Science Sundays #1 – Vaccines
Introduction
I wanted my first piece of this project to be something that would demonstrate the different goals I have for this project. I want the topics I write about to be scientific, have real-world implications, to be relevant to my life in some way (that may just be that they are interesting to me), and to be commonly misunderstood.
So I feel like vaccinations are the perfect first topic. They’re obviously scientific and have real-world implications. But they’re also very related to my life and commonly misunderstood. People with cystic fibrosis can have many different types of bacteria that colonize our lungs, so most of us are slightly to severely immunocompromised. People that receive double lung transplants are on immunosuppressants, so they are also at higher risk of getting sick. Though there are vaccines for many types of viruses and bacteria, the one that most of us initially think about is the flu vaccine. It’s easy to mistake the flu for not being a very big deal, but the flu can be life or death for people with suppressed immune systems (or anybody, really). I don’t take lightly to people not getting flu vaccines for what are really inane reasons. I want this piece to enlighten people so they don’t seem like such a mystery and I also want to dispel a lot of common myths, like autism being linked to flu vaccines, or people getting the flu from the vaccine itself.
So let’s get into it!
The Science
Vaccines capitalize on the body’s natural way of combating infection. Essentially, in a natural immune response, there is an antigen – these are molecules on bacteria, viruses, or some other microorganism – that the body recognizes which triggers an immune response. Antigens are then targeted by antibodies that should destroy the antigen and prevent any further immune response. Antibodies are tailored to the specific antigens they destroy. Vaccines utilize this strategy to “teach” the body to recognize the antigen.
(Note: I want to keep this relatively basic. I’m not necessarily going to delve deeply into the body’s immune response and all kinds of specific cells. I think that would only complicate and muddy the waters here.)
Vaccines themselves are preparations that contain the ingredients to help provide immunity, preserve, and stabilize the vaccine. Some vaccines also contain antibiotics, growth media, and inactivating ingredients. Vaccines contain either a dead or significantly weakened version of the antigen.
There is a common misconception that vaccines can cause the very infection they are intended to protect against. While there are relatively common small adverse effects and rare serious adverse effects, vaccines are safe. They indeed contain the antigen of the virus or bacteria. There are dead (inactivated) antigen vaccines and attenuated (weakened) antigen vaccines. These antigens are no longer virulent and cannot cause infection, but they do still contain enough of their structural integrity to “teach” the antibodies in the human immune system to recognize that they are foreign invaders. Once the body recognizes the antigens on the infection agent, the body is then equipped to destroy the infectious agent before we can ever get sick. This teaching process takes about two weeks after the vaccination, so it's possible that infectious agents can already be incubating in our body before we ever get vaccinated. Even those these antigens are no longer virulent, they are still foreign objects entering the body. Your body's immune response is what is responsible for the soreness, or some of the other side effects that occur afterward.
There are ways to determine if vaccines are safe and effective. Like all medical interventions, there are FDA guidelines to ensuring that what we put into our bodies is safe and effective. Vaccines are developed and tested in labs before they are ever put into human patients; this is also true for modulators and other drug trials in cystic fibrosis. They first have to be tested for safety then efficacy in small subject populations, then they're tested in a larger population. Once these trials are finished and reviewed, they are recommended for usage.
Something that infuriates me when it comes to science and medicine is the blatantly erroneous claim that vaccines and autism are linked. First and foremost, the evidence is nonexistent. This isn't up for debate. Vaccines have been administered to tens of millions of children and there has never been a case of a child being diagnosed after vaccination that was attributed to the vaccine. The original paper that (former) doctor Andrew Wakefield published was falsified and fraudulent and retracted from the medical journal in which it was published. This paper is still referenced by prominent anti-vaxxers to this day. This pernicious myth is deadly. There have been resurgences in preventable diseases like measles, mumps, rubella, polio, and whooping cough across the world since this study was published, likely due to Wakefield's incompetence and downright deception.
The misunderstanding around vaccines is exactly why I want to do this project. Vaccines aren't scary! They're relatively simple to understand. They are incredibly important. They keep us safe and healthy. They have saved millions of lives. I can sympathize with parents that want the best for their kids; I can't sympathize with carelessness that has no basis in reality and puts vulnerable people at risk.
There is also a little bit of fear around the safety of thimerosal, which is a preservative and is used to prevent microbial growth, in vaccines. There has been ample evidence showing thimerosal is safe, but if you're uncomfortable, there are available formulations of vaccines without thimerosal. The thimerosal controversy is just another arm of the autism argument. Though it is safe, it is being weaned out of usage in the US anyhow.
I also want to talk a bit about another common argument against flu vaccines: they don't actually protect you against the flu. Every single time I hear this discussion, it is almost certainly paired with a single piece of evidence, and flimsy evidence at that: the anecdotal refutation. The "Yeah but my friend got the flu vaccine and still got the flu that year." Influenza is complicated and isn't a single infection, so trying to prepare the flu vaccine for what will be the dominant strain is a difficult science – usually, there are trivalent and quadrivalent formulations that are developed that cover three and four strains respectively. It's hard to predict and the vaccine that gets developed doesn't cover all possible strains. So even though you are protected against what is predicted to be the dominant strain, it's possible to get a different strain and still get sick. With that being said, even if the coverage of strains doesn't match the prominent strains affecting the community, there is still solid evidence suggesting that flu vaccines help make your illness milder, so it's still smart to get vaccinated.
In Conclusion
Vaccines are a medical marvel and the world is a better and much safer place because of their existence. There is no evidence that vaccines and autism are linked, and the overwhelming evidence suggests they are safe for all the populations they are approved for. If you are around me, I ask that you be vaccinated against the flu annually as it protects me as well as yourself. I don't want everybody to take everything I'm writing as gospel and I encourage you to read up on the topics I write about to educate yourself as well. I always welcome genuine good-faith discussions so I would love to hear feedback.
Next week, I'm trying to decide between a couple of topics that I want to write about! I'm debating between writing about photosynthesis in plants, how caffeine affects the body, or climate change. If you're interested in one of those in particular, please let me know! I would love feedback on if there was anything else I should have included in this, so comment or message me on facebook or whatever to reach out.