Exploration of the Role of Vaccines in Medicine
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Exploration of the Role of Vaccines in Medicine
Introduction
A vaccine is a substance that is administered in an individual with the aim of stimulating the production of antibodies so as to provide immunity against a single or several illnesses. The World Health Organization defines vaccines as biological preparations that help improve the immunity of an animal or human being to a particular disease. Vaccines can be therapeutic and prophylactic. Prophylactic vaccines are used to ameliorate or prevent the impacts of future disease by a certain natural pathogen. On the other hand, therapeutic vaccines are meant to prevent various types of cancer. These types of vaccines are still under intense investigation. A vaccine can help prevent one disease and in some cases, several vaccines are combined to prevent several diseases with a single shot of the vaccine. For instance, the MMC vaccine is administered to prevent Mumps, Measles and German measles (Rubella). Vaccines are usually administered orally or by the use of needle. A vaccine normally encompasses an agent that bears a resemblance to the microorganism that causes the disease being prevented (Plotkin, 2010). The agent is a killed or weakened form of the disease-causing microorganism. When a vaccine is administered, the agent provokes the immunity system of the body to identify the agent as a foreign substance. The immune system then annihilates the agent by producing antibodies. The immune system also keeps a record of the disease-causing agent so as to identify and destroy any of such agents that it may encounter in the future.
Safety of Vaccines
Vaccines are believed to be very safe with millions of adults and children getting vaccinated against various diseases every year. However, the main definition of safe as a word implies that something is harmless. This suggests that any negative effect of the vaccine would render it unsafe. By use of this definition, then no vaccine can be said to be 100% safe. At the site of injection, most vaccines results to redness, tenderness or pain. For instance, the vaccine for whooping cough (pertussis) is known to cause high fever, inconsolable and persistent crying and seizures that can be attributed to high fever (Miller, 2008). Even though none of such severe effects results to any enduring damage, they can leave one very frightened. Nonetheless, in truth, very few things in this world meet the standard of being harmless. From a vaccination perspective, safety can be described in terms of the effect that the vaccine has on the health of a person or animal it is administered to. The benefits of most vaccines normally outweigh the risks associated with the vaccine. One is likely to be more unsafe from contracting the vaccine-preventable disease than by the vaccine itself. For instance, a preventable disease like polio causes paralysis whereas measles results to blindness and encephalitis. Other vaccine-preventable diseases result to death. However, the vaccine for polio has no major side effects and hence, its benefits greatly outweighs the risks associated with failing to take the vaccine (Stratton, Almario & McCormick, 2003). For the measles vaccine, the most common side effects are tenderness or swelling at the injection area as well as fever. In general, severe reactions to taking vaccines are very rare and happen to one or two people out of a million shots of vaccine administered. Furthermore, research on why some vaccines have adverse effects on people is on progress to make such vaccines safer. Again, before a vaccine is approved as legit, it undergoes numerous clinical trials to ensure it does not cause damage to those who take it. In general, vaccines can be said to be very safe.
History of Vaccines
Introduction of Variolation
Perhaps, the utmost success story in healthcare is the decline of infectious diseases; an occurrence that resulted from the discovery of vaccines. The history of vaccines and vaccination dates back to 900 AD when the Chinese discovered variolation (inoculation). Variolation was a primitive sort of vaccination that was discovered in China. Its discovery was greatly attributed to the discovery by Thucydides, a Greek historian, in 429 BC that people who survived a small pox infection never contracted the disease again. The Chinese carried out the oldest documented form of variolation which dates back to the 15th Century (Hinrichs & Barnes, 2012). At this time, they carried out a technique called nasal insufflations where powdered materials of small pox, usually scrabs, were blown up the nostrils of an individual. Variolation also entailed rubbing or inserting powdered scrabs of small pox into shallow scratches made on the human skin (Deng & Wang, 2011). The scrabs used were left to dry for sometime before they are administered to humans. This is because it was feared that fresh scrabs were likely to cause a full blown smallpox infection in case they were administered in humans. By the early seventeenth century, variolation had spread to Middle East and Africa. By this time, Western Europe medicine professionals still saw variolation as a folklore and mediocre practice. However, the efforts of Doctor Emmanuel Timoni, an Italian Physician based in Constantinople, promoted the practice of variolation in the Western Europe region. After coming across its practice, Dr. Timoni wrote a letter that described the technique in detail. In 1714, the letter was made public after the Philosophical Transactions published it. The letter caught the attention of Lady Mary Wortley Montagu (the wife of British ambassador) and Cotton Mather, a preacher from Boston. Lady Mary Wortley Montagu had survived small pox but had lost his brother to the disease. She came across the practice of variolation when it was being carried out on people of Constantinople. She decided to have the practice carried out on her son, Edward Montagu and later on her daughter in 1721. The variolation on her children proved to be successful and when she returned to England, she advocated its practice. As a result, variolation became a major practice in various regions across England. The Suttons, a family of physicians, helped revolutionize variolation by coming up with the suttonian method of variolation. The suttonian method involved making a shallow scratch and carefully inserting weakened form of smallpox scrabs on the skin with no bleeding occurring. They published the way to go about this practice in their book called “The Inoculator”, which was published in 1796. By this time, variolation had spread to the rest of Europe and America, though suttonian method was being practiced in the Great Britain only.
Edward Jenner
From the early 1760s, a number of medical professionals such as Benjamin Jesty, Peter Plett, John Fewster and in particular Edward Jenner, gained interest in the use of substances from cowpox to prevent smallpox. Edward Jenner, a British physician, is praised for being the individual who discovered vaccination as it is in the modern form. Edward Jenner was a Berkley native born in 1749. He started his apprenticeship in medicine and surgical practice in 1764. During the apprenticeship, Jenner became interested in the concept of protective impacts of cowpox. For many years, Jenner had heard stories of how dairymaids who had suffered from cowpox would naturally become protected from smallpox. Pondering this, he made a conclusion that cowpox could not only protect against smallpox but could also be transmitted from one individual to another as a deliberate means of protection against smallpox. In May 1796, Jenner came across a young dairymaid by the name Sarah Nelms who had numerous cowpox wounds on her arms and hands (Baxby, 1981). Using the matter from Sarah’s wounds, Jenner inoculated James Phipps who was an eight year old boy. A week and two days after the procedure, James claimed to feel cold and had lost his appetite, but a day later, he felt much healthier. In July of the same year, Jenner inoculated James for a second time. This time, he used substances from a fresh smallpox wound. In this case, no infection developed and the conclusion made was that the process of protection was complete. A year later, Jenner communicated to the Royal Society making a detailed description of his experiment and findings. Unfortunately, his information was rejected. Having added a few more case studies to his first discovery, Jenner issued a booklet in 1798. The booklet was called “An inquiry into the causes and impacts of the variolae vaccine: a disease discovered in some western England counties, specifically Gloucestershire and known by the name cow pox” (Baxby, 1981). Vacca and Vaccina are the Latin words for cow and cowpox, respectively. Edward Jenner named his new procedure vaccination. The booklet published in 1798 had three major sections. In the first section, Jenner talked of cowpox as a disease that originally affected horses but was later transmitted to cows. The claim was discredited during his lifetime. This part also presented Jenner’s hypothesis that the contracting cowpox prevents smallpox infection. The second section of the publication encompassed the relevant findings relating to the hypothesis. The final section was a lengthy discussion of the observations and a highlight of various issues concerning smallpox. Jenner’s 1798 publication was met with mixed reactions among medical professionals (Fisher, 1991).
After making the publication, Jenner made a journey to London with the aim of searching for volunteers for vaccination with no success. At this time, people in London only embraced vaccination from surgeon Henry Cline, Drs. William Woodville and George Pearson. Jenner decided to conduct a nationwide survey with the objective of searching for attestation of resistance to smallpox. The findings of the survey confirmed that his claim was right. Despite several errors, chicanery and numerous controversies, the use of Jenner’s vaccination became widespread in England and by the start of the nineteenth century, it had reached most countries in Europe. Even though sometimes he would run out of supply, Jenner would send his vaccine to many acquaintances in the medical field and anyone who requested it. Jenner would receive orders even from outside Europe. For instance, he sent some of it to a professor of Physics at the Harvard University who went by the name Benjamin Waterhouse. Waterhouse introduced Jenner’s vaccine to New England and persuaded a colleague to practice it in Virginia. Soon, an organization was created to put into action a national vaccination program in the US. Despite receiving a worldwide recognition and numerous honors, Edward Jenner never tried to enrich himself by taking advantage of his discovery. In 1802, his discovery was recognized in England and was awarded a total of $30,000 for his good work. Eventually, Jenner’s vaccination replaced variolation. In 1840, variolation was banned in England and the rest of the world followed in doing so too.
Louis Pasteur
In 1880s, another hero in the vaccination field came to the limelight, Louis Pasteur. Born in Paris in 1843, Pasteur was a microbiologist and chemist well known for his major discoveries in pasteurization, microbial fermentation and vaccination. More often than not, you will hear of the claim that Edward Jenner was the man behind vaccination while Pasteur discovered vaccines. Pasteur’s initial discovery in the field of vaccination took place in 1879 and was related to the chicken cholera disease (in the modern day medicine, the bacteria that causes the infection is categorized in the genus Pasteurella). Using an attenuated form, Pasteur inoculated chickens and demonstrated that the animals were defiant to the fully vituperative strain. After the discovery, Pasteur directed his entire experimental work towards vaccination and applied this theory to numerous other diseases. In 1879, he started investigating anthrax. During this period, an anthrax epidemic had hit France and other parts of Europe killing numerous sheep and attacking some people as well. A German physician by the name Robert Koch proclaimed anthrax bacillus isolation; which Pasteur substantiated. Pasteur and Koch independently used experimental findings to prove that indeed, anthrax bacillus was the causative agent of anthrax. As a result, the germ theory of the disease was established. Pasteur went ahead to apply the principle of immunization to anthrax. He set up attenuated bacillus cultures after finding out that the conditions that resulted to loss of virulence in organisms. In the early 1881, farmers provided financial support to Pasteur so that he could carry out a large scale publicized experiment on immunization against anthrax. The experiment entailed Pasteur immunizing seventy farm animals and to his advantage, the experiment proved to be a complete success. The experiment entailed 2 inoculations at intervals of a fortnight with vaccines of diverse potencies (Debre, 1998). 35 sheep received the first vaccine which was from a lesser virulence culture. A second vaccine from a more powerful culture was administered in the same 35 sheep a few hours later. Two weeks following these initial inoculations, the control and vaccinated sheep were inoculated using a powerful anthrax strain. The entire control sheep died after a few days while all the vaccinated ones lived on. These observations convinced a large number of people that Pasteur’s claims were valid. The success experienced in the anthrax vaccination experiment motivated Pasteur to focus on the microbial basis of the disease. His research work on animals affected by pathogenic microbes made him the main pioneer in the infectious pathology field. In 1882, Pasteur decided to dig deep into the problem of rabies. During this time, rabies was viewed as a horrifying disease that fascinated many especially because of the mystery surrounding its origin. Conquering this disease would prove to be Pasteur’s greatest endeavor.
Pasteur inferred that a microbe was probably the causative agent of rabies (later, it was discovered that the causative agent was a virus). The microbe was too tiny to be viewed under a microscope and hence, experimenting with rabies called for new methodologies. He settled for the use of rabbits in his experimentation and he would transmit the infectious factor from animal to animal by the use of intra-cerebral inoculations. He desiccated the infected animals’ spine cords so as to assuage the invisible agent. Later on, Pasteur recognized that instead of making an assuaged form of the agent, the treatment had in fact neutralized it. Therefore, unknowingly, Pasteur had come up with a neutralized agent. This way, he opened the way for the production of a second category of vaccines called the inactivate vaccines. With his newly discovered vaccine, Pasteur vaccinated a 9 year old lad, Joseph Meister, who had been attacked and bitten by a dog that suffered from rabies (Debre, 1998). This took place in July 6, 1885. The vaccine proved successful and brought major fame and glory to Pasteur. Pasteur’s discovery meant that bite victims around the world had been saved from the severe effects of rabies.
Efficacy of Vaccines
The efficacy of vaccines can be defined as the level at which vaccines help reduce the probability of occurrence of a disease among vaccinated people compared to the incidences of occurrence of the disease among the unvaccinated individuals. This section focuses on efficacy of vaccines in terms of the manner in which they work, the disease causative agents they work against, as well as their effectiveness.
How Vaccines Work
Vaccines are normally given to people when they are at a very tender age of between birth and just before the onset of puberty. Most vaccines are administered in children by use of shots with the nasal spray being used in some cases such as for the influenza vaccine. Others such as the polio vaccine are given by mouth. No matter how a vaccine is administered, the general ideology behind vaccination is all the same. To better understand how vaccines work, it is essential to focus and understand the way the body’s immune system works.
When a person is infected by a disease, the body looks to its immune system to fight the microorganism invading the body. The white blood cells become stimulated and yield proteins that are referred to as antibodies. These proteins locate the invading microorganism with the aim of generating a counter offensive. The microorganisms will already have caused several symptoms by the time the antibodies locate them. In some cases, the response of the antibodies proves to be too late to deal with the causative agent and by then, it will have caused life threatening or severe symptoms. Despite that, by launching an attack, the immunity and antibodies can finally stop numerous infections and ensure that the patient recovers. One key thing to note about this process is that even after antibodies are through with their work, they do not disappear. Instead, they stay put in the bloodstream where they are actively on the lookout for any invading microorganism that may make a return. Whether these microorganisms return after days, weeks or many years, the antibodies are always ready to defend the body. They often prevent the disease altogether or bring a stop to the causative agents before they produce the first symptoms. This is the reason as to why if one had measles or mumps as a child, s/he can never contract it again. It does not matter how often or long, s/he is exposed to the same causative agent.
One of the main characteristics of antibodies is the fact that they are extremely specific. This means that if they are produced to respond to one disease, that is the only disease they will respond to. For instance, if they are created to respond to the measles virus, they will not work against smallpox. However, there are some antibodies known not to be very specific and hence, can respond to infections caused by bacteria whose features are almost similar. When it comes to vaccination, this scenario fully applies. Vaccination relies on the antibodies to fight the disease. Nonetheless, after vaccination, the antibodies start their work before the development of the first infection. Live vaccines are composed of a weakened form of the disease causing virus or bacteria. In some cases, dead forms of the microorganism that causes the disease are used in the vaccine. The microorganisms used in dead form are killed in such a way that their immunity or protective power is preserved. In other cases, a toxin acquired from the microorganism is used in the vaccines in an inactivated form. When a vaccine is administered, the immune system of the body identifies the dead or weakened form of the disease causing germ and responds to it the same way it would react to the occurrence of a full blown infection. The immune system starts to produce antibodies to fight the contents of the vaccine material. The antibodies stay put in the body system and are geared up to respond if the actual infection attacks the vaccinated individual.
The vaccine can be said to trick the body into assuming that it is under attack and hence, the immune system creates a weapon to defend the body when the real infection threatens. Sometimes, a single dose of a vaccine is sufficient to protect an individual against a disease, but often, more than a single dose is required. This is because, some antibodies are known to protect for a lifetime while others need boosting. For instance, the tetanus vaccine can drop to a level that can no longer protect a person and hence, a booster dose is required from time to time. On the other hand, the antibody against measles lasts for a lifetime and hence, no booster dose is needed. Again, some viruses such as the one that causes influenza alters itself from time to time and hence, makes the existing antibodies futile. This is the reason as to why the vaccine against influenza is required every year.
Vaccines against Viruses and Bacteria
Vaccines are created in several ways. Nonetheless, all vaccines have a similar general goal which is to weaken the bacteria or virus in such a way that makes it possible for an individual to generate an immune response in the absence of the development of any symptoms of the disease. From the above statement, it is clear that vaccines work against both viruses and bacteria. To work against viruses, vaccines are created in three major ways. First, weakened form of a virus forms a part of the vaccine. Examples of virus caused diseases that are vaccinated using viruses made this way include shingles, varicella (chickenpox), intranasal influenza, polio, rotavirus, rubella (German measles), mumps and measles. Viruses normally cause diseases by multiplying themselves numerously in the human body. Natural viruses multiply themselves thousands of times throughout an infection whereas the vaccine viruses normally reproduce fewer than 25 times. Since the vaccine viruses do not reproduce themselves at a high rate, they do not cause disease. Instead, the vaccine viruses replicate sufficiently well to provoke “memory B cells” that offer protection against the disease in the future. Weakened vaccines against the virus are advantageous in that they offer a life-long immunity. However, they cannot be used in patients who have weakened immune systems such as HIV/AIDS or cancer patients.
The second way in which vaccines against viruses are created is by use of the inactive form of the virus. In this case, the viruses are inactivated completely or killed by the use of a chemical. This way, there is no way that the virus can multiply itself or cause an infection. Examples of vaccines against viruses that are made this way include rabies, influenza and hepatitis A vaccines. This approach of manufacturing vaccines against viral infections is advantageous in that it cannot cause even the mildest form of the disease its meant to prevent and also can be given to patients whose immunity system is weak. Nevertheless, several doses of such vaccines are required for immunity to be achieved. The third approach used in creating vaccines against viruses is the use of an element of the virus in the vaccine. A single part of the virus is taken out and used as a vaccine. Examples of vaccines made this way are the HPV and Hepatitis B vaccines. These vaccines encompass a protein that exists on the virus’ surface. This approach is used in case an immune response to a single part of the virus is responsible for defense against infections. After three doses, these vaccines induce long-term immunity and in addition, they can be administered in people whose immunity is weak.
Some bacteria cause infections by producing harmful proteins called toxins. A number of vaccines against bacterial infections are made by inactivating the toxins by use of chemicals. Inactivated toxins are referred to as toxoids. Once it is inactive, a toxin can no longer cause harm. Examples of bacterial diseases vaccinated against using such vaccines include pertussis, tetanus and diphtheria. Bacterial vaccines are also made by using an element of the polysaccharide (sugar coating) of the bacteria. The defense against diseases caused by some bacteria is based on the polysaccharide’s immunity and not the entire bacteria. Nevertheless, since young children do not create sufficient immune response to the polysaccharide alone, the coating is bonded to a harmless protein to produce a conjugated polysaccharide vaccine. Examples of vaccines made this way include meningococcal, pneumococcal and Hib (Haemophilus Influenzae B) vaccines. Bacterial vaccines can be administered in patients with weakened immunity. However, these vaccines necessitate several doses to induce the ample immunity.
Effectiveness of Vaccines
Vaccines are made to trigger an immune response that defends the vaccinated person during the future incase s/he is exposed to the disease vaccinated against. In some cases, the immune systems of different individuals differ and some do not produce a sufficient response. This means that such individuals will not be efficiently protected after vaccination. That being said, most vaccines have an effectiveness of almost 100%. Research shows that 99.7% of individuals who receive a subsequent dose of the MMR (measles, mumps and rubella) vaccine become immune to measles (Miller, 2008). After three doses, the inactivated polio vaccine proves to be 99% effective. When it comes to chickenpox (varicella) vaccine, 85% to 90% of individuals who receive this vaccine become fully protected from all varicella infections. When it comes to preventing severe and moderate chickenpox, this vaccine is 100% effective (Naff, 2005).
Before licensing and availing of vaccines to the public, extensive regulatory and scientific procedures are carried out to ensure that the vaccines have a high degree of efficacy and safety. These procedures include clinical studies that take in numerous volunteers who receive the vaccine under scrutiny. This process does not come to an end even after the authorization of the vaccines is granted. Instead, there is a continuous collection and investigation of data regarding vaccine safety by health authorities. Millions of people are vaccinated annually. The truth is, nothing in life is 100% safe or effective. Vaccines are not left out either. Nonetheless, they are very effective. It is better to be vaccinated against the disease than the opposite case.
Innate Immunity versus Vaccine Acquired Immunity
Natural or innate immunity is so called since it is the immunity present at birth and is not learned via exposure to an invader. This type of immunity makes an immediate response to disease causing agents that invade the body. Nonetheless, the components of innate immunity treat all the infectious agents the same way. They identify only a limited number of antigens on the causative agents. Nevertheless, these antigens are a part of numerous different foreign invaders. Unlike the vaccine acquired immunity, natural immunity lacks memory of the encounters and hence, it cannot recall a particular foreign antigen and is incapable of providing any progressive protection against future infection.
The fact is the human body is assaulted by pathogens such as viruses, amoeba and bacteria on a daily basis but yet does not surrender to the infectious diseases. The main reason as to why this happens is because of the innate immune system. The innate immunity comprises of antibodies, white blood cells and the lymphatic system (Gonzalez, 2007). The lymph and white blood cells circulate throughout the body’s cells, tissues and organs while simultaneously purifying them from toxins, naturalizing pathogens and debris along the way. The innate immune system is well layered and operates at various levels. The system consists of a variety of lines of defense that help deal with the pathogen. The innate immune system uses numerous filters to screen pathogens so as to ensure that any foreign invader perishes before it can cause the disease. The mucus lining along the orifices of the body, the skin and saliva are a part of the natural immune system that ensure the internal organs are safe from disease causing agents. Other organs such as the liver cleanse the blood of all sorts of toxic materials while the excretory organs such as kidneys help get rid of waste toxic products. In order for a pathogen to cause infection, it must pass via natural filters, both external and internal. Vaccines lack these filters. They bypass the external to internal process since most of them are directly injected and therefore, they fail to induce the full immune response. However, the innate immunity is not capable of protecting the body against various number of pathogens and hence, the vaccine acquired immunity becomes the better option (Gonzalez, 2007). For instance, the natural immunity proves weak when it comes to protecting the body against diseases such as measles, polio and tetanus. A person who has not been vaccinated against measles is likely to succumb to an attack from the disease compared to a vaccinated individual. Administering vaccines for these diseases helps make the natural immunity to these diseases. In general, the innate immunity is effective in protecting the body against various infections but sometimes, it needs a hand from the vaccine acquired immunity so as to help deal with some diseases such as tetanus, measles, hepatitis B, among others. Therefore, the vaccine acquired immunity complements the innate immunity.
Active, Passive and Herd Immunity
Active immunity involves the exposure of the body to an antigen with the aim of generating an adaptive immune response. An adaptive immune response may take a few days or weeks to develop but once formed, it has a long lasting impact and sometimes, livelong (Clynes et al, 1998). Active immunity can be natural or acquired. When one suffers from wild infections such as HAV (hepatitis A virus), the subsequent recuperation from the infection creates a natural type of active immune response which normally results to lifelong protection. Alternatively, taking two doses of the HAV vaccine gives rise to an acquired type of active immune response which leads to a long-lasting and perhaps, lifelong protection. Active vaccines are meant to protect the body against infectious disease by stimulating the process of production of antibodies in the body so as to fight off the virus or bacteria invading the body.
On the other hand, passive immunity entails administering lgG antibodies to protect the human body against infection for a particular period of time which is normally very short. Passive immunity provides an immediate but short-term protection that runs for a few weeks to three or four months at most. Just like active immunity, passive immunity can also be natural or acquired. The mother transfers antibodies such as the maternal tetanus antibody (which is mainly lgG) through the placenta where it supplies natural passive immunity to the infant for a few weeks/months to the point where the antibody is lost or becomes degraded. On the contrary, acquired passive immunity entails acquirement of serum from immune persons, pooling this, pondering the fraction of the immunoglobulin and finally injecting it on a vulnerable individual to offer protection (Clynes et al, 1998). The most widely utilized immunoglobulin preparations include human hepatitis B, human rabies, human varicella-zoster and human tetanus immunoglobulin.
Herd immunity is also referred to as community immunity or herd effect. Herd immunity is a kind of immunity that occurs when the immunization of a significant proportion of a herd (population or community) provides a protective measure for persons who have not yet developed immunity. This form of immunity arises when a large portion of the people in the community is protected against a bacteria or virus through immunization thereby making it hard for the disease to spread since there are few vulnerable individuals to infect. Herd immunity effectively helps prevent the spread of disease in a particular population. It is vital to protect people who cannot be vaccinated for the reason that their immunity maybe too weak to receive vaccines that carry some form of the disease causing pathogen. This is achieved through herd immunity. For instance, herd community has always played a major role in preventing the spread of measles in the UK and pertussis in the US (Kim & Goldie, 2008). The declining rates of immunization in the recent decades have led to the breakdown of herd immunity which in turn has led to an outbreak of the diseases in the two countries.
Why some Vaccines Require Boosters
A booster dose is an extra vaccine administration subsequent to an earlier dose. It re-exposes the body to the vaccinating antigen cell. Some vaccines lose effectiveness as time goes by. The immune system loses the ability to recall the exposure to the actual infection or vaccine. Therefore, a booster helps increase the acquired immunity from the previous dose back to a level that fully protects the individual. For instance, a tetanus shot booster ought to be taken every ten years. The subsequent doses also help account for any mutations or changes in some of the viruses and bacteria that cause infections.
Modes of Administration of Vaccines
Subcutaneous Injection
This mode of administration injects the vaccine into the subcutaneous layer which is placed below the skin and above the muscle (Naff, 2005). When practicing this mode, the skin is bunched up and the syringe is inserted into the fatty acid located just below the skin. The syringe is inserted at an angle of 45 degrees. It is recommended that the needle be short so as to decrease the chances of reaching the muscle. The vaccines that are administered using this technique include zoster vaccine, MMRV (measles, mumps, rubella and varicella vaccine), MMR II, VV (varicella vaccine), Imojev (Japanese encephalitis vaccine), 4vMenPv (quadrivalent meningococcal polysaccharide vaccine) and IPV (inactivated poliomyelitis vaccine).
Intramuscular Injection
This mode of administration inserts the vaccine substance into the muscle mass. The skin is stretched flat by the use of the index finger and the thumb with the aim of optimizing the insertion into the muscle. The needle is injected at a perpendicular angle (90 degrees) to the skin. The needle used in the intramuscular injection technique ought to be long enough so as to reach the muscle (Wells, 2007). There are numerous vaccines that are administered this way. These include PCECV (rabies vaccine), 4vMenCV (quadrivalent meningococcal conjugate vaccine), MenCCV(meningococcal C conjugate vaccine), typhoid VI polysaccharide vaccine, 13vPCV (13-valent pneumococcal conjugate vaccine), 10vPCV (10-valent pneumococcal conjugate vaccine), JEspect (Japanese pneumococcal conjugate vaccine), human papillomarivus vaccine, Hepatitis B vaccine, Hepatitis A vaccine, DTPa-vaccines, and dT (diphtheria-tetanus vaccine).
Intradermal Injection
This technique inserts the vaccine to the uppermost layer of the skin. Intradermal injection helps reduce the possibility of occurrence of neurovascular injury. The only vaccines administered this way include BCG (bacilli calmette-guerin vaccine) and influenza vaccine. Figure one below shows the level of injection for each technique of injection of vaccines discussed above.
Figure 1: Different injection techniques of administering vaccines
Oral Administration
This method entails placing a drop of the vaccine in liquid form in the individual’s mouth. This method makes vaccination easier by getting rid of the need for a syringe and needle. The vaccines administered this way include rotavirus, polio, cholera and typhoid vaccines.
Vaccines and Disease: Do Vaccines Cause Diseases?
Andrew Wakefield’s MMR Vaccine Controversy
The autism and vaccine debate has always made headlines since a medical research and former British surgeon by the name Dr. Andrew Wakefield published a falsified research paper in 1998 in support of the currently discredited theory that there is a connection between the MMR (mumps, measles and rubella) vaccine and the occurrence of autism. In his publication Dr. Wakefield argued that autism spectrum and colitis could result from the administration of the MMR vaccine (Archer, 2013). According to Dr. Wakefield, there were intestinal infections in children with autism he scrutinized. Based on the medical backgrounds of the children, he linked their intestinal diseases to their autistic regression to the MMR vaccine. Recent medical journals have proved Dr. Wakefield’s study connecting autism and vaccines was a fixation and that his findings were nothing more than an elaborate fraud. It was also found out that two years before he published the 1998 paper, Dr. Wakefield had been hired by a lawyer to attack the MMR vaccine. The lawyer, Richard Barr, was known to raise tentative class action court cases against drug companies that created the MMR vaccine (Dyer, 2007). Repeated studies from various parts of the world have confirmed that Wakefield’s link of the intestinal disease in autistic children to the MMR vaccine was invalid and inadequate.
Vaccines and Cancer
Vaccines are not tested to find out if they are carcinogenic or not. Since cancer has become one of the leading killer diseases in the world, more attention has been given to this issue. A growing number of researchers attribute various epidemics such as childhood cancer, sudden infant death syndrome, infantile convulsions, cerebral palsy, auto-immune disease, asthma and leukemia to vaccination. However, such cases are minimal and whenever they occur, there is not much proof to show a direct linkage to the vaccines. Immunization has been said to cause cancer in adults too. A study carried out in 2002 in Lancet approximated that about half of 60,000 cases of non-Hodgkin’s lymphoma every year are linked to the polio vaccination which was administered years ago (Miller, 2008).
Some vaccines contain aluminum, formaldehyde and mercury compounds that are well known to cause cancer. The aluminum in vaccines can cause cancer by shifting iron from its defensive proteins which raise the quantity of liberated iron in the blood thereby eliciting intense inflammation, lipid peroxidation and free radical generation. The fact that some vaccines contain some sort of virus means that there is a possibility of causing cancer. For instance, the monkey virus referred to as SV 40 which is a part of the polio vaccine, has been confirmed as a causative agent of cancer. SV 40 is attributed to an outbreak of lymphatic, bone, brain and lung cancers. However, polio vaccine manufacturers assure people that the vaccine has been free of SV 40 since 1963 and hence runs no risk of causing cancer (Selgelid, Battin & Smith, 2006). The research in the field of cancer and vaccines is young and hence, it needs to be intensified so as to ensure vaccines are safe or find an alternative to vaccines that are found to be contaminated.
Objections to the Use of Vaccines in the United States and the World at Large
In the United States, the main source of objection to the use of vaccines is religion. There are certain beliefs and religious systems promote optional perspectives towards vaccination. For instance, even if the Catholic Church recognizes that vaccination is a valuable medical activity meant to protect the health of the society, it asserts that its members may seek alternatives to vaccines where possible. The religion based objection against vaccines is founded on two grounds. First, the ethical predicament surrounding the use of human tissues in order to create vaccines is an issue (Selgelid, Battin & Smith, 2006). Second, the belief that the human body is sacred and was created in God’s own image means that it should not be contaminated with any tissues, blood or chemicals from animals has proven to be a bone of contention between religion and the process of vaccination. There are some religions that believe that the human body should only be healed by God and hence, it should be a natural process. Most of the states in the United States, Mississippi and West Virginia excluded, allow people to apply for religious based exclusion from mandatory vaccinations (Brueggemann et al, 2007).
Apprehension and suspicion about immunization is common particularly among the disenfranchised societies in the US and the rest of the world. For such societies, the apprehension and misgiving is best understood in a historical and social context of mistrust and inequality (Daniel, 2012). For instance, research has revealed that the racism legacy in the field of medicine against African Americans that involved denial of proper medication is a key factor behind such community’s distrust in public and medical health procedures, including immunization. On a global scale, in some parts of Africa and Asia, the mistrust of vaccination is can be attributed to the western plot myths that claim that vaccination is a scheme to sterilize non-western societies. Edward Hooper’s publication about HIV/AIDS being transmitted from monkeys to human beings through the polio vaccine was a one of the factors that greatly increased suspicion against vaccination in numerous parts of the world with many parents saying no to their children being vaccinated against polio (Friedman et al, 2011). This happens despite the fact that medical scholars and scientists have proved that the vaccine does not carry the risk of transmitting HIV/AIDS.
Risks of not Vaccinating
Vaccination is a recommended medical procedure and is a mandatory activity in most parts of the world. This is because failing to carry out this procedure is associated with major negative effects of one’s health during the process of growth and development. First, without vaccination, a child is at a great risk of contracting one of the vaccine avertable diseases as s/he grows up. A child who is not vaccinated is automatically more vulnerable to deadly diseases such as tetanus, measles, polio, among others. In addition, when an unvaccinated person contracts such diseases, s/he is likely to take a lot of time with the sickness, lose a lot of money seeking medication, and facing a great deal of pain. The ultimate health risk of skipping vaccination is death from the severe symptoms of the vaccine preventable diseases.
From a social perspective, failing to get vaccinated increases the risk of a person getting isolated from the society. If one is sick from a particular vaccine avertable disease such as measles, the one has to be isolated for a given period of time, even from the family members. If an outbreak occurs in the community, a child may be taken out of their school and other organized social institutions. The isolation costs the child a lot of time s/he would have spent carrying out constructive activities. If isolation does not take place in a timely manner, such a child is likely to infect other unvaccinated people in the community which leads to an outbreak of the disease (Plotkin & Orenstein, 1999). For instance, due to quite a high number of unvaccinated individual in the State of California, there are high incidences of outbreak of vaccine-preventable diseases such as Hepatitis A, pertussis, mumps and rubella every single year.
Benefits of Vaccinating
The American Academy of Pediatrics argue that most of the vaccines given at childhood level have proven to be 90-99% effective in protecting the child from diseases throughout his life (Wells, 2007). Therefore, a person who was vaccinated as a child will lead a healthier life compared to the one who was not. A vaccinated society can be said to be a healthy society. This gets us back to the concept of herd immunity. When everyone or almost everyone in a given community is vaccinated against various diseases, the risk of outbreak of diseases is very low. For instance, in the states of Mississippi and Virginia where no one is exempted from vaccination, the annual cases of disease outbreak are minimal.
Vaccination is more advantageous than giving medicine to patients to make them feel better. The health benefit of vaccination is invisible since it means that a child may never contract the disease. On the other hand, using medication to treat the disease that could have been prevented via vaccination leads to loss of time and money. Vaccination helps save these two important resources.
Vaccines help protect the health of the future generations. Vaccines have eliminated several diseases such as smallpox that used to kill many people in the past (Naff, 2005). By administering the rubella vaccine in children who grow up to become future mothers, the risk that these mothers will transfer the rubella virus to their newborns is very low. If vaccination is continued, parents of tomorrow will be assured that diseases in the current world will no longer harm their young ones in the future.
Conclusion
A vaccine is a substance that is administered in an individual with the aim of stimulating the production of antibodies so as to provide immunity against a single or several illnesses. Vaccines contain a dead or inactive form of the pathogen that causes the disease being vaccinated against. Vaccines are very safe and have proved to be almost 100% effective. They are administered via four major techniques namely intradermal, intramuscular and subcutaneous injections as well as oral administration. Edward Jenner and Louis Pasteur were the two key brains behind vaccines and vaccination. Vaccines are known to work against different kinds of pathogens including viruses and bacteria. Research has proved Andrew Wakefield’s claim connecting autism to vaccines to be false even though the polio vaccine has been linked with various types of cancer. Religious and cultural beliefs among different communities in the United States and around the world are the main sources of objection to vaccination. Nonetheless, the dangers of failing to vaccine are grave while the benefits of vaccinating are massive.
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