy testing new vaccines, looking for ways to maximize the benefits of existing ones and tirelessly working to change public-health policies based on their research.
Blumberg, in fact, plays a crucial role in ensuring the health of Californians, especially children, through research and advocacy related to vaccines.
"Dean Blumberg has an enormous impact on the daily health of the children of California, but you wouldn't know that by talking to him," says ChrisAnna Mink, an infectious-disease specialist working at Harbor UCLA Medical Center.
Despite Blumberg's low profile, state public-health officials rely heavily on his expertise, according to Mink. He is called upon to review legislation, has helped set vaccination requirements for public school attendance and often educates the public whenever concerns arise over vaccine safety.
For instance, last summer, Blumberg testified before the California Assembly Health Committee in support of a bill aimed at increasing pertussis immunization rates among teens to protect them against whooping cough, prevent school-based whooping cough outbreaks and decrease overall transmission of the infection.
"It's a lot of work without a lot of fanfare," says Mink, who has been a collaborator of the UC Davis physician for 20 years.
Under Blumberg's direction, UC Davis has participated in many national multicenter clinical trials aimed at improving the safety and efficacy of vaccines.
"Dr. Blumberg is very involved in determining what is safe and efficacious and at what age vaccines are given to patients," says UC Davis colleague Kevin Tracy, assistant medical director of UC Davis' primary care network. Blumberg takes a hands-on approach to running these studies, taking time to answer questions parents have about vaccines and the trials, he adds.
Recently, Blumberg and Tracy were involved in a clinical study that determined that hepatitis A vaccine was safe and effective for 1-year-olds. Previously, the federal Food and Drug Administration had only approved the vaccine for use in children age 2 years or older.
One-year-olds, who are still in diapers, are at a particularly high risk for the viral disease that spreads through fecal contamination andcauses inflammation of the liver. It was important to find out whether younger children could be protected from the disease.
"We found that the immune response was good, and the vaccine was safe. It is now licensed for 1-year-olds," Blumberg says.
Flu vaccine for babies
In an ongoing study, Blumberg and his colleagues are looking at the safety and efficacy of giving flu shots to children at 2 months of age.
Infants have higher hospitalization rates than elderly adults due to the flu, and they can suffer deadly bouts of pneumonia and encephalitis.
"The results are not final," Blumberg says of the current study, which is so far showing promise. "We are optimistic that the influenza vaccine will be able to protect children when they are most vulnerable."
If it turns out that 2-month-olds do indeed benefit from flu shots, Blumberg will likely be among those involved in the long political process to change public-health policy guidelines and laws. According to Blumberg, it takes several years from the time a vaccine clinical trial is completed until the results are put into clinical practice.
Blumberg's advocacy work also includes a massive effort to move California's vaccination system into the information age. A former chair, Blumberg is now on the executive committee for the Shots for Tots Regional Coalition. The coalition is implementing a computerized, Web-based registry of immunization records on children in all age groups within the seven-county area surrounding and including Sacramento.
"The main problem is that kids don't get the shots they need and then they are vulnerable to disease," Blumberg says.
Conversely, doctors sometimes err on the side of caution and give a child a vaccine he or she has already had. Studies show that computerized systems increase immunization rates up to 30 percent, but they also decrease the number of wasted vaccines given to children with incomplete records, Blumberg says.
Shots for Tots Regional Director Carol Fisher-Stockman is on the front lines of the effort to modernize immunization records, where she sees Blumberg playing a key role locally and at the state level.
"He's a strong advocate within our coalition, within the community and beyond."