Wednesday, 16 April 2014

Infecting with Immunity: How Vaccines Actually Work

One of the major challenges scientists face is communicating important information to the general public. As brilliant as many of them are, hours spent in a lab hunched over a microscope do little to improve a person’s ability to explain things simply and comprehensibly. Complicating things further is the fact that scientists are trained to constantly question and test their ideas so they say a lot of things like “we believe” and “these results suggest” when really they mean “I am sure this is true, these are facts.” When you’re talking about the evolutionary history of Amazonian frogs or something like that, it tends not to matter; but occasionally a topic comes along where a clear explanation of how things work is even more important than a detailed reporting of the facts. Vaccines are one of those topics.

Right now in the Fraser Valley of British Columbia Canada, several hundred people (mostly children) are infected with an unpleasant and occasionally fatal illness that scientists basically cured a long time ago. Over 200 cased of highly contagious measles have popped up in the region and a few infected people have found their way to Ontario and the Atlantic coast, largely because the Fraser Valley has one of the lowest measles vaccination rates of anywhere in Canada (between 70 and 80%).

Much of the problem lies in the fact that vaccines inject viruses and bacteria into people’s bodies. Generally speaking we are taught that this is a bad thing, so our instinctive reaction is to avoid it. Teaching people that infections are bad and then telling them that you need to inject them with a virus is generally a hard idea to sell because, quite frankly, it makes you seem insane.

The truth is vaccines actually are made of the viruses and bacteria that they are trying to prevent. To understand why that is necessary we need to understand the immune system. You see, when an unfamiliar virus or bacteria makes its way into your body it sounds an alarm that activates an immune system response. These invading organisms are called antigens and their goal is to replicate as much as possible. 

Since our bodies are not designed to handle that sort of thing the results can be very bad, resulting in sickness and sometimes even death.

Your body doesn’t like dying, so once that alarm is sounded you’re white blood cells get to work. Your T-cells identify which cells in your body are infected by the intruder and destroy then to try to contain the infection. Meanwhile your B-cells produce antibodies, which attack antigens directly and try to prevent them from infecting more of your body’s cells.  

Vaccines take advantage of this response by tricking your body into thinking it has been infected by a specific virus or bacteria, but in order to do that they need to introduce some of these intruders into your body. Obviously the goal of vaccines is to prevent infection so it wouldn’t make much sense to pump you full of measles. Instead, vaccines use a weakened or inactive (dead) form of the intruder/antigen.

Vaccines that use weakened antigens are called live-attenuated vaccines, because they inject still living infections. The trick with live-attenuated vaccines, however, is that they use the dumbest, laziest individual viruses and bacteria possible. To create these vaccines scientists take something dangerous like measles and give it a relaxed, cushy life in a test-tube. The infection is continually transferred from one test tube to another, each time getting a little more used to the good life. After enough time and transfers (77 in the case of the measles virus) the infection is so used to not have to do anything to survive that it has lost most of it’s tenacity. When injected into the bloodstream these infections reproduce at most 20 times rather than the thousands and thousands of times they normally would. Your body is easily able to identify and destroy these antigens.

The cool thing is that you immune system has a great memory, so once the infection is gone your B-cells continue to produce the antibodies that can kill it, making you immune for life.

Inactivated vaccines use dead viruses that don’t reproduce at all. The benefit to this is that there is zero chance of any kind of negative reaction (live-attenuated vaccines can lead to soreness at the injection site and occasionally some mild symptoms), the downside is that you often need multiple shots to maintain immunity because your body thinks the disease is a dud.

One of the most publicized fears about vaccines is so-called link between vaccination and autism. This link is a myth. It arose when some people discovered that a disinfectant used in some vaccines (Thimerosol) contained mercury. There is however no reliable research supporting this claim (Parker et al., 2004). Even still, most vaccines now contain no Thimerosol because the companies that produce the treatments want to make parents feel as safe as possible. One real health concern that goes along this vaccines is the risk that some flu shots pose to people with egg allergies. Since influenza is grownin eggs to create the vaccine, there is a chance it can cause an allergic reaction. If you’re allergic to eggs to can still get a flu shot, you just have to talk to your doctor about getting one of the varieties that is not developed using eggs (there are plenty).

Vaccines are clearly a very cool topic. They have eliminated diseases like polio and smallpox from much of the world and continue to save millions of lives each year. In closing, I just want to say that it is okay to question things. Skepticism is a great quality that can lead to critical thinking and amazing ideas and innovations. That being said, the science behind vaccines is inarguable. They prevent needless suffering and protect at-risk people from terrible diseases. If you have questions about them, by all means continue to read up on the subject; but rest assured, vaccinating yourself and your children is the most responsible decision to can possibly make. It’s a no-brainer.