Vaccines and the Bizarre Hounding of an Established Science

Iffat Ara Sharmeen
Former Student
School of Life Sciences
Independent University, Bangladesh

April 23, 2018

The idea behind vaccines originated in China during the 10^th century. The Chinese prevented smallpox by blowing powdered smallpox scabs through the nostrils, i.e., literally breathing in the smallpox virus through the nose. It was Edward Jenner in the 17^th century that popularized such peculiar ways of inoculation in Britain. He observed how milkmaids never contracted smallpox, because they were previously infected with cowpox. Curious, he took cowpox pus from a milkmaid and scratched it onto a young boy. A few weeks later, he inoculated the boy with smallpox and observed that the boy did not get smallpox. He introduced the term “vaccine”.

Vaccines began to enter the mainstream after Louis Pasteur created vaccines for chicken cholera and anthrax during the 18^th century. Laws on compulsory vaccination began to get established. Vaccines against diphtheria, measles, mumps and rubella became revolutionary. Discovery of polio vaccine in the 1950s and eradication of smallpox were major accomplishments in medical science. Till now, vaccines remain one of the most heavily-researched and thoroughly debated topic among scientists worldwide.

Currently Used Vaccines

Until 15 months after a baby is born, a number of vaccines are recommended, even compulsory in many countries. The list includes vaccines against hepatitis B, BCG, rotavirus, diphtheria, tetanus, pertussis, influenza, polio, measles, mumps, rubella, varicella, hepatitis A, pneumococcal conjugate and polysaccharide, meningococcus and human papilloma virus. Many of these vaccines are followed up in later years, until 18 years of age. Unfortunately, there have been many vocal concerns from parents about the dangers of vaccination in recent years.

The Science Behind Vaccines

Vaccines might sound scary, but they are a proven way of protecting us against some very horrible diseases. So what exactly are vaccines made of. Some vaccines may be preparations of micro-organisms that were once active but have been killed or inactivated. Some vaccines may contain live, virulent particles that have been weakened to be safe. Still others contain deactivated toxic compounds derived from organisms, which are the main causes of disease rather than the organisms themselves. One recent innovation is the protein subunit vaccine against human papilloma virus which contains the viral capsid without the genome inside. One might wonder, why inject such harmful substances in our body? Wouldn’t it cause more harm rather than do good? Actually, it is quite the contrary.

When viruses or bacteria enter the human body, the immune system responds by identifying the virus or bacteria as “foreign”. Parts that are specifically recognized and subsequently targeted as markers of infection are called antigens. During the first encounter with a pathogen, it takes a while for the specific immune response to develop (four to seven days) and produce antibodies to target the antigens. By this time, many pathogens can cause disease. However, if the host is able to survive, and the immune system is able to mount an immune response and produce antibodies to control the infection, it also retains memory of the antigen and the response. This means that the next time the antigen attacks, the immune system is prepared to immediately take it on. Vaccines work by deceiving the immune system into mounting an immune response against specific antigens, so that during infection by the real pathogens carrying those antigens, the host is ready. But the vaccines themselves do not cause disease as they are dead or weakened forms of the pathogens.

How Vaccines Came to Be Considered As Harmful

Worryingly, a very small but increasingly significant number of the population believe and depict vaccines to be harmful. They argue that vaccines may be responsible for conditions like autism or argue that there has not been enough research done to ensure vaccines are completely safe. However, these are not well-researched opinions, since decades of medical research has indeed shown vaccines to be completely safe. The anti-vaccination movement can be traced back to a 1998 study that showed a link between the MMR (Measles, Mumps, Rubella) vaccine and autism. The study has since been discredited and retracted from its journal of publication for containing fabricated data, but the author Andrew Wakefield continues to fan the flames it set off. In addition to the autism scare, some parents are concerned about how large pharma companies and public health organizations earn huge profits by selling vaccines, that are shown to be effective, but are actually not. They also feel that vaccines are expensive and too numerous. None of this is based on fact.

A Vaccine Awareness Poster

Not vaccinating? Think Again

Parents make decisions for their children, keeping in mind their healthy and safe future. However, what if some of these choices end up endangering their lives, the very thing they wanted to protect their children from? The MMR vaccine scare has had real consequences. Measles is coming back around the world from the verge of eradication. A study that looked at the incidence of measles in the US between 2000 and 2015 showed that it has doubled in this time span, although the overall incidence is still quite low (so far). There have been more outbreaks of more than 20 after 2010, suggesting a rising trend. People have also evidently forgotten the harsh realities of diseases such as measles and whooping cough, leading them to downplay the risk. In an important act of science communication and creating public awareness, this was addressed in an episode of the famous medical drama, House MD.

Dr. House comes across a teenaged patient who has been experiencing double vision, sleeplessness, and night terrors. After going through and eliminating several possibilities, including PTSD (from sexual abuse, for instance), and concussion, Dr. House is initially stumped. He observes the patient’s leg is exhibiting a myoclonic jerk, which occurs due to sudden muscle contractions. Dr. House gets even more intrigued after results from MRI showed a blockage in the corpus collosum of the brain due to excess cerebrospinal fluid (CSF). As the condition progresses, the patient starts to have auditory hallucinations and violent shaking. After much drama, Dr. House realizes that the patient’s biological mother had not been vaccinated. She  had also never had measles. During the first few months of a child’s life, the child relies on anti-measles antibodies that it gets from the mother during breastfeeding as the MMR vaccine is administered at nine months. In this case, since the unvaccinated mother left the patient vulnerable, and the observed symptoms match up a rare (1 in 100,000 cases) form of persistent measles: sub-acute sclerosing pan-encephalitis. This is an extremely rare consequence of persistent measles infection (1 in 10,000 thousand cases of measles). The virus hid inside the patient’s brain and ultimately led to severe inflammation there, resulting in the symptoms described.

If the biological mother had been vaccinated, none of this would happen. Vaccines are not as expensive, if long-term thought is given. The patient, fictional but relevant, required various tests, including MRI scans, and two surgeries, which are individually and collectively far more expensive compared to vaccines. Many argue about pharmaceuticals and public health organizations profiting vastly from vaccines which might not be even as effective as they advertise to be. However, a 2015 statistics report showed that the top 20 pharmaceutical drugs with the biggest profit were not even vaccines. If what they sold were not effective, and if years of research and history were wrong about vaccines, there would have been large epidemics of preventable diseases by now. But that is not the case. During the 1950s, 3-4 million people in the USA got measles. Vaccination until now has reduced chances of measles by 95%. Similar decreases have been seen for numerous other diseases such as polio, whooping cough, diphtheria, and tetanus. By accusing vaccines of causing autism, birth defects and other conditions without solid statistical proof, parents are depriving children from their ability to fight diseases that have been prevented by millions of people in this century. France points us toward a possible solution: it is a criminal offence there for a parent to not vaccine children.

The Future of Vaccines

Research on vaccines is still at large, as there are no established vaccines for HIV, hepatitis C, Ebola, respiratory syncytial virus, cytomegalovirus and malaria, although there are many experimental candidates, and there have been several trials. Several new approaches to vaccinations are being tested. For instance, DNA vaccines, which have been in the works for several years, use the concept of inserting viral/bacterial DNA into the body for the DNA to be expressed as proteins in host cells, and the immune system to then respond to them as antigens. But continued progress relies on public funding which in turn ultimately depends on public opinion. Therefore, for preventing preventable diseases, and generating novel vaccines against emerging pathogens, the importance of vaccines cannot be overstated.

Sharmeen is a recent Biochemistry graduate from IUB. She loves to explore the real world and her inner self through science and logic.

How Smallpox Was Conquered

Farina Afrin Malik

Freshman

School of Life Sciences

Independent University, Bangladesh

March 23rd, 2017

From the day we are born and sometimes prior to birth, we humans have had one constant companion: disease. However for as long as disease has existed so has our ability to survive despite them. Over the centuries, by sheer perseverance humans have discovered many ways of treating these diseases. We have made great advancements in our methods of treatment and have attained means of curing and preventing innumerable diseases. One such illness that we have actually managed to successfully eradicate is smallpox.

Smallpox is known to be caused by a virulent form of the Variola virus. The symptoms of this disease include small rash-like bumps forming all over the body. Some may confuse smallpox to be chickenpox, as their symptoms are quite similar, but their most distinct difference would be the fatality rate. Smallpox had a 30% death rate, unlike chickenpox which has a less than 1% mortality rate. Smallpox also often resulted in lifelong scarring and disfiguration whereas chickenpox causes mild scarring which would heal with time. 

Public domain

An 18^th century English scientist, Edward Jenner, was the mastermind behind the vaccine; he discovered that milkmaids who were infected with a milder disease called cowpox (a viral disease which commonly occurs in cows) did not suffer from smallpox. He transferred some of the fluid found in the pustules in the skin from the cowpox-infected person to a healthy individual, and later challenged him with smallpox. The disease was effectively prevented, suggesting that exposure to cowpox had somehow made the individual immune to, or protected against smallpox. Edward Jenner coined the term vaccinia to denote cowpox, and this became the origin for the term vaccine.

Since Jenner lived in a time with much more lax ethical standards in society, he was able to carry out human testing. Today however, animal testing of some form is carried out before human trials since it is considered unethical and risky to test on humans first. 

Jenner's original discovery led to the development and standardization of a commercial vaccine against smallpox. To continue the work started by Jenner, many individuals all over the world collaborated to establish The Smallpox Eradication Programme that began its work in 1966. One of their main techniques that helped in conquering this disease was the “ring vaccination” method. This particular form of vaccination involved administering the vaccine to all the individuals living in a radius surrounding an infected person so that the disease would not spread beyond this area. Infected and exposed individuals were isolated or quarantined to minimize spread.

As part of the worldwide eradication effort, the exact same methods of treatment were conducted in Bangladesh during the 1970s, by the American doctor, D.A. Henderson who traveled across the country examining every case of smallpox and preventing it from being spread to neighboring villages. Once all individuals had been vaccinated, he offered rewards to anyone who could bring forth a patient who had acquired smallpox. Near the end of the decade, the disease was declared by the WHO (World Health Organization) to have been successfully eradicated. 

From this success we can gather that with large-scale collaborative effort, it may be possible to replicate this for other pathogens. It is also quite likely that it may happen sooner than we expect, as recent updates state that polio and measles are on the road to eradication as well.

Farina is a Freshman at IUB who aspires to be a biomedical scientist. In her free time, she enjoys delving into the sciences of baking and imaginative fiction.

Revisiting the 2009 Swine Flu Pandemic

Amira Mohammed Ali
Senior
School of Life Sciences
Independent University, Bangladesh

23rd March, 2017

Influenza, commonly known as the "flu", is a disease caused by the influenza virus. The virus is known for its ability to cause pandemics, in which cases of the disease spread across multiple continent. The 1918 Spanish flu pandemic is estimated to have killed up to 50 million people. The virus has resulted in a few more pandemics since then, notably the 1957 pandemic that claimed around 4 million lives worldwide, and most recently the 2009 swine flu pandemic. Influenza virus has several subtypes, and is known to frequently produce new strains. It not only also has the ability to adapt through mutations or random changes in its genetic code, but can also exchange genes with other strains of influenza in cases where two or more strains infect the same individual. Seasonal influenza is very common and occurs every winter throughout the globe, and the new strains we see every year occur mostly as a result of accumulating mutations. The other mechanism of variation, in which exchange of genes can create new, unpredictable strains, resulted in the 2009 H1N1 pandemic strain which had never infected humans before. It was derived from an animal influenza strain, and different from the seasonal H1N1 strains that normally affect humans.

The first infection with this new strain is believed to have occurred in March 2009 in Mexico. Immediately after the first case, suddenly a number of these new H1N1 infection cases were rushed into many clinics across the country. The outbreak received increasing attention as the infection started to spread out to the northern parts of America. The CDC (Center for Disease Control) collected patient samples from infected people, and confirmed the emergence of the new strain. After few weeks of initial emergence of the new virus, it spread to 74 countries causing 29000 cases. The WHO (World Health Organization) declared it a global pandemic. The number of infected patients increased steeply as the winter approached globally.

Intensity map of confirmed cases of 2009 swine-derived H1N1 influenza. Public domain

To tackle the infection, a huge number of antiviral drugs, Oseltamivir and Zanamivir, were released to treat the patients. When existing drug supplies were insufficient and sometimes ineffective in meeting the rapidly increasing demand for treatment, the FDA (Food and Drug Administration) issued emergency use of previously unapproved antivirals and diagnostic tests for the H1N1 strain. Other measures were taken at that time to halt the spread, e.g. by monitoring airports.

After these efforts, the pandemic started to decline from May 2010 and in August 2010, the WHO declared that it was over. Even though the pandemic was over, it had taken more than 18,000 lives (laboratory confirmed) and made many more people sick globally. The WHO then declared a post-pandemic period where people received help to overcome the difficulties they had gone through. To help prevent any such pandemic in the future, the US government and private manufacturers have developed a vaccine in the form of injections (flu shots) and nasal spray, for swine-derived H1N1 influenza virus.

Amira is a wanderer and tries to understand the wonders of life. She wishes to have a lab of her own one day where she will unravel the mystery of life.