Vaccine prevents some flu deaths

With the onset of the flu season, a sudden shortage in the flu vaccine supply is causing concern across the nation, but one Penn professor has developed an alternative solution.

The Pneumovax 23 vaccine developed by Penn School of Medicine professor emeritus Robert Austrian can protect asthma sufferers and HIV carriers from influenza's most common fatal complication -- pneumococcal disease, a prevalent strain of pneumonia.

This fall, one of the nation's two major flu vaccine suppliers shut down its British plant production -- cutting the nation's vaccine supply in half -- when regulators discovered instances of contamination.

U.S. health officials advise that only those most vulnerable to the infection should receive the vaccine.

The flu is commonly transmitted in densely populated areas, such as college campuses and major cities.

"When people die from influenza, the most common cause of death is bacterial pneumonia," said Neil Fishman, director of the Department of Healthcare Epidemiology and Infection Control in the University Health System.

Fishman deemed 88-year-old Austrian a maverick of his day.

According to Fishman, with the advent of the "wonder drug" penicillin in the 1940s, people believed there was no need to worry about pneumococcal disease any longer.

"The disease hadn't gone away at all -- perception was simply altered," Austrian said.

In pursuit of an interest that he developed as a student at Johns Hopkins University, Austrian went to the Kings County Hospital Center in Brooklyn, N.Y. -- the third largest hospital in the nation at the time -- in the 1950s to study the bacterium.

There, he was told that the 3,500-bed hospital only saw around three to four cases of pneumococcal disease annually.

Austrian soon discovered that the hospital was 99 percent off. There were actually around 400 cases of the pneumonia per year that went unrecognized as such, and which were being treated with penicillin as viral diseases.

"If you are destined to die early in infection, killing the organism won't save your life," Austrian said.

Whether penicillin, serum or no treatment was used, the death rate was the same, Austrian said, so it was important to look into prevention.

He received a grant from the National Institutes of Health for vaccine studies and flew to South Africa in 1970 with his wife, after finding that gold miners there had high rates of pneumonia.

He proceeded to divide the 18,000 gold miners into three groups -- 1/3 of which were treated with the pneumococcal vaccine, 1/3 with a spinal meningitis vaccine as a control and the last 1/3 with saltwater.

The effect of the pneumonococcal vaccine on the miners was a 40 percent reduction in the death rate, according to Austrian, without statistical possibility that the reduction happened by chance.

In 1982, the vaccine inoculated against 13 types of the pneumonococcus bacterium. The vaccine now guards against 23 types and is the most complex vaccine available today, Austrian said.

"He is very humble," Fishman said. "He will not do or say anything to indicate his standing in the medical community."

Austrian received the Lasker Award for Clinical Medical Research in 1978, which is equivalent to the "American Nobel Prize," Fishman said.

Austrian currently types pneumococci for the World Health Organization, still using his 1960s microscope. The Medical School has named a room and an auditorium in his honor.

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