vaccination

I have a couple of questions about vaccinations:

How do they work?

Why don’t the make you sick?

What are all these terrible diseases and why don’t I want to get them? I think the list (see like below) of diseases is now:
Hepatitis B
Diptheria, Tetanus, Pertussis
Haemophilus Influenzae type B
Poliomyelitis
Measles, Mumps, Rubella
I mean, I’ve had Rubella as a kid and it wasn’t that bad.

Why do you have to have multiple shots when you’re having them at the same time (eg at 2 & 4 months in the Australian immunisation schedule you get two shots at the same time, why can’t the make it one shot with the lot?)

Why do you have to have the same vaccine multiple times (eg DTPa at 2, 4, 6, 18 months & 4 years)

Some of the vaccines are new since I was a kid, so even though I got all the required shots back then, there are some I haven’t had (the Pa bit of DTPa, HepB) - should I go back and get them?

How important is when you have it? For example they recommend MMR at 12 months now, but I got it in year 6, when I was 12 years old. Why can’t you get it all over and done when you’re a little baby, rather than having various shots as a teenager & adult)

Why do you take some orally (eg sabin - the foulest tasting substance on earth), but others have to be a shot?

Who decides what vaccines everyone should get (and are therefore free)? (Here in Australia if it’s on the schedule, you don’t have to pay - or it’s heavily subsidised by the government or something, but if it’s not on the schedule, you have to pay for it).

Why do they hurt so much? I’ve had blood taken, I’ve accidently stuck myself with a sewing needle, but none hurt quite so much as a vaccination.

Robin lots of info available at www.traveldoctor.com.au should answer some of your questions.

Thanks leechbabe I had a poke around but that’s not really what I’m after - I’m more after the standard set of vaccinations that one gets as a kid, and general vaccination info not what ones I would need to travel.

I know that Rubella, for instance, while not a very serious disease, can cause birth defects if a woman is exposed while she is pregnant.

And nobody has to worry about foul-tasting Sabin oral vaccine anymore, because smallpox has been eliminated (we hope).

A lot of the childhood illnesses are not serious if you get them as a child, but are serious as an adult - rubella can cause a type of arthritis for example, if you get it as an adult, and makes you very ill with severe flu-like symptoms, in addition to the standard rash (when I got it as a kid, I got 2 weeks of school for being infectious, whilst feeling perfectly healthy), so there are good reasons to have a vaccination against childhood illnesses if you’ve never had that illness.

Mumps, IIRC, can cause sterility in males, so that’s another reason to vaccinate against it.

Pertussis is whooping cough, a fairly nasty disease, but rarely caught outside of childhood & AFAIK no more or less serious at either age.

As for how the vaccines work, it depends on the disease - some vaccines contain live, but weakened forms of the virus/bacteria, some contain dead forms of the virus/bacteria, and some contain fake forms of the virus/bacteria - it looks like it to your body’s immune system, but it’s not the real virus, dead or alive.

The trick here is that your body fights viruses & other diseases by producing chemicals/cells that lock onto the outside of the virus, and destroy it. To protect you against a new disease, there’s a time lag while they work out the shape they’re going to lock onto & start to produce the right antibodies. During that timelag, of course, the virus is reproducing like crazy & making you ill - in some cases killing you.

If they give you a weakened form of the virus or bacterium that causes the disease, or a shot of dead virus/bacteria, your body will get to learn the shape to react to without having the disease caused. Then if & when you get exposed to the disease, your body can just start whacking out antibodies straightaway with no learning period (& it usually maintains a low level of the antibodies constantly too, so it should mop up the odd one or two viruses that happen to occur before they even need that wholescale warfare gearing up to happen).

You do sometimes get a less severe form of the disease because you’ve had the vaccine - the MMR vaccine apparently can cause a mild fever and a rash about 3 weeks after the shot (that’s about the usual incubation time for the measles virus for the symptoms to show) and that’s because it’s a live virus, but a weakened one that you get given.

Now then - what diseases haven’t I covered?

Polio - this disease can kill you, or leave you paralysed, at any age. There’s a new combined vaccine out for Diptheria, tetanus & polio that allegedly covers you for life. If you haven’t had it, get it. If it’s not available where you are, get your booster shots ever ten years.

Tetanus - this is a bacterium, the spores are found in soil, so it’s all around you, theoretically, but can only enter the body through an open wound - any time you get a bad cut that needs stitching, they’ll usually ask you at the hospital when your last tetanus shot was. If it’s over 5 years, they tend to jab you again, so you feel doubly in pain ;). It causes a disease called lockjaw in its common name - the bacteria produce a toxin that causes all your muscles to try to contract. All of them, at the same time. Causes pain, paralysis & death (heart can’t keep beating, lungs can’t expand).

Diptheria - caused by a bacteria, and again, it’s the toxins it produces that kill you - they can damage heart & nervous tissues. In the UK, in 1940, 46,281 cases and 2,480 deaths were notified, but since vaccination came in, only 2 deaths have been recorded since 1972 & most cases are acquired abroad by people who have let their vaccinations lapse.

Hepatitis you definitely don’t want - it can be transmitted by blood or by sexual conact - ther are various different strains & they recomend different vaccines depending on where you’re going - Hep A & B are the common ones to get protected against, but it varies by country of destination. You can also get a vaccination of antibodies against the disease if you leave it to close to your trip to be immune from the actual proper vaccination. The immunity from that only lasts about 3-6 months though, and the immunity from the other method lasts about 3 years for the current vaccines.
The antibodies are prepared from human blood (Immunuglobulin A) & the shot is given into the gluteus maximus (backside). If you are at all concerned about health risks from blood products, or have religious reasons not to receive blood from other people, then you have to skip that method & have the proper vaccine (which is a much better option anyway - longer protection).

I don’t know anything about that type of influenza, but I do know that people at risk are often vaccinated against whichever the current strain of flu is - usually the elderly & the very young, and anyone with a weakened immune system, or possible complications from respiratory diseases, like asthma. That needs doing each year, as the virus mutates so fast & changes its outer coat, so your body stops recognising it.

I think that covered everything. If you have more questions, just ask.

You can find the answers to your questions at:
http://www.cdc.gov/nip/

Thanks guys!
h.sapiens I thought sabin was for polio, not smallpox and Fierra from what I can find Haemophilus Influenzae type B
(Hib) is not related to traditional Influenza despite the name, but I can’t find anything that tells you what it is and what it does - what I can find seems to say that if you get Hib, it can cause complications such as meningitis…

The link Yeah provided was great - but there are a few differences between what we do here in Australia (for example, we don’t get the polio vaccine in a shot, we take it orally).

Robin more links for you below and you are correct the oral sabin vaccine is for Polio. There is also an injectible Polio vaccine that has less side effects that Sabin but most people choose Sabin because they don’t want an injection.

http://www.vicnet.net.au/health/

CSL or Commonwealth Serum Laboratories - based in Parkville VIC. (near Melb.Zoo) make most of the vaccines supplied to the Australian Govt.

Possible Reactions to Immunisations

Brisbane City Council FAQ about immunisations

Immunise Australia Information Campaign

Info from Uni of NSW

Immunisation info for Parents

If you want more info just type “immunisation” into google. Took make it for location specific (ie Aussie info) I typed “immunisation site:.au”

Finally the other big vaccine provider in Australia is Glaxo Smith Kline

coding fixed – Alpha

:eek: Aurgh my coding!!! :smack: I’ll get this sorted one day.

The Sabin vaccine IS for polio - you are quite correct. It is a live virus vaccine (the virus has been weakened so it only causes a very mild infection). Why use it? “Normal” (wild type) polio is contracted orally - you ingest the virus, and it infects the gastrointestinal tract, where it proliferates. After a period of proliferation in the gut, the virus then spreads through the blood stream to the nervous system. The killed virus vaccine (the injectable one) causes antibodies to form in the blood, which are protective and prevent the spread of virus to the nervous system - but if a person who’s been vaccinated with it is ever exposed to the wild polio virus, the wild virus can still set up housekeeping for a while in the person’s gut - and be shed in the person’s feces (thus posing a risk of infection to others). But the gut itself is a place where antibodies can be formed (it’s lined by lymphoid tissue); a person who’s been given the Sabin oral polio vaccine has the weakened virus proliferating in their gut, then producing the secondary bloodstream infection, just like a natural polio infection. When they are exposed later to wild polio, the wild virus CAN’T propagate in their gut OR in their bloodstream, because they’ve formed an immunogenic respnse in both places from their earlier vaccine exposure. So the Sabin oral vaccine gives better immunity to polio. But there’s a slight downside to it - VERY rarely, the weakened virus can revert to full-strength, and then the vaccine itself may cause polio in the recipient! So in many countries where polio has become very rare, health systems are switching to the killed vaccine exclusively, or administering the live virus vaccine only after giving one or two doses of the killed vaccine first (so the person has some blood immunity in place before being exposed to the live virus to induce the gut immunity - this makes it a bit less likely that they would develop full-blown polio if the live virus in the vaccine should revert to a dangerous form).

As for HiB - this has NOTHING to do with the flu. Hemophilus influenzae is a bacterium (not a virus, like influenza), which generally causes upper respiratory infections (it’s a big player in children’s ear infections) and sometimes pneumonia. But the type B strain of this bacterium can cause bacterial meningitis - a serious infection of the central nervous system which can be rapidly fatal; survivors may have permanent brain damage. HiB meningitis is most common in preschool-aged children - or it WAS, before the vaccine became available. Now that the HiB vaccine is a standard part of the pediatric vaccination schedule in developed nations, this terrible disease has mercifully become rare.

Oh and about pertussus - people can catch it at any age, but the disease is much more serious in infants and young children than in adults (who generally just think they have a bad cold). That’s why there’s so much emphasis on vaccinating infants and toddlers for this disease - it can be fatal to them. The common name “whooping cough” PERFECTLY describes the symptoms in young children.

Any other questions, just ask away!

As for boosters, infants and very small children don’t have fully active immune systems yet, so their bodies “forget” antigens a lot more easily than the adult body. You have to get revaccinated periodically in order to maintain immunity, but because of their rapidly changing immune systems kids have to get boosters more often than adults do.

Also, each exposure to the antigen strengthens and speeds up the body’s response, so your body gets busy kicking virus butt before you get a serious enough infection to make you ill.

Oh, and IIRC, the tetanus shot is actually against the toxin, not the bacteria themselves. The bacteria aren’t such a huge deal other than producing a deadly toxin.

The guidelines for repeating immunizations are (or should be) variable depending on the risk for the area where you live, or expect to travel. The duration of immunity is a variable, and it turns out that some people keep immunity for a long time, while others keep only a very weak immune response beyond a few years.

Recent testing shows that some people vaccinated against smallpox in the late sixties still show good immune response to the surface antigens of closely related viral particles. That means there are probably a lot of people in the world with some level of smallpox immunity even after so very long. Also, it many cases the wild strains of viruses for which vaccination programs have been very successful are rare enough that the danger of infection is very little more than the danger of inoculation, which is never zero.

Oh, and smallpox vaccine does not contain smallpox viruses. It contains Vaccina viruses. While it is possible to become ill from Vaccina, it is rare, and it is extremely unlikely that you would communicate the infection if you did. Even in the unlikely event that it was communicated to another, it still would not be smallpox.

When panic sets in, and the US begins mass smallpox vaccinations again, it will probably kill between twenty and two hundred people. Those deaths will not be deaths from smallpox. Most of those people will die from anaphylactic shock, and a few from extreme susceptibility to vaccina infection. There are a lot of people in the medical world who think that number is lower than the number who would die if a “ring response” vaccination program were prepared to be administered by federal emergency teams instead of unplanned implementation of mass vaccination by local health systems.

Tris

“When panic sets in, and the US begins mass smallpox vaccinations again, it will probably kill between twenty and two hundred people. Those deaths will not be deaths from smallpox. Most of those people will die from anaphylactic shock,”

Triskadecamus, can you give a cite for the estimate that most deaths from smallpox vaccine will be from anaphylactic shock?

I was wondering this myself lately.
My son had his immunizations before age 5.
Now he has (probably) measles.
When i was little, i had everything.
mumps, measles, once when I was a teen, i had scarlet fever and measles at the same time.
I was sick a lot.
I wonder if I’d been immunized enough as a child (born 1958).
Did the laws change (you must immunize before we let them in school? When?)

I believe that the laws vary from state to state. Most states make allowances for “religious objections” to vaccination. Of course, enforcement could also vary from school district to school district, even from school to school.

Here are some dates for the U.S.:

measles vaccine licensed 1963
mumps vaccine licensed 1967
rubella vaccine lincensce 1969

There is no scarlet fever vaccine.

My information doesn’t come from an internet site. In the literature included in most injectable drugs anaphylactic shock is the most common serious expected side effect. So strong is that possibility that many doctors keep patients in their offices for twenty to thirty minutes after any injection. Sadly, many public health faciilities are far more busy than a doctor’s office. More would be so in a mass immunization program, especially under the stress of an emergency response.

The raw numbers I gave came from a NIH report on the potential risk of vaccination programs, and I admit freely having projected the breakdown as to cause of death. Other sources list the potential for deaths as high as ten thousand. I did not include those, since I found that to be somewhat alarmist.

Risk analysis is a very difficult task.

Tris

“I admit freely having projected the breakdown as to cause of death.”

I don’t think you can assume, in the absence of evidence, that a live virus, introduced into the epidermis, is likely to cause the same spectrum of adverse events as do injectable drugs. And in reading the literature on adverse reactions to smallpox vaccine, I have not run across a mention of fatal anaphylactic reactions.

Scarlet fever, incidentally, starts out as strep throat (and if untreated can develop into rheumatic fever), though not all cases of strep throat develop into scarlet fever. Scarlet fever is rare in countries with good health care systems these days, because strep infections are nearly always treated with antibiotics as soon as they’re diagnosed, before they have time to develop into the more dangerous stages.

Could anyone confirm or deny fierra’s report of a combined diphtheria-tetanus-polio vaccine? DPT has been diph-tet-pertussis (whooping cough) from the time it came out and at least until totnak got his baby shots. He got the polio vaccines in the same shot with HiB, but the nurse said that was just to save jabs since, here, the shots are usually given at the same time anyway.

Aventis has a DTaP, Hib, polio, hep B vaccine in in Phase II trials
Aventis has a DTaP, Hib, polio, vaccine in in Phase III trials
GlaxoSmithKline has a DTP, Hib, polio, hep B vaccine in Phase III trials