An Appreciation for Vaccines, and How Far They Have Come

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The first pertussis vaccines were developed and tested in the 1920s and 1930s and became universally applicable in the late 1940s. And they worked. Dr. James Cherry, a distinguished pediatric research professor at the David Geffen School of Medicine at the University of California at Los Angeles and an expert on pertussis who has conducted extensive research on both the disease and the vaccines, cites more than 36,000 pertussis deaths from 1926 in the United States through 1930, most in young infants; from 1970 to 1974 there were 52.

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Answers to your vaccine questions

If I live in the US, when can I get the vaccine?

While the exact order of vaccine recipients may vary from state to state, most doctors and residents of long-term care facilities will come first. If you want to understand how this decision is made, this article will help.

When can I get back to normal life after the vaccination?

Life will only get back to normal once society as a whole receives adequate protection against the coronavirus. Once countries have approved a vaccine, they can only vaccinate a few percent of their citizens in the first few months. The unvaccinated majority remain susceptible to infection. A growing number of coronavirus vaccines show robust protection against disease. However, it is also possible that people spread the virus without knowing they are infected because they have mild symptoms or no symptoms at all. Scientists don’t yet know whether the vaccines will also block the transmission of the coronavirus. Even vaccinated people have to wear masks for the time being, avoid the crowds indoors and so on. Once enough people are vaccinated, it becomes very difficult for the coronavirus to find people at risk to become infected. Depending on how quickly we as a society achieve this goal, life could approach a normal state in autumn 2021.

Do I still have to wear a mask after the vaccination?

Yeah, but not forever. The two vaccines that may be approved this month clearly protect people from contracting Covid-19. However, the clinical trials that produced these results were not designed to determine whether vaccinated people could still spread the coronavirus without developing symptoms. That remains a possibility. We know that people who are naturally infected with the coronavirus can spread it without experiencing a cough or other symptoms. Researchers will study this question intensively when the vaccines are introduced. In the meantime, self-vaccinated people need to think of themselves as potential spreaders.

Will it hurt What are the side effects?

The vaccine against Pfizer and BioNTech, like other typical vaccines, is delivered as a shot in the arm. The injection is no different from the ones you received before. Tens of thousands of people have already received the vaccines, and none of them have reported serious health problems. However, some of them have experienced short-lived symptoms, including pain and flu-like symptoms that usually last a day. It is possible that people will have to plan to take a day off or go to school after the second shot. While these experiences are not pleasant, they are a good sign: they are the result of your own immune system’s encounter with the vaccine and a strong reaction that ensures lasting immunity.

Will mRNA vaccines change my genes?

No. Moderna and Pfizer vaccines use a genetic molecule to boost the immune system. This molecule, known as mRNA, is eventually destroyed by the body. The mRNA is packaged in an oily bubble that can fuse with a cell, allowing the molecule to slide inside. The cell uses the mRNA to make proteins from the coronavirus that can stimulate the immune system. At any given moment, each of our cells can contain hundreds of thousands of mRNA molecules that they produce to make their own proteins. As soon as these proteins are made, our cells use special enzymes to break down the mRNA. The mRNA molecules that our cells make can only survive a few minutes. The mRNA in vaccines is engineered to withstand the cell’s enzymes a little longer, so the cells can make extra viral proteins and trigger a stronger immune response. However, the mRNA can hold for a few days at most before it is destroyed.

When I first started in pediatrics in the 1980s, the DTP was without a doubt the shot we least liked to give. From the recordings we routinely took, the children were more likely to react – with fever, sore arms, and sometimes, though very rarely, more serious reactions. We sometimes called it “reactogen”.

The reactions had a lot to do with what was going into the vaccine: whole inactivated Bordetella pertussis bacteria. And although bacteria are microscopic, they are enormous and complex cells compared to viruses, which are made up only of protein and nucleic acid (DNA or RNA). In other words, a whole-cell vaccine had many different compounds that the body could respond to – there are more than 3,000 different proteins in the bacterial cell. For diphtheria and tetanus, individual “toxoids” were used, inactivated versions of the poisons made by these bacteria, so these components were much less reactive.

There were parents who believed their children had been harmed by the vaccine and a strong mood against what we would now call the anti-vaccine movement, as well as ongoing medical controversy over what problems the vaccine had caused and what coincidences were of timing in a vaccine at ages 2, 4, and 6 months and then again in about a year and a half.

Since 1999, children in the USA have been vaccinated with DTaP rather than DTP, with the “a” standing for “acellular”. No more whole cells; These vaccine developers used specific proteins that the body would make immunity to. DTaP recordings are significantly less “reactogenic”.

They also tend to be less effective in eliciting a long-lasting effective immune response; In a 2019 report, Dr. Cherry that the whole-cell vaccines were more effective than the acellular vaccines in almost every clinical study. This included some risk / benefit trade-off and ongoing discussion, as the switch to DTaP has recently been linked to the most recent number of cases, but not necessarily fatalities, and Dr. Cherry argues that the increased number of reported cases may actually be a result of awareness raising and better testing. But even if there is more pertussis in adults thanks to the vaccines, it is no longer a fatal disease in young children.

Although a safe adult booster called Tdap has now been developed, there is still a major pertussis infection among teenagers and adults that is often undiagnosed even by doctors because it may not look so different in adults than other coughs and colds.

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