The Great Vaccine Debate

As a healthcare professional, the issue of childhood vaccinations is an important issue to me.

In the past decade or so, childhood vaccinations have come under fire from a small group of people, parents, mommy blogs, some alternative healthcare providers, and as of late, by President Trump. Today, I want to break down some of the topics involved with vaccines and discuss what exactly is at stake.

What are vaccines, and how do they work?

Vaccines come in several different forms, and each form works in the body differently. Generally, the vaccines have proteins from a killed, an inactivated, or a weakened live strain of a virus and (sometimes) bacteria, which normally causes significant disease in the general population. These proteins are suspended in a solution with some preservatives to prevent contamination, stabilizers to keep it potent during transport and storage, and adjuvants to help stimulate a stronger immune response.

When injected into the body, these proteins, or antigens, are recognized by the body’s immune system, which begins to form immunoglobulins against that specific antigen. It takes the body several days—up to a couple of weeks—to build up a response and create antibodies that recognize the antigens. The antibodies then signal other cells in the body to begin mounting a response against a certain pathogen. This is why a flu shot doesn’t immediately provide protection against the flu but, instead, takes a couple weeks to become effective. If your body has never come in contact with one of the antigens in a bacteria or a virus, there is no way for it to immediately mount up a good fight against that pathogen.

At times, I find it easier to understand by seeing this happen. TED Ed has made a great 4 minute video explaining this process, so if you are interested, see the link below.

How many pathogens are covered with vaccines?

Currently, there are approximately over 30 different individual viruses and bacteria that are covered by a vaccine with several others currently in research and development. There is no need to have every single pathogen covered by a vaccine because we have antibiotics to help fight against most of the harmful bacteria, and some viruses are not harmful to the health and wellbeing of humans.

Some of the most common pathogens addressed by vaccines include organisms that cause influenza, meningitis, hepatitis, chickenpox, and pneumonia. There are many others, but for the sake of time and space, I only chose to mention a few.

Are vaccines effective?

Vaccines have reduced or nearly eliminated many of the bad infectious diseases of the twentieth century. Individuals with polio are no longer seen on the streets because people were inoculated with the polio vaccine, which enabled their immune system to fight off the virus. Likewise, except in some rare locations, it is extremely uncommon to find measles. Such areas of exception are where one might find small sects of people who have chosen not to vaccinate their children, and outbreaks are occurring there currently. The chart below shows the number of people who suffered from a disease before the vaccine was invented as compared to today.

Why do I have to get the flu shot every year?

The influenza virus is different than many of the other viruses and bacteria because every year, it undergoes what is called “antigenic drift.” There are very small mutations, or changes, that occur often in the influenza virus that alter the makeup of the antigens; therefore, the flu shot is not effective from one year to the next. This mutation process also makes it difficult to predict which strain of the flu will be present each year in the U.S. Scientists have to analyze the flu seasons from other countries to help them make an educated guess as to which strain might show up here during our flu season, which runs from early fall to spring. Some years, they guess correctly, and the flu shot is very effective against the virus. Other years, the strain that is most common in the U.S. is a different strain than what was covered in the flu shot, and it is, therefore, less effective.

Think of the antigenic drift process by envisioning a boat floating in the ocean. The boat has no sails or motor, but it will slowly drift to a different position over time. The influenza virus acts like that boat, slowly changing, in no particular direction. Imagine trying to pinpoint the exact position of that boat on any given day. This simple analogy provides a better idea of what it is like to match the flu virus strain to the flu shot.

Are vaccines safe?

Vaccines are generally regarded as safe for the majority of Americans. Typically, vaccines are some of the safest medical products available, but, although small, they do carry some risks. The most common side effects for most vaccines include soreness around injection site, mild fever, fatigue, muscle/joint pain, and headache. These side effects are similar to what you would experience at the beginning of an illness, as the body begins to try and fight off the pathogen.

There is a chance that more serious side effects could occur, many of which are related to other pre-existing conditions or illnesses. For example, many of the vaccinations are grown in a medium with egg proteins to help grown the antigens. An individual who is allergic to eggs should not receive those particular vaccinations because of the allergy to one of the components. However, sometimes, a patient might not know he/she is allergic to eggs until after the vaccination is administered, so they could have a more serious reaction than some soreness or fever.

Generally speaking, the more serious side effects are very rare, and most are still manageable with medical interventions.

Do vaccines cause autism?

In a word: no. There is no scientific proof that vaccines cause autism. In fact, as the awareness and understanding of autism’s pathological process grows, professionals can see more and more evidence at an earlier time in a child’s growth that signals the development of autism.

The popular belief that the MMR (measles, mumps, and rubella) vaccine caused autism was started in the early 90’s by a British doctor, Andrew Wakefield. He published an article in The Lancet linking the MMR vaccine to the development of autism. Soon after, it was discovered that his research was highly flawed and fraudulent, so it was retracted. This article, however, has done irreparable harm to the vaccine reputation that continues to stick with society today.

The most common signs of autism begin to show up around 18-24 months of age and expand rapidly after 24 months. This was and has been one of the most common rallying cries for the theory that the MMR vaccine causes autism—the first MMR dose is given at 24 months. Nonetheless, correlation does not equal causation. Recent studies have shown that autism characteristics and changes can be seen as early as 6 months by professionals using advanced imaging and techniques. These scientific advances almost completely eliminate the idea that the MMR vaccine given at 24 months would cause autism that is present at or before 6 months of age.

There is much more research and understanding needed concerning the process and pathology of autism, but the scientific evidence is overwhelmingly abundant to proceed with the notion that vaccines do NOT cause autism.

Why do I need to get vaccinated? I’m OK with taking the risk.

Disease prevention efforts rely on the concept of herd immunity, or community immunity. The concept is that if a certain percentage of the population is immune to a particular disease, then those who are not immune or cannot be immune will not have to worry about contracting that particular disease.

There are a number of people who, for medical reasons, cannot receive the vaccination. Some may have an autoimmune disease; some may have an immune system that is incapable of mounting a fight against a pathogen; or some could be allergic to contents of a vaccine. There are many different reasons that one individual cannot tolerate a vaccine, but herd immunity helps to protect that particular individual from contracting a potentially deadly disease.

While a member of society, in particular, might have a health immune system that could successfully fight off a disease, that person could be a carrier of the pathogen and could be able to transmit it to someone else. A neighbor’s child might have a disease like leukemia or SCID (Severe Combined Immunodeficiency) and cannot get vaccinations because the child’s immune system will not mount any type of an immune response. In order to protect people like this, the vaccination rates in the U.S. need to be somewhere between 80-95% of the population.

I got the flu shot, and it gave me the flu.

I have heard this myth often. The answer is always, no, the vaccine did not cause the flu. Every flu shot is made up of proteins from the flu virus, but it is not the actual virus. The virus was killed before it was used to create the antigens contained in the flu shot. Therefore, when one receives the flu shot and subsequently gets sick with the flu, it is because of two possible reasons:

  1. The flu virus was contracted before or concurrent with the timing of the flu shot, and flu symptom became present before the immunization had time to become effective.
  2. Mild side effects, such a fever, body aches, and fatigue were experienced, but the flu virus itself was never contracted.

Long story short, someone has not and cannot contract the flu virus by receiving the flu shot.

So, what does this all mean?

President Trump has been critical of vaccinations in America. From what I can tell, it is due to some of the sad stories about children “contracting” autism from the MMR vaccine. President Trump has spoken out about the terrible effects of autism and that if it is vaccines that are causing it, then he doesn’t think children should be required to be vaccinated. The problem is, these myths of autism and vaccines have been debunked by the scientific community over and over again. Scientists and physicians alike need to make their voices heard at the White House so that President Trump is aware of the other side of the argument—the truth.

I do give him credit for establishing a counsel at the White House that is charged with gathering the facts related to the issue at hand. More than any other president in recent memory, President Trump seems to listen to both sides of the argument and, then, come to a decision based upon the evidence he has seen. While some may not like the decision he makes, at least he is trying to be well informed on the issues.

I hope that President Trump sees the overwhelming evidence that support routine vaccinations and is able to ignore the mommy blogs and detractors. This really is a life or death issue.

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