Real World Problems: Vaccines

For this week’s topic on Real World Problems, I collaborated with PhD to Success (IG: phd_to_success) to discuss vaccines and their role in public health.

The role of vaccines in public health

A vaccine is something we put in our bodies that looks like or has a tiny part of the ‘microbe’ that produces a disease. When we introduce it in our body, the immune system produces the right antibodies to fight it. The immune system also is quite smart andremembers” this, so that it is able to recognize and destroy any of these microorganisms that show up later on.

The act of introducing an active ingredient to stimulate an immune response is not a new idea. Before the 15th century, primitive forms of inoculation are believed to have been practiced all over the world. For instance, ancient Chinese may have taken small pieces of smallpox scabs and inhaled or rubbed them on their skin to become immune.

image528251xFrom the 1500 to 1900’s, various infectious diseases were very common. Smallpox, measles, whooping cough, chicken pox, and influenza are examples of diseases that were highly contagious. With the discovery of the Americas and movement of European settlers, many native people were introduced to diseases that caused 80 to 95% of them to perish due to lack of immunity. The world’s first “true” vaccine was in 1796 when Dr. Edward Jenner found that he could infect people with a benign cowpox virus, people could be immunized and therefore overall mortality rates due to smallpox could be reduced.

e0a4ffc1a6e6120cb2efb8c6a58dcc93.jpgA common misunderstanding is that diseases had already been disappearing even before the introduction of vaccines due to better hygiene practices. Indeed, better hygiene and sanitation, as well as better nutrition, contributed greatly to the health of populations. You can also say that the development of medical treatments, antibiotics, and less crowding of populations have also contributed to better health. However, when analyzing the correlations of all these factors with a drop in infectious diseases, it is clear that vaccines are most prominent causes of preventing diseases. By looking at vaccines and the incidence of disease (new cases of a disease) over time, the relationship becomes more than just a simple correlation. For example, the permanent drop in measles incidence coincides with the measles vaccine beginning in 1963. Sanitation today is not any better than it was in the 1900s, and therefore cannot be attributed the drop in diseases. This is particularly true for the Hib vaccine as huge drops in the Hibs disease all throughout the world have been attributed to the vaccination.

“But I know someone who has been vaccine injured!”

Let us repeat, vaccines are actually incredibly safe. Let’s talk about common ingredients for vaccines. A vaccine is made of an active ingredient and other added ingredients. The active ingredient triggers the immune response. The added ingredients have different roles, such as improving the immune response, or acting as a preservatives, stabilisers or suspending fluids.

These added ingredients are those contested due to their toxicity. But when speaking about toxicity, there is a very important point to make. An important indicator of toxicity is LD50 (lethal dose 50), which is the dose at which 50% of individuals die. For example, aluminium salts are used in many vaccines as adjuvants. This means that they help by stimulating the immune response and by a slow release of the active ingredient. The most used salts are aluminium hydroxide, aluminium phosphate and potassium aluminium sulphate. Data about these compounds are freely accessible by searching for their material safety data sheets (MSDS) on the big chemical suppliers’ websites, such as Sigma Auldrich. None of the salts above are reported as carcinogenic, and the LD50 of aluminium phosphate, for example, is more than 5,000mg/kg for mice. The total quantity of the aluminium in a vaccine is less than 1mg (0.001g), which is a very low quantity. In the normal European diet the amount of aluminium we intake from food varies between 3–10mg a day.

SAS-Dose-Makes-The-Poison-FINAL.png

Vaccine composition lists also include compounds and products used in the manufacturing process – even though at the end of manufacture they are present only in trace amounts, if at all. One of the chemicals on this list that scares people is formaldehyde, which is indeed carcinogenic with an LD50 of 42mg/kg for mice. Nevertheless, the quantity present in a vaccine dose is less 0.1 mg. One 200g pear contains 12mg of formaldehyde. We should always remember ‘the dose makes the poison’.

“Herd immunity is a myth! I know someone who hasn’t been vaccinated, and they’re just fine.”

Some people argue that because many vaccinated people still get the disease, herd immunity is a myth and vaccines are overall ineffective. Vaccines are not 100% effective. Not everyone who receives a measles vaccine becomes immune. However, most routine childhood vaccines are effective to 85-95% of recipients. In countries like the US, those who are vaccinated far outweigh the number of those who are not. Therefore, when outbreaks occur, herd immunity allows for those with more compromised immune systems to be protected from contracting the disease.  Let’s look at this example:

“In a high school of 1,000 students, none has ever had measles. All but five of the students have had two doses of measles vaccine, and so are fully immunized. The entire student body is exposed to measles, and every susceptible student becomes infected. The five unvaccinated students will be infected, of course. But of the 995 who have been vaccinated, we would expect several not to respond to the vaccine. The efficacy rate for two doses of measles vaccine can be as high as >99%. In this class, seven students do not respond, and they, too, become infected. Therefore seven of 12, or about 58%, of the cases occur in students who have been fully vaccinated.”

In other words: The vaccine wasn’t 100% effective for everyone. However, 100% of children who did not get vaccinated got measles. Less than 1% of children who got the vaccine got measles. In the case where no one had been vaccinated, all 1,000 students would end up getting measles. When the majority of the population (83 to 94%) is immunized, a large proportion of the population is immune, therefore contributing to a herd resistance to disease for those who have not developed immunity to a disease.

Vaccines themselves do not solve all of the world’s health problems. However, they provide safety to populations who are at risk of contracting some of the world’s most debilitating infectious diseases. Make healthy choices and do your research!

You can read more about the common misconceptions about vaccines from the WHO or CDC. Always do your own research and read with a critical eye!

 

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3 Comments

  1. Thanks for this amazing collaboration. I have learned so much about vaccines and their story. Hope this article can reach as many people as possible. #strongertogether.

  2. Hi Susanna! I appreciate this post and have read it with an open mind. I have many problems with vaccines based on my own research over the last few years, but I won’t list all of them here.
    I just wanted to touch upon the idea of “herd immunity” based upon information that I’ve presented below.
    The estimated duration of protection from vaccines is shockingly low: the pertussis vaccine offers 4-6 years of protection. The polio vaccine is the highest offering at least 18 years of protection, and the diphtheria vaccine offers around 10 years of protection, etc. All the rest are listed in the website I’ve provided.
    Reference: http://www.immune.org.nz/vaccines/efficiency-effectiveness

    A 2016 survey done by the CDC concluded, “Many adults in the US have not received the recommended vaccinations”. According to this study, adult vaccination rates for most vaccines are below 50%.
    Reference: https://www.cdc.gov/vaccines/imz-managers/coverage/adultvaxview/pubs-resources/NHIS-2016.html

    With many adults (including myself since my last vaccinations were when I was 14 years old) not up to date with their vaccinations, I would argue that a large percentage of the population is not immune to these diseases.
    This is a great article titled “If only half of America is properly vaccinated, where are the epidemics?” that sums up this issue.
    Reference: https://thehill.com/blogs/congress-blog/healthcare/295562-if-only-half-of-america-is-properly-vaccinated-where-are-the

    I quote this from a study published in Pediatrics in 2000, “Thus vaccination does not account for the impressive declines in mortality seen in the first half of the century…nearly 90% of the decline in infectious disease mortality among US children occurred before 1940, when few antibiotics or vaccines were available.”
    Source: https://vaccinesafetycommission.org/pdfs/45-2000-Pediatrics-Vital-Statistics.pdf

    I have done my research on this issue with a very critical eye since I one day will have my own children and will be responsible for the health of my patients. I will always respect your opinion but I might not agree with it… but I am in no way angry or mad at you or anyone who speaks highly of vaccines. Open discussion is important!

  3. Susanna, I also have to comment on vaccine safety, as I do not believe vaccines are safe for everyone as a “one fits all size” approach.
    Vaccine manufacturers are completely free from liability for their products and cannot be sued due to the 1986 National Childhood Vaccine Injury Act. Are you aware of the VAERS database? In order to capture adverse events that may arise from vaccination in the real world, this Vaccine Adverse Events Reporting System was established and is operated by HHS (Human Health Services) and co-sponsored by the CDC and FDA.
    VAERS is passive and not a mandatory reporting system. In fact, most doctors and nurses are not aware of this reporting system. We never learn about this in medical school and I have personally found most of the residents and doctors I work with to not know that this database exists.
    In 2016, VAERS received 59,117 reports of adverse effects following vaccination, including 432 deaths, 1,091 permanent disabilities, 4,132 hospitalizations, and 10,284 emergency room visits.

    A HHS-funded review of vaccine adverse effects over a three-year period by Harvard Medical School involving 715,000 patients found that “fever than 1% of vaccine adverse events are reported” to the VAERS database.
    Source: https://healthit.ahrq.gov/sites/default/files/docs/publication/r18hs017045-lazarus-final-report-2011.pdf

    A U.S. House Report similarly stated, “Former FDA Commissioner David A. Kessler has estimated that VAERS reports currently represent only a fraction of the serious adverse events.
    Source: https://www.congress.gov/106/crpt/hrpt977/CRPT-106hrpt977.pdf

    This is extremely concerning to me and should be to anyone! Does this mean that the numbers above (VAERS 2016 reports) represent only 1% of adverse events? So that means there could have been 5.9 million adverse events, 43,200 deaths, 109,100 permanent disabilities and 1 million ER visits due to vaccines?

    There is so much more I can write about this issue. I have personally met a mother whose daughter was paralyzed by the DTaP vaccine. There are so many stories like this that are out there if you are open to them.

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