'tis the season when we argue, falalalala la la la laaa!
There are so many great things about fall and IMO pumpkin spice is not one of them.
Just doesn't do it for me. Man, I'm right out the gate again, pulling triggers. Hello to you!
There's football, at least we are getting a taste of that! Temperatures in the 60's are on the books for south Louisiana already, which is amazing for September. Any time us southerners aren't drowning in the wet air we are privileged to breathe all summer - it's a great day. Also, if it were normal life we would be planning tons of get-togethers for tailgating, Halloween, Thanksgiving, Christmas (____insert whatever holidays your culture celebrates), or the New Year. All the girls are excited about fall décor and their fall wardrobes. #booties #sweaters #leggings #maroonlipstick #mediumlatteinhand #everythingsmellslikecinnamon
Can I please poll the audience?
When and why did y'all start calling lipstick "lippies?" *shudder* LMK.
This is also the season when people remind each other to buy the next person's coffee in the drive-through. Lots of messages in the media telling us to be nice to each other during the holiday season, serve how we can, public service announcements reminding us that people may be lonely.
But, the best part about this time of year, the warmest and fuzziest part I'd say, is the annual, Facebook-wide, argument about the Flu shot (and then all other vaccines). How! Festive!
Warning: Opinion ahead: There is almost no original thought about vaccines out there, guys. Your thoughts aren't original. My thoughts aren't original. This isn't the year 1720. There is absolutely no stance, argument, opinion, research, conspiracy theory, mommy Facebook group, anti or pro-vaxxer group, meme, or evidence that is fresh and changing anybody's mind about vaccines at this point in life. You know if you believe in the shot and subsequently take it, and you know if you don't, and won't. Moot points.
I'd suppose that perhaps the only thing that could change a mind about vaccines is a life-altering health event. You don't have to replace Morris Bart on a I-10 billboard so that everybody that drives by you knows who you are and that you REFUSE to let that poison into your body. And those TV and radio commercials that tell you getting your flu shot shows you'd do anything to save the lives of others - sigh. Sorry, flu shots aren't organ donations, Mother Theresa.
You simply don't get a billboard on I-10 either way.
Do you, boo. And no matter if you are Morris or Mother - SNEEZE INTO YOUR ELBOW.
End of Opinion.
SO. Let's get to it. Today's topic is about the CONCEPT of vaccination. The concept.
Not my medical opinion on vaccines, not my opinion on whether or not you should take them, not my opinion on side effects, not my opinion on long term effects. The concept.
Remember, this blog was created to explain, simplify, and empower you to understand medical concepts and then make up your own mind about things.
This is not a random Facebook post that's been shared 11.6k times (although I'd low-key love it if that ever happened lol). This isn't a random meme. This isn't me parroting what I see other people say or write.
Wine? It feels like we should pour wine for this one. CBD tea? Something. Y'all know how y'all tend to get hot&spicy with these controversial topics!
Multiple sources unanimously agree that the smallpox vaccine (smallpox was like super-bad chicken pox) was the first successful, primitively studied, widely-used vaccine, given methodically across Europe and what is now the US in the 1700s. Almost 300 years ago. Small pox ravaged the entire world, disfiguring or killing millions of people, and is still considered by multiple sources to be a potential biological warfare tool. The concept of using a sick person's or animal's material to inoculate a healthy person in order to prevent disease did not start with the smallpox vaccine. But it's the first one that was fully developed that the people stuck with. And it worked. (1) (2)
"The term small pockes (pocke meaning sac) was first used in England at the end of the 15th century to distinguish the disease from syphilis, which was then known as the great pockes (8)."
Always good to tell smallpox and syphilis apart, I'd say! Early scientists began what we now know as vaccination by taking infectious material from cowpox lesions, and directly injected this material into healthy people, conferring immunity from small pox - a process they named "variolation".
A person named "Edward Jenner's work represented the first scientific attempt to control an infectious disease by the deliberate use of vaccination. Strictly speaking, he did not discover vaccination but was the first person to confer scientific status on the procedure and to pursue its scientific investigation."(1)
The people who were vaccinated first were the aristocrats, royalty, George Washington's military, volunteers, and Jenner himself vaccinated the poor. What a man What a man What a man What a man What a mighty good man - mighty mighty good man. Jenner became rich and famous for this, and also, someone threw a bomb through a window of his house for doing this. Win some, lose some. But - he successfully achieved a 2% case fatality rate with this method of vaccination immediately, down from 14%+, and eventually smallpox was eradicated... gone. It took until the 1950's for worldwide, aggressive vaccination to occur, but, "On May 8, 1980, the World Health Assembly announced that the world was free of smallpox and recommended that all countries cease vaccination: 'The world and all its people have won freedom from smallpox, which was the most devastating disease sweeping in epidemic form through many countries since earliest times, leaving death, blindness and disfigurement in its wake'." (1)
So much has happened since Edward Jenner's time. But, "The germ theory of disease, the discovery and study of viruses, and the understanding of modern immunology tended to support his main conclusions..." about why his method was working.
So what happens in our bodies when we receive a vaccine? Short answer: A lot.
We are born (y'all - there are exceptions to e v e r y rule in medicine - of course, some people are lacking components of a whole immune system - you should now be familiar with the term "immunocompromised" thanks to Covid19...) with a two pronged immune potential. Please note, I'm talking about your average, run-of-the-mill, vanilla or chocolate human). K. So...
"The immune system can be divided into two main subsystems, the innate/general resistance system and the adaptive system." (3)
The innate system is our built-in, day-in-day-out set of defense mechanisms: our skin and all it's features, our sneezes and coughs, our ear wax, our snot, our stomach acid, the
linings of the insides of our mouths/noses, our normal body temperature and our ability to make fever, and more! Wow - sign me up for 1 easy payment of $19.99 plus shipping and handling, Laurie. I'm amazing!
Don't forget - for 1 extra payment of $19.99, you also get immune globulins and a wide variety of inflammatory responses with your original order of an innate immune system! And like, immune globulins (IgM and IgG panels) have become really popular in 2020. Your innate immune responses are open 24/7, 365 and are non-discriminatory/non-specific. What a deal.
"The inflammatory response is another essential part of the innate immune response. The inflammatory response is the body's reaction to invasion by an infectious agent, antigenic challenge, or any type of physical damage." (3)
Your infectious agents and antigenic challenges are illnesses and vaccines.
There are even more Pac-Man type proteins your body squirts out, like the in-the-news C-Reactive Proteins and cytokines. All hot topics with COVID, and all-included in your base-model human body. The innate system eliminates a lot of threats on it's own, but for certain invaders, it can activate a response from the adaptive immune system.
Your innate immune system functions are happening all the time. They were also happening all the time before people started wearing face shields and blue gloves to the grocery store.
"In contrast to the innate immune system, the actions of adaptive immune system are specific to the particular pathogenic agent." (3) Specific responses to specific bugs. Also, the adaptive immune response has a memory! Innate responses put up a fresh fight every day to all the germs in our environments and daily lives. Adaptive responses happen after exposure to a certain bug ..."This response will take longer to occur than the innate response. However, the adaptive immune system has memory which means that the adaptive immune system will respond more rapidly to that particular pathogen with each successive exposure." (3)
This is good.
The adaptive immune response has 2 parts, and 1 part involves cells called B-Cells and T-Cells. B&T no lettuce.
And definitely no mayo. @ me.
B and T cells function differently, but give essentially the same results. Think of germs as having a surface like a legos table. Like the blue/red/yellow/green table at your kid's dentist, yes. That one. Lego table skin. Different skin patterns for different germs.
B cells live in your lymph nodes (your glands) and they can recognize and de-activate germs all on their own. They don't need no man. T cells are "helper cells". Some germs must be grabbed by T cells first, changed up a bit, and then presented to the B cells to plug into and de-activate.
Antigen = germ / invader.
Antibody = immunity material / soldier.
Some antigens (germs) are called "T-independent antigens because T-cell activation is not required to activate the B–cells... however, the immune response is weaker and the induction of memory is weaker than with T-helper cell activation. In contrast, activation of B–cells with T-helper cell activation results in a much better immune response and more effective memory. This long-term, effective immune response is the type of reaction that is the goal of immunizations." #BetterTogether
"In contrast, activation of B–cells with T-helper cell activation results in a much better immune response and more effective memory. This long-term, effective immune response is the type of reaction that is the goal of immunizations." (3)
Bottom line: B–cell(s) mature into a plasma cell(s) which then begin production of the particular antibody with the best corresponding fit to the antigen... this is why they were asking y'all to donate plasma after you got COVID so they could give it to the sick, sick COVID people... based on this concept. B-cells also can clone themselves and change to match similar germs in the future. Soldiers live in your lymph nodes and plasma. Cool.
Immune globulins (Ig). IgM. IgG = Little microscopic blobs your body makes in response to an illness or a vaccine. Shout all the way out to Dr. Sandra Brown at Southern University A&M who taught us about immune globulin panels and made it so understandable! Simplified:
IgM = miserable (IgM is the first responder). IgG = gone.
M = active infection. G = past, controlled.
Most important IG antibody when it comes to vaccines is IgG.
Remember, the adaptive immune system has a memory. It makes cells with a memory, that live on in you, and can clone themselves. So, future "exposures to the antigen will result in a more rapid and effective secondary immune response. With this secondary immune response, the reaction will be quicker, larger, and primarily composed of IgG." (3) Letting yourself be sick with those minor colds and things actually make you stronger...
"What doesn't kill you makes you stronger.." -Kelly Clarkson
You can become immune to various conditions passively or actively. The most commonly known method of passive immunity is a mom passing her antibodies ("immune system") to her baby while she's pregnant, and then via breast milk after baby is born. People can also receive IVIg (like, an IV in your arm with tubing and the stuff that goes in is Ig) if they are immunocompromised or in situations like COVID. They take plasma out of a bunch of people's donations and "pool" it together and give it to you if your immune system is weak or for a while, if you were dying of COVID.
Whether that helps or not is TBD depending on the patient and condition.
Active immunity is actually being exposed to an illness via being by a sick person or getting a vaccine. Passive immunity is temporary. You are using someone else's pre-made antibodies to boost your immune system temporarily. Active immunity is long-term. Notice I did not say "life-long"... I said long-term. Active immunity is your body making from scratch it's own antibodies, which will live on in you.
There are B-cells & T-cells, no lettuce. If you further break it down - there are two main types of T-cells, CD4 cells and CD8 cells. T-cells are helper cells for B-cells. And CD4/CD8 cells are just different flavors of T-cells that are the bouncer. They are at the door recognizing specific types of dudes that don't belong in your night club. CD4 cells bear-hug and wrap up infectious invaders. CD8 cells bear hug and wrap up cancer cells, amongst other jobs, respectively. Different invaders or germs get greeted and bounced by specific CD cells depending which type of invader they are.
For vaccines, as you may know, we get shots for both viral and bacterial germs (antigens). Some viral vaccines are live, most are inactivated (not capable of causing disease). Viral vaccines are polio, influenza, hepatitis B, HPV, etc. Example bacterial vaccines are tetanus, Hib (childhood vaccine), and the pneumococcal vaccine.
Both divisions of your immune system (innate and adaptive) work together to build antibodies in you when you are exposed to a vaccine. Some vaccines will cause changes within the cells of your body, and other vaccines will produce antibodies that live in your plasma, plus a mix of both. Each vaccine is made in a lab in it's own way. Each is a virus or bacteria that is treated with heat, radiation, or a chemical that changes it's structure, or the germ may broken down into smaller parts.
HERE'S where y'all argue : The Flu vaccine does NOT give you the flu.
But, are there vaccines that could potentially cause an illness in the wrong person? Yes.
The chances of this are slim, but some vaccines are "live" viruses - measles, mumps, varicella (chicken pox), live flu. You receive this vaccine first at age 12 months, and it is such a tiny amount of live virus - you should have built up an immunity to other viral and bacterial illnesses from other passive and active vaccination by this time - that you don't develop measles or chickenpox when you receive this vaccine. LIVE virus vaccines cause your body to make many more immune cells that last longer in life than inactivated vaccines.
One guess......... the inject-able flu vaccine is inactive. The immunity it hopes to give you is temporary... one season... This is active immunization. Whether the scientists matched up this season's flu viruses to the vaccine or not, does not mean the vaccine doesn't "work", it just may have not been specific. However. Please note: your adaptive immune system has a memory. You have not received the flu vaccine or any others in vain. Additionally, you are welcomed to catch the flu, ride it out, and make your own antibodies that way, also using your innate and adaptive immune systems! Either one works - but the goal of the flu vaccine is to prevent such large, overwhelming numbers of people from contracting the same illness at the same time.
If I were on glass number 2 or 3 of cab right now... the next thing I'd do is state my opinion on who should or should not receive this vaccine. But, it's 0930 and I'm sipping coffee and water, so my fingers are under control! #somature
And another thing. The Tylenol people just keep gettin' richer off y'all. If you haven't already x'ed out this blog because I told you the flu vaccine doesn't give you the flu - let me tell you what it CAN give you... and any other vaccines can for that matter.
What you or your child are experiencing is called "Post Vaccination Syndrome" and unless you begin to become paralyzed from your toes to your nose with a fever of 104-105, you are having a MILD and expected immune response to your vaccine! We learned earlier that FEVER is a normal immune response. What is fever? Sources differ, but a number we can usually all agree on is a core/internal temperature of 100.8 Farenheit. A medical provider who wants you and your child to get stronger will tell you to allow the patient to have a fever up to 102F before medicating them. Fever is miserable. You don't have to wait til 102, but certainly do not medicate with for a temp less than 100.4. Fever is your frenemy. We need fever in certain circumstances. Nothing is wrong with you or your child unless your fever reaches heights of 103.5+ and/or you start having extreme things go wrong after a vaccine. The body aches, malaise (feeling just yuck), low grade fevers or even a little redness/swelling at the injection site are signs that your body is recognizing the invader and bouncing it out! YES! (4)
Bacterial vaccines produce a weaker immune response. Most of you know you need a "tetanus booster" in life. As we learned, "these vaccines produce weaker immune responses therefore additional booster shots are required to maintain immunity". Children receive a "PCV" vaccine which protects them against a mean bacterial pneumonia, but this vaccine is bacterial. It's a "thing" in pediatrics to send a kid who just keeps getting sick all the time, out of proportion to whats going around or compared to others their age/in their family to a pediatrician who specializes in immunology. Your regular pediatrician could also do the test, but a kid who gets sick all the time and doesn't ever seem to get better needs to be checked out. Bloodwork can be done .... for guess whaaaaat... IG panel for pneumococcal antibodies! You knooww what this means now! They check to see if your kid had a big enough immune response to their vaccine - some kids don't, it happens. In general, we don't all always mount an adequate immune response to infections or vaccines. The fix? A booster PCV shot. It's all coming together.
Anybody can have their vaccine titers drawn (levels of immunity). I had to get mine done in order to attend NP school, my vaccine record wasn't good enough for admissions. Happy to report my titers were all super high and my immunity is good!
This one was detailed and intense, I hope you made it this far and you have a better understanding of how vaccines work, and that they aren't all meant to work the same way.
Alert: For those of you out there who are both smarter and more educated on this subject than I am (doctors, biologists, medical scientists, etc... know that I know that I know, that this is s simplified explanation and many components of immunity/vaccination are omitted), please focus on the take-away -- general understanding of how vaccines work, and their intended purpose.
And, so, when y'all are on Facebook (or social media outlet of choice), and you are 38 comments deep in an argument about the flu vaccine - I hope you think of me and wish me happy holidays...
Until next time...