This week’s installment on Preventative Health addresses the role of vaccination in keeping us healthy.
I understand that this can be a contentious topic, and believe me, I’m not the least bit interested in addressing the political implications of vaccines. I’m a doctor, not a politician.
As a doctor I believe in giving my patients my best medical advice and helping them to make the best decision possible, but ultimately accepting whatever they decide for themselves, even if that decision is not what I recommended for them. That said, I’ll be happy to discuss what I would recommend for the general population, or for most people without specific medical problems.
For vaccine recommendations specific to you and your situation, you should request an evaluation by your healthcare provider. Before I address specific vaccines, I’d like to “briefly” summarize some “basic” elements of the immune system. Vaccines are meant to expand our immune system’s ability to fight infectious diseases. Infectious diseases are those that invade from outside the body, and can be acquired from person-to-person spread, from the environment (soil, water, air etc.) or from animals.
An extremely simplified explanation of our immune system includes B-Cells which make antibodies, and T-Cells which go on the offensive against diseased or foreign cells, and macrophages which help to “eat” and break down debris that shouldn’t linger in our system. Macrophages help us by finding things that don’t belong (like viruses and bacteria) and showing it to B-Cells so that antibodies can be produced against that invader. Our immune system works great, except when it doesn’t. God gave us our immune systems, and He also gave us inquisitive, scientific minds which afforded us the ability to make ourselves stronger and healthier.
The natural history of an unvaccinated human is to get a whole bunch of illnesses throughout their life, most of which they survive if they’re even the tiniest bit lucky. If a person is unvaccinated, the only way to gain immunity against a particular illness is to get sick with it. Naturally, getting sick yourself also increases the chances that you get someone else sick, probably without even knowing it. Vaccination gives us the ability to develop immunity without getting seriously ill, and minimizes our personal contributions to the spread of infectious diseases.
There are multiple ways to create vaccines. Sometimes a virus or bacteria is destroyed in the lab using enzymes to digest it, and fragments of the pathogen (infectious substance) are administered in an injection. The immune system doesn’t recognize the fragments, so it makes antibodies to attack them. Those antibodies will recognize the full virus/bacteria if it ever attempts to invade the body in its true form, and your immune system will be much quicker at making those same antibodies the second time. Other vaccines actually contain live virus in a functional genome, but certain genes have been identified and removed to make it extremely unlikely that a full infection actually occurs.
Some people are concerned that getting the vaccine just makes them sick. This is possible, but unlikely. It is possible to have a reaction to a vaccine, but serious reactions are extremely uncommon. We expect people to have mild reactions to vaccines, but this is not because you’re getting sick with what we are immunizing you against. It’s actually just a side effect of your immune system ramping up to build antibodies against the non-functional pathogen. A good portion of the discomfort associated with getting sick is actually inflicted by our own immune systems.
For instance, when you have a fever and/or chills, that’s actually your brain changing the set point for your internal thermostat. It almost never has anything to do with the infection, it’s actually your immune system doing it to you. If you ever want to know how much pain your immune system can inflict on you, ask a patient suffering from Lupus, or countless other autoimmune disorders. This vaccine reaction (fever/chills, body aches, fatigue) is totally normal, does not mean you’re getting sick, and usually resolves with in 24-72 hours.
What about those who do actually get sick shortly after getting a vaccine? That’s possible too, but in that case, you were probably just the right combination of unlucky and late to the party. A vaccine takes 10-14 days to be fully effective. This is because the immune system has to go through the process of making two different types of antibodies. IgM’s are the first type of antibodies produced, and these are the best we can do on short notice, but they aren’t super effective. Once the pathogen has been destroyed and studied enough by the immune system, IgG’s are produced instead. These antibodies are custom made for each specific pathogen, and are significantly more effective, and can be produced far more quickly the second time. Imagine trying to invent a car from scratch… that will probably take a while. Now imagine having to reproduce a car that you’ve already built before, and you’ve still got a copy of the blueprints and assembly instructions. Way quicker right? It takes 10-14 days to produce IgG antibodies whether you get sick or get a vaccine.
If you go get a flu shot on Monday, and then allow your school-age child to serve you from a public finger-food buffet on Tuesday… let’s be honest, we know what’s going to happen there. You haven’t had time to produce antibodies yet. That’s not the vaccine’s fault, it’s probably yours for what some might describe as some dubious dietary decisions. Furthermore, most cases of flu occur during ‘Flu Season’, which runs from about December-March each year in the United States. During these four months, the vast majority of flu cases occur. The best time to be vaccinated is September or October, so that you’re immune system is ready to go by the time viral activity spikes, but influenza is prevalent all year, and you can get the flu at any time. This is just one example with a specific virus, but the principle is the same for all vaccinations.
In the interest of time and page-space, I will continue this discussion next week. I wouldn’t want to bore you to tears all at once. Next week I will address other potential concerns about vaccines, starting with the issue of “mercury” in vaccines. I look forward to providing healthy doses of both reassurance and scientific explanation. Until next time then! H. Dan Derbes, MD — H. Dan Derbes, MD 757-309-3093