There are many myths around vaccines. They are an ideal medium for the non-stop discussion on “Vaccinate or not vaccinate?” We will try to briefly and clearly answer the most frequently asked questions about vaccines.

Magda does not remember the last time she was sick. For years, she has not suffered from severe strep throat or even an ordinary runny nose, she has not even contracted it when visiting her sick friends. Oh, innate immunity. Until here last year, her company decided to provide employees with seasonal flu vaccinations. Although Magda saw no such need, she finally let herself be persuaded. In the first winter after vaccination, she fell ill. Twice! Did Magda’s company throw money down the drain, could the vaccine cause the disease and does it always have to stop it? To answer these questions, we first need to find out what they contain and how vaccines work, whether they are XNUMX% effective, and why we are actually taking them.

What does the vaccine contain?

The most important ingredient in the vaccine is the microbes that cause the disease against which we are to immunize. They may be dead or alive. In the case of the latter, however, there is no fear that they will cause disease, because they are always attenuated, i.e. they have a significantly reduced virulence. They may contain broken microorganisms, products of bacterial cell metabolism or the so-called recombinant antigens obtained by genetic engineering. More modern acellular vaccines do not contain whole cells of microorganisms, but only those fragments that are essential for boosting immunity.

Many vaccines also contain mercury because it is part of the preservative thiomersal they contain. Of course, mercury is harmful to the body, but the amount in the vaccine is minimal. Nevertheless, this element has started to be eliminated from vaccines and now some of them are deprived of it. These are especially single-dose vaccines (the package is used to vaccinate one person). Thiomersal or another preservative, on the other hand, is always used in multi-dose packages.

Vaccines also contain trace amounts of the medium on which the microorganisms were grown. Sometimes it is chicken protein, which is a strong allergen. This is why it sometimes happens that vaccines trigger an allergic reaction.

How does the vaccine work?

Vaccines are designed to stimulate our immune system. The point is to create the so-called immune memory. Thanks to it, memory cells – T and B lymphocytes – will be quickly activated to fight this infection in the event of an attack by virulent (i.e. capable of causing infection) microorganisms.

How long the vaccine will protect us depends on how long the antibodies remain in the body – and this can change. Today, for example, it is believed that a hepatitis B vaccine is lifelong, whereas previously it was recommended to get vaccinated every 7-10 years. The opposite is true for whooping cough. In some countries, adolescents are given an additional dose after childhood immunization – and there are indeed indications for this. So if only the money is available for it, perhaps the same solution will also be introduced in Poland.

Why is it possible to get sick after vaccination?

Vaccines do not provide XNUMX% protection, so even after being vaccinated, we can get sick. However, thanks to the earlier intake of the vaccine, the disease, even though it does occur, will be milder. Unfortunately, it is not always possible to get vaccinated. Before vaccination, you must check your overall health and the capacity of your immune system. Contrary to popular opinion, it is not a contraindication to vaccinate just any infection, but only the serious one with, for example, high fever. However, people with reduced immunity – whether caused by natural or artificial factors, such as chemotherapy – cannot be vaccinated. This also applies to children with dysfunction of the neurological system. They should either be released from vaccinations or be given a vaccine other than the standard vaccine.

Where did the anti-vaccine movement come from?

The anti-vaccine movement is almost as old as the vaccines themselves. Already after the appearance of the first, against smallpox, which was created on the basis of observations about cowpox (see box), the side effects in the form of … horns protruding were scared.

The more vaccination became popular, the lower was the incidence of the diseases against which they were supposed to protect. Parallel to this trend, there was a growing interest in the undesirable consequences of vaccine administration. It has been seen as a link between its administration and the incidence of various serious diseases such as multiple sclerosis and autism (see box on page 28). Many of these opinions were later scientifically challenged.

Why are adolescents only vaccinated against HPV?

Young children are already vaccinated against most diseases, but there are exceptions. This is the case, for example, with vaccination against the human papillomavirus (HPV), which causes cervical cancer. In this case, it is enough to be in time before sexual activity begins. Earlier vaccination does not make sense as the virus is only sexually transmitted. In the United States, such vaccination is recommended from the age of 9, in Poland – around 13 years of age.

Vaccinations against HPV are not reimbursed by the National Health Fund. A person interested in vaccinating should prepare for a considerable expense, because the cost of three doses is about 1,5 thousand. zlotys. However, it is worth asking about any local preventive actions – HPV vaccines are financed by local authorities.

It is one of the newest vaccines, so we do not yet know about its possible long-term side effects. However, it must be remembered that in order for any vaccine to be registered, it must meet very high requirements: it must pass Phase I, II and III clinical trials, where it is precisely determined which population must be tested in each of them.

Are there any deaths following the administration of the vaccine?

Fatalities do not actually happen anymore, they are completely unique situations. Although two children in Japan died shortly after receiving the whooping cough vaccine in 1974, there was no evidence of a causal relationship between their immunization and their deaths – it was only a temporal relationship. However, as a result of this incident and the media turmoil that arose around it, many parents refused to vaccinate their children. It did not take long to see the results – there was an epidemic increase in whooping cough incidence very quickly – in 1979 as many as 49 children died of this disease in Japan!

Are all vaccinations for adults paid?

Whether or not we have to pay for vaccines depends on contracts concluded by the National Health Fund. Indeed, most adult vaccinations are paid, although some professional groups, such as healthcare professionals, are vaccinated for free against the hepatitis B virus. Fortunately, we should already be immune to most diseases by the time we enter adulthood. After all, throughout our childhood and adolescence, we were subjected to them: from the first compulsory vaccine administered only one day after birth (hepatitis B, tuberculosis) to the last one (diphtheria, tetanus) in the 19th spring of life.

Three questions about childhood immunization

Iwona Łętowska, MD, PhD from the Department of Prevention of Infections and Hospital Infections at the National Medicines Institute is responsible.

Should children be vaccinated against seasonal flu?

The preventive vaccination program recommends vaccinating healthy children from 6 months of age. This should be done according to the vaccine manufacturer’s instructions.

Is there a link between the MMR (measles, mumps, and rubella) vaccine and autism?

In 1998, an article by Dr. Andrew Wakefield, who argued that the presence of mercury in vaccines is directly related to the onset of autism in children. This link, however, was confirmed by families – not doctors or scientists! – twelve kids. This was followed by at least 20 high-quality medical studies covering 500 children who have refuted the hypothesis that there is a causal relationship between MMR vaccination and the occurrence of autism or this type of disorder.

Are all combination vaccinations paid?

No, not all of them. The DTP vaccine is free, although it protects against whooping cough, diphtheria and tetanus. Highly combined vaccines that immunize you against up to six diseases – in fact, they are often paid. However, they are sometimes prescribed free of charge when there are indications to replace them with the standard vaccine, e.g. when a child has neurological problems or when there is a fear of undesirable post-vaccination reactions.

Worth knowing

Smallpox defeated

Smallpox (also known as black pox) was the first to be eradicated among infectious diseases – this means that there is no longer a risk of contracting a wild virus. The World Health Organization announced it in 1980. The fight against this disease with a vaccine took over two centuries!

As early as at the end of the XNUMXth century, British doctor Edward Jenner noticed that milking machines with scars from cowpox did not contract smallpox. So he started experiments inhumane from today’s point of view, infecting a sick woman of a few-year-old boy with pus by cutting the skin on his hand. The boy fell ill, but the course of the disease was mild. Then Jenner gave him the smallpox virus in a similar way, but this time the little one remained healthy. This was the path to the first vaccine, named after the Latin word vacca, meaning … a cow. Hence the name for the branch of science dealing with vaccinations – vaccinology.

The smallpox virus, however, has not completely disappeared from the face of the earth. It is stored in several laboratories for research purposes.

A LITTLE GLOSSARY OF TERMS

Preventive vaccination program – announced annually by the Chief Sanitary Inspector, contains a list of compulsory and recommended vaccinations. It is available at www.pis.gov.pl, where you can also find important information for travelers.

Compulsory vaccinations – free. Failure to submit to them may be prosecuted under the Code of Petty Offenses (risk of a fine of approximately PLN 1).

Recommended vaccinations – paid.

Combined vaccines – immunize against several diseases at the same time.

Specific vaccines – are directed against a specific pathogen, e.g. streptococcus.

Non-specific vaccines – stimulate innate immune mechanisms. They are most often used against recurrent respiratory or urinary tract infections. According to practitioners, they help more or less every second person.

Polyvalent vaccines – protect against different types of the same microorganism. This is the case, for example, with the polio vaccine, which causes three types of virus.

Post-vaccination Adverse Reactions (NOP) – A feverish reaction, redness and pain at the injection site, which may be accompanied by lack of appetite, general malaise, and constant crying in children. Most NOPs are mild, transient in nature and leave no lasting repercussions. More severe reactions are really rare (once in tens or hundreds of thousands of vaccinations), but there are also serious reactions that may even be life-threatening.

Text: Dorota Jastrzębowska. Consultation: Iwona Łętowska, MD, PhD, Department of Prevention of Hospital Infections and Infections, National Medicines Institute.

Source: Let’s live longer

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