If you want to be healthy

Myths and Truth about Vaccines

Maria Syrochkina, Pfizer blog, Naked Science

There is a fairly common myth that vaccinations are needed exclusively for children, since the immunity of adults is able to protect itself, which means that they do not need vaccination. The reason for the myth is a lack of information. First of all, an adult is different from an adult: there are people with good health, and there are people with special features, with chronic diseases, and this directly affects the behavior of the immune system. In fact, any chronic disease creates a predisposition – for example, to infections caused by bacteria with a capsule (for example, meningococci and pneumococci).

Secondly, age-related risk factors should be taken into account. Some infections, such as pneumococcus, are dangerous and are more common in children in the first five years of life, as well as adults over 60-65 years old. In these two age groups, due to the peculiarities of the immune system, pneumococcus can penetrate beyond the nasopharynx and enter the bloodstream, causing invasive infections that are severe and highly life-threatening.

In addition, the risk of death in adults is several times higher than in children, due to the accumulated diseases over a lifetime. There are infections that are most dangerous in adolescence, for example meningococcus: its rapid spread is facilitated by risk factors such as hormonal and immune rearrangements in connection with adulthood and maturation, as well as behavioral factors – active communication, first kisses and close contacts. There are also occupational risk factors: nurses and doctors are constantly in contact with a large number of people, which increases the risk of diseases.

It is important to note that vaccination only for children is rather not a myth, but a habit. In reality, the use of some vaccines is necessary throughout life, starting from the prenatal period (that is, from the mother's pregnancy).

As a rule, most people do not know that in adulthood and old age it is also necessary to be vaccinated. At the moment, the direction of adult vaccination is intensively developing, vaccines aimed at the adult population are being developed. Recently, a vaccine against Herpes zoster, the consequences of chickenpox, appeared in the West.

Anti-varicella vaccination is important not only for children, but also for the rest of the population, because when primary infection and chickenpox disease are prevented, it becomes possible to prevent its very delayed consequences and chronization. Herpes zoster is the same virus that causes chickenpox and after the infection remains alive in the nerve nodes, and later, in adulthood, if a person has a cold, weakened or, for example, experienced intense stress, it manifests itself and causes very severe conditions called shingles – pain syndrome (so strong, what can mimic a myocardial infarction), skin lesions (rashes).

So far, the vaccine from Herpes zoster is on the vaccination calendar only in the USA, but it will probably appear in other countries in the future.

In addition, there is a human papillomavirus, an HPV infection, which it is desirable to start vaccinating against in adolescence. For women, this is important because it is a measure to prevent cervical cancer, but vaccination is also important for men. HPV infection can cause laryngeal papillomatosis, head, neck cancer and other oncological diseases.

There are very few hard opponents of vaccination – those who believe that any vaccinations are evil, in fact, very few: in reality, only about 5% of such people in all countries. Most are not against vaccination, but they doubt it. These are those who would like more clarity and more faith, because vaccines are always an emotionally charged topic, surrounded by fears and speculation, which is associated with a deviation from an understandable treatment regimen.

When someone is sick and needs medicine – in the case of vaccination, the situation is complicated by the fact that it is necessary to realize the importance of taking the drug even when everyone is healthy. Vaccines give us the opportunity to protect ourselves and our loved ones from the most dangerous infections, and it is extremely important that information is publicly available, as much as possible confirmed by facts and high-quality scientific research.

So, there is very little information about revaccination, which is necessary for the "survival test" of the knowledge of the immune system. Most of the vaccines currently included in the national preventive vaccination calendars form immune memory, and when a revaccinating dose is administered, the doctor, on the one hand, checks how well the "material has been assimilated", and on the other hand, helps the immune system refresh knowledge.

The secondary immune response (i.e., the response to the revaccinating dose) is higher than the response to the first training series, and as a result, a longer-term protection is obtained. So, in adults, a revaccination for diphtheria, tetanus and whooping cough should be carried out every ten years, primarily because an adult can not so much get whooping cough himself as infect others with it, especially young children.

Compliance with the full vaccination schedule is always critical, otherwise the risk of an infection breakthrough increases. If only the primary complex was introduced, this does not mean that the child will not get sick at all, but most likely the infection will be transferred more easily, the body will cope with it faster, and there may be fewer complications.

Many myths about vaccination are associated with the well-being of patients after vaccination. It is important to note that, although the dose of antigen that is administered with the vaccine is tens of thousands of times less than the dose that enters the body with the disease, nevertheless, the first 30 minutes after vaccination must be under the supervision of a specialist. This is due to the fact that immediate allergic reactions cannot be predicted in advance: they are extremely rare, but in order to protect yourself from the risk, it is important to be under the supervision of a doctor or nurse of the vaccination office for half an hour.

In addition, there are constant contraindications for certain types of vaccines. For example, if a patient had an anaphylactic reaction to the previous administration of a vaccine or drugs containing the same substances contained in the vaccine, such drugs are contraindicated to a person forever.

In cases where a person has congenital severe primary immunodeficiency of a certain type, live vaccines may be contraindicated. The danger lies in the fact that often this kind of immunodeficiency manifests itself only after episodes of the disease or just after vaccination.

However, the only live vaccine that is made in the first year of life, in the first months, is BCG, a vaccine against tuberculosis. BCG prevents cases of severe tuberculosis infections (meningitis, miliary or multiple tuberculosis), but does not always protect against infection with Mycobacterium. Other live antiviral vaccines include measles, rubella, mumps (or mumps), chickenpox (chickenpox). In the case of an acute illness with fever or inflammation, vaccination should be postponed.

Cases when the vaccine "does not work", that is, the vaccinated person gets sick, can also undermine the credibility of immunization. But we must take into account the fact that vaccines are still limited in their composition. For example, influenza vaccines include those viruses that are selected by the World Health Organization on the basis of very careful, global surveillance in different countries.

It happens that this forecast is not 100% justified, and it may turn out that some other flu virus has manifested itself - then even a vaccinated person can get sick. It is impossible to say that vaccination protects against the disease completely. But the fact that it helps to reduce both the risk of infection, and the risk of serious diseases, and the risk of dangerous complications, is true.

It is important to understand that vaccines are a specific product, they target specific microbes or specific viruses. Therefore, it is in relation to those antigens that are contained in their composition that vaccines almost always work. With regard to other pathogens that are not part of a specific vaccine, actions are not worth waiting for: for example, you cannot expect from a pneumococcal vaccine that it will protect against staphylococcal infection.

It should be borne in mind that pathogens are often presented in several variants. For example, there are quite a lot of varieties of hemophilic bacillus: a, c, e, d, as well as untyped hemophilic bacillus, but the vaccine includes only type b, as the most pathogenic causative agent of diseases such as meningitis, pneumonia, epiglottitis, otitis media in children and immunocompromised adults.

The study of the composition of vaccines, that is, which pathogens will be included as material for training the immune system, is also determined by epidemiological studies, when experts look at what is happening in different regions of the world, in different age groups, which of these pathogens is the most dangerous.

In addition, there are individual characteristics of the recipient – the person receiving the vaccine. For example, people with immunodeficiency may not respond to all types of vaccines like healthy patients: they may have a weaker immune response, and as a result they will not be as well protected.

The state of the immune system may initially be the same or change in connection with treatment – then the immune system is less teachable and remembers worse who it needs to fight. For example, a person with HIV infection, if he is not treated, develops an immunodeficiency condition that affects how the vaccine is perceived. People who take antiretroviral therapy in a timely manner and in accordance with the doctor's recommendations, in turn, actually respond to vaccination in the same way as healthy people.

Patients who have special treatment, for example, for autoimmune diseases, rheumatoid pathologies, may receive an immunosuppressive, or suppressive immune response, drug. This is necessary when the body begins to react inadequately to its own cells or fluids and try to fight them as if they were strangers.

Naturally, when the immune response is suppressed, it becomes less active not only in relation to its own antigens. Therefore, people who receive immunosuppressive therapy are more susceptible to infections. In this situation, vaccination can help, because it reduces the frequency of exacerbations and the severity of diseases, and can speed up recovery.

There is a myth that vaccines contain a very large amount of mercury and other harmful substances, which leads to overload and poisoning of the body. In reality, mercury salts were previously used as a preservative that inactivates the bacterium, and in modern vaccines they are practically absent.

I note that even before that, the concentration of such substances was not even at the level of the maximum permissible concentration (MPC), but 1000 times less than it. Even if we collect all the doses of vaccines that a person receives for a lifetime, we will not get even close to the MPC: we can get much more mercury and other harmful substances when we eat seafood that filters mercury from seawater.

Modern vaccine production is hyper-high-tech. They contain only the antigen itself, water for injection and substances that serve as stabilizers and preservatives. Adjuvants may also be contained – substances that are required for the immune system to see the antigen and respond better to it.

Also, a popular myth about the connection of vaccinations with autism appeared back in the 1990s, initially this topic was raised in an article on vaccination against measles. The only small study was published where it was not even directly claimed that there was a link between measles vaccination and autism, but the article was submitted by the media as proving the connection between autism and measles vaccination.

Subsequently, based on the results of scientific research and proceedings, the original article was withdrawn from the journal, and the journal apologized for its publication. Unfortunately, by that time the principle of a damaged phone had already worked, and as a result, people began to be afraid of vaccinations in general, associating them with autism.

We are still reaping the fruits of the misconception that appeared more than 20 years ago, as people stopped being vaccinated against measles and an active increase in the incidence began. Measles is a very contagious infection: if you meet it and you have no immunity, then you will definitely get sick.

It is impossible to predict how the disease will take place in a child, or even more so in an adult or teenager, because measles occurs in a variety of forms – up to very severe ones that give complications to the nervous system. A person can get over measles in childhood, and already in adolescence, closer to the age of 18, he may unexpectedly develop a severe neurological condition provoked by the measles virus, which remains in the body for many years.

All this means that in order to control measles at the population level, vaccination or immunization coverage of at least 95-98% is needed – and this figure was achieved at the time. Now we see that people do not resort to vaccination very often: in the last few years there have been outbreaks of morbidity in Ukraine, in Kazakhstan. In my opinion, deaths from measles in our time are not even the level of the Middle Ages, but of the Stone Age, since there is no cure for measles, but there is a vaccine that can be used effectively.

That incorrect publication led to the fact that people began to be vaccinated less – and measles returned. However, there were also positive consequences: the study stimulated many scientists to study autism. Great attention was paid to this disease, research began to find the causes and development of the disease. To date, the work has been carried out for more than ten years, these are very solid and diverse studies: neurological, immunological, genetic.

Autism spectrum disorders (this is a broader name that is now used instead of the term "autism") have many causes, and in order to say what caused the disease in a particular situation, you need to conduct a lot of examinations. It is precisely established that there is no connection between vaccination against measles and the development of autism.

Let me remind you that scientific research is published in specialized journals for a very limited audience. That very publication about vaccination against measles and autism is the first one that received such a wide public response and provoked many misconceptions and fears that have persisted to this day. That is why it is important to talk about the specifics of the production and the principle of action of vaccinations, as well as the risks that they help to avoid. Unfortunately, we don't have a vaccine against bugs yet.

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