Vaccination – yes, no, maybe?

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More and more often the media is reporting on outbreaks and deaths relating to diseases preventable by vaccines. Just recently at the end of 2014 in the area of Berlin, a measles infection outbreak was reported. In February the media reported that a small boy died of the measles.

By means of a preventive vaccination, an immune protection can be established before the body is exposed to the pathogen, which then leads to an enhanced immune response in the event of an infection. As immunologists, it is difficult to understand for us, why one would not be vaccinated because the vaccines nowadays are well developed and offer good protection. We can vaccinate ourselves against infections that got rare, thanks to vaccination campaigns, such as measles or rubella, but vaccines against the annual flu are also made available.

What happens during a vaccination?

The basic idea of a vaccination is that the immune system gets the pathogen presented in a harmless form, so that the pathogen can be recognized, memorized and fought more easily in an infection situation. In order to accomplish this, sub-components of the pathogen which are inactivated or attenuated are injected. The pathogen components are recognized by immune cells (eg, macrophages, dendritic cells), and then in turn these activate and mobilize other immune cells. Thus, a normal immune response is taking place, as in the case of infection, only that the attenuated or killed pathogen in the vaccine would not make us sick, but it is sufficient to activate the immune system and to develop protective immunity. In the case of an actual infection with the natural pathogen later on our immune system recognizes the pathogen faster, before it can multiply and spread in the body, and combat it more effective.

Another kind of vaccination is the passive immunization, in which instead of a virus component an immune system component, called antibodies, is injected, which accelerates our immune response. Such a vaccination can be given, if there already is an infection and the immune response has to be supported. Examples include the passive rabies vaccination or the Tetanus vaccine. In these cases, pathogens are transmitted through bite wounds or dirty wounds.

Concerns about vaccinations

Certainly, some among us have concerns about getting vaccinated. They fear to become sick from the vaccine itself. It is important to distinguish that vaccinated people do normally not develop the disease of the injected pathogen, but rather report an increased temperature or redness. We must not forget that the goal of vaccination is to induce an immune response. This has, among others; the result that immune cells increasingly accumulate at the injection site to respond to the vaccine, which caused redness. Also, an elevated temperature may be due to an increased activity of the immune system, because in an immune response inflammatory mediators are released which can, for example, increase vascular permeability, so that immune cells can more easily get to their destination. Therefore, physicians usually recommend not to participate in any endurance sports and to rest a day or two after vaccination. This can help to prevent, for example, cold symptoms such as fatigue and fever.

A major setback for the acceptance of vaccination was caused by a publication in the journal “The Lancet” in February 1998. In this work, a correlation between the mumps, measles, rubella triple vaccination and autism was postulated. However the study had, according to an inspection of the British Medical Association, numerous deficiencies, after which the publication was officially withdrawn from the magazine and the author and physician got his medical license revoked. Nevertheless, the message about autism being caused by vaccinations still persists in the minds of people and led to a decline in vaccination rates.

Personally I am, not at least because of my passion for traveling, vaccinated against pretty much all diseases out there and I feel better because of that. I also never experienced any side effects from my vaccinations. In addition, when considering a vaccination we also have to think beyond the personal protection from diseases. Diseases are spreading because people infect each other. This can be stopped if as many people as possible are vaccinated against diseases and develop a protection. Thus, people profit from an improved immune protection, less people come sick and the chain of infection can be interrupted. Therefore, I personally think it is important that as many people as possible get vaccinated, so that we can hopefully soon declare more diseases as extinct. It is also important to still get vaccinated against diseases that have become rare, to continue to prevent another outbreak. Moreover, in this context it is also important to note is, that some vaccinations are not possible until a certain age is reached, for example, the measles vaccine is intended for children from 11 months onwards. Thereby a vaccinated population also provides an indirect protection for those who cannot get vaccinated themselves and could potentially be infected.

So once again look into your vaccination record and check if you need a refresher or new vaccination. An overview of the refresher times and recommended vaccinations can be found here.

If you have any questions please contact us.



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