Friday, August 23, 2013

Vaccinations Protect All of Us

By Steven Cole, DO
Dallas Allergist and Immunologist

Vaccines are one of medicine’s greatest triumphs. They have led to the eradication of smallpox worldwide and made polio a thing of the past in the United States. A recent study published in the New England Journal of Medicine demonstrated a decrease in hospitalizations from pneumonia after the newer pneumococcal vaccine was introduced into the United States Physicians are equipped with precious few tools that are so efficacious in disease prevention. Think about it. ... No antibiotic can target a bacterium with as much accuracy, and no surgeon’s scalpel can cut so exact as to compare with the precision of vaccines.

The reason that vaccines are so successful is the mechanism in which they work: They use the body’s own defense system to prevent infection. Specific types of white blood cells are exposed to tiny amounts of the vaccine contents after the person receives the vaccine. Most of the time this results in the production of antibodies that will tag the invader for destruction or help to block the invader from attack. This enables the immune system to learn how to deal with the disease if it is ever exposed to the actual disease-causing organism in the future.

Despite the successes of vaccinations in this country, much work is still needed. More than 40,000 adults will likely die this year from vaccine-preventable illness, and only about one-third of U.S. adults received a flu shot last year. Misunderstanding about the safety and efficacy of vaccines has led to vaccine refusal among some populations in our country. However, not only the people who refuse the vaccine actually end up facing the consequences of this decision. Many children are too young to receive the vaccine because of a still-developing immune system. They depend on the rest of us to be vaccinated so that the disease is not present in the general population, and this way they are rarely ever exposed to the disease to begin with. This is known as herd immunity, and it also protects the elderly with waning immune defenses as well as people who have immune deficiencies. Some people with a weak immune system are unaware of their deficiency until they are hit with an unusual infection that most of our immune systems would normally just shrug off.

I like to think of getting vaccinated as akin to washing your hands after going to the bathroom. Sure, I wash my hands because I don’t want to get sick after eating a chocolate éclair all covered in E. coli (the predominant bacterium found in poop), but not washing my hands could make other people sick as well. Using poor hygiene, whether it’s spreading around bacteria on doorknobs, or not getting routine vaccinations, exposes everyone else to unnecessary risk. If it were only a single individual making the conscious decision to forgo the hand washing in favor of a poopy éclair, this would not be as big of a public health concern as it is. Similarly, when people choose not to get vaccinated, they decrease the immunity of the herd. I don’t want other people’s disease-causing germs on my food, and I’m certain that babies, the elderly, and those with a weakened immune system don’t want disease-causing germs in their air.

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