Global Health Chronicles

Dr. Walter Orenstein

David J. Sencer CDC Museum, Global Health Chronicles
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0:55 - Background/EIS

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Partial Transcript: To start, would you tell us a little bit about your background before you came to CDC, and how you came to work here in the first place?

Segment Synopsis: Dr. Orenstein describes his education, how he became interested in joining the EIS program, how his first assignment changed his life and how he got involved in polio.

Keywords: A. Langmuir; Aligarh; Atlanta; Berkeley; Bronx; D. Francis; Denver; EIS officer; H. Rubin; Immunization; Important Information Statements; J. L. Conrad; J. Modlin; Los Angeles; P. Brachman; Reyes v. Wyeth; San Francisco; slums; Vaccine Information Statements; W. Foege

Subjects: Advisory Committee on Immunization [ACIP]; Africa; Albert Einstein College of Medicine; Bill and Melinda Gates Foundation; Centers for Disease Control and Prevention [CDC]; City College of New York; Cutter Incident; EIS [Epidemic Intelligence Service]; India; National Vaccine Injury Compensation Program; north central India; pediatric nephrology; Phoenix Labs; polio; Smallpox Eradication Program; Uttar Pradesh; vaccine-associated paralytic polio [VAPP]; West Coast; Wyeth laboratories

GPS: Aligarh, Utter Pradesh, India. Dr. Orenstein’s first EIS assignment where he found the state’s last case of smallpox.
Map Coordinates: 27.8974, 78.0880

13:52 - CDC's Institutional Growth

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Partial Transcript: Can you talk a little bit about how you think polio changed the direction CDC took, or maybe how polio affected CDC and CDC affected polio?

Segment Synopsis: Dr. Orenstein discusses how polio played a major role at CDC, vaccine associated polio, the development of molecular epidemiology, which has helped global polio vaccination campaigns.

Keywords: 317 Immunization Grant; circulating vaccine-derived polioviruses [cVDPVs]; inactivated polio vaccine [IPV]; M. Pallansch; O. Kew; oral polio vaccine [OPV]; vaccine virus; wild virus

Subjects: CDC; Global Polio Eradication Program Initiative [GPEI]; molecular epidemiology; National Vaccine Injury Compensation Program; Nigeria; Pan American Health Organization [PAHO]; Polio; United States; VAPP; Western Hemisphere

24:15 - Work on polio outbreaks/vaccines

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Partial Transcript: Talking about where polio is, before your time there were polio outbreaks in this country; there were outbreaks other places still after you came. Were you ever a participant in any of those outbreaks?

Segment Synopsis: Dr. Orenstein looks back at his first polio outbreak causing him to question the use of the inactivated polio vaccine versus the activated vaccine, after seeing many VAPP [vaccine-associated paralytic polio] cases in person it caused him to advocate for an all-IPV immunization schedule.

Keywords: A. Sabin; cVDPVs; Detroit; Houston; IPV; L. Schonberger; OPV; passive immunization; polio antibodies

Subjects: ACIP; Israel; Lancet Journal; Salk vaccine; Vaccine-associated paralytic polio[VAPP]

31:42 - IPV vs. OPV

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Partial Transcript: Can you talk a little bit about how that process happens—how the decisions are made, which version of the vaccine to use—and then how that’s adopted within the medical community?

Segment Synopsis: Dr. Orenstein discusses the reasoning behind changing from the IPV vs. the OPV and the ACIP finally agreeing to the change in the vaccination schedule, his encounters with Dr. Sabin and Dr. Salk and the coordination and accomplishment of changing to IPV in developing countries.

Keywords: A. Sabin; Aligarh, India; Amish population; cVDPVs; IPV-only schedule; J. Salk; maternal antibody; moral value issue; OPV; OPV-induced immunity; poliovirus; sequential schedule

Subjects: Bill and Melinda Gates Foundation; CDC; Department of Health and Human Services [HHS]; developing world; GPEI; Hispaniola; Immunization Program; Iraq War; measles; PAHO; Rotary International; smallpox; Strategic Advisory Group of Experts on immunization [SAGE]; UNICEF [United Nations International Children’s Emergency Fund]; United States; Uttar Pradesh; Vaccine Injury Compensation Program; VAPP; Western Hemisphere; World Health Assembly; World Health Organization [WHO]

52:59 - Risk in eradication

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Partial Transcript: So does the infrastructure to do what you’ve already done stay in place?

Segment Synopsis: Dr. Orenstein explains the importance of proper laboratory containment, control in potential bioterrorism, and other risks in order to stop reintroduction of poliovirus upon certification of eradication.

Keywords: Aligarh; bioterrorism; essential polio laboratories; laboratory containment; Merca, Somalia; reintroduction; type 2 virus

Subjects: northern India; Somalia; United Kingdom

71:41 - Global partnerships in the eradication of polio

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Partial Transcript: Now, speaking of the collaborative efforts, you’ve talked about some of the collaborative efforts that you had related to polio eradication and other programs.

Segment Synopsis: Dr. Orenstein discusses the different partner’s roles within the Global Polio Eradication Initiative, a history of the initiative and how the program must not stop until eradication has been achieved.

Keywords: endemic; episodic; eradication; independent monitoring board; laboratory resources; SAGE [Strategic Advisory Group of Experts] polio working group; training resources; vaccine-preventable diseases

Subjects: Afghanistan; CDC; Gates Foundation; measles; Nigeria; Pakistan; Rotary International; rubella; STOP [Stop Transmission of Polio]; UNICEF; United States; WHO

78:14 - Anti-Vaccination and the future of vaccines

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Partial Transcript: That’s a very good explanation. What would you say to people who choose not to vaccinate their children?

Segment Synopsis: Dr. Orenstein explains how vaccine-preventable diseases still occur in the United States, why he worries about some reemerging, and how noninfectious diseases could have vaccines in the future.

Keywords: cancer; cervical cancer; hepatitis B vaccine; HIV [human immunodeficiency virus] vaccines; human papillomavirus [HPV] vaccine; liver cancer; malaria vaccines; noninfectious diseases; P. Offit; pediatric infectious diseases; S. Plotkin; terrorism; Vaccines

Subjects: AIDS [acquired immune deficiency syndrome]; Hib; meningitis; Sabin oral polio vaccine; Salk vaccine; Tuberculosis; United States

88:18 - Polio eradication support/Global Immunization

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Partial Transcript: So now I’m aware that we’ve been talking for a while, and I wondered if there were things that you wanted to address that we haven’t covered yet, before we finish up.

Segment Synopsis: In closing, Dr. Orenstein stresses the importance to continue to support polio eradication, because as long as polio is anywhere in the world, there’s a risk of it coming back here.

Keywords: Disneyland; foreign virus; global immunization programs; measles virus; outbreak; polio eradication

Subjects: global immunization programs; global security; polio; U.S. government