VACCINES - The magic of the 21st Century

Let's start with the story.

Harka and Ram are good friends. They both have wealthy family. Harka lives and "Halchowk Community" and Ram lives in "Pulchowk Community". There was news of theft in various communities in TV. Harka didn't do anything. One day, large number of thieves with gun came to his house. He called the police but it took time for them to appear and hence thieves took the valuable things from the house. He was just able to save his life. After being robbed only, he was able to call the policemen. There were good amount of valuable things still after robbery. Due to potential theft again, policeman guarded his house thereafter.

On the other side, Ram after listening news of theft in news suddenly he faked robbery in his house. Due to this, he was able to call policemen and showing the probability of potential theft again, he was able to keep them thereafter. The outsider may be his relatives too. So, he distributed ID of all the relatives to the policemen and lived happily thereafter. I will relate to this story later.

Before how vaccination works, it is important to know how disease is caused and basic immune system. When the foreign invaders invade the body and multiply, infection happens and it causes illness. There is defense mechanism to fight this invasion. Especially, white blood cells contain macrophage, T lymphocytes and B lymphocytes to fight.
When foreign agent enters the body, at first macrophage swallows up and leaves out antigens. These antigens are potentially dangerous for the body. This is recognized by Major histo-compatibility complex (MHC). MHC has suitable combination to attach antigens. These are finally sent to B-lymphocytes where it proliferates and large number of antibodies are made to destroy antigens. This defense mechanism is post defense. It may take time and disease may be serious equivalent to police coming late and theft in the story.

In vaccination, we inject antigens ourselves. The question may occur why are we gonna hurt ourselves through vaccination then? This is because the antigen we inject won't be harmful to us and it will stimulate B-lymphocytes to produce antibodies. There is a saying in my country that goes like this, "sarpa pani maros, latthi pani nabhachiyos", that means " killing snake with a stick without breaking it". We can make antigens less harmful by chemically treating it, using dead antigen or just using less harmful part i.e. nucleus just enough for stimulation. This corresponds to faking of robbery in story above.

Pros:

1. Once, measles, chicken pox, polio used to be life threatening disease. Now, vaccination is able to eradicate and prevent many diseases including these.
2. Prevention is better than cure, vaccination is prevention and can save money and time in medication.

Cons:

1. Physical pain during vaccination.
2. Vaccination is artificial immunization. It is shorter than natural immunization. So, there is compromise to defend body longer
3. There is probability of injecting harmful and toxic substances to body i.e. Mercury, Aluminum.

History of the Vaccine

You’re not a man unless you’ve gotten shot(s). That goes out to the ladies too. And I’m not talking anti feministic. All I mean is if you hadn’t gotten shots when you were younger you’d have been long gone. Yes, I’m talking about the pain in the ass, and sometimes the shoulder, that you must bear if you want to survive. No, I don’t mean your smothering parents that don’t let you do anything so you sit in front of a computer all day and then your eyes weaken so you wear glasses and the girl you date doesn’t like guys who wear glasses and leaves you for some guy who’s not even going to call her while you’re staring at her picture with those glasses that you wore because you don’t have a vaccine for preventing eye weakness because if there was, you’d totally get the shot. Why? Because you’re awesome and vaccines are awesome and just imagine the level awesome you’d reach together. We’ll that’s one way of putting it.

So, vaccines…

Before the vaccine of small pox was developed millions of people each year would die of the disease. Only in the UK around 400,000 people per year and also 5 kings died of small pox. This was before a country doctor, Edward Jenner discovered the cure. While people were dying of smallpox, there were milkmaids living in the countryside, survived when the famine came along and never even had a scar of smallpox on them. This curious case rattled him and after conducting various experiments and research he speculated that maybe cowpox helped the maids develop immunity against the virus. And to prove his hypothesis he extracted cowpox pus from a milkmaid’s hand and inoculated into a cut made in the arm of a local 8-year-old boy. And after six weeks, into a second cut he introduced the small pox virus yet the boy was unaffected by it. So in 1798 Edward Jenner developed a vaccine for smallpox although he didn’t know the reason behind this but is credited for saving around 450 million lives. this set the stage for the development of modern vaccines or vaccinology as a whole.

Then in 1877 Germ theory of disease was first proposed. Louis Pasteur then found that attenuated microbes could be used to prevent disease. In 1885, he successfully tested his rabies vaccine on a human subject and the rest is history. Now, he is the man responsible for expanding the horizon of the meaning of the word vaccination. Edward Jenner coined the term vaccination for his treatment of small pox and before 1885, it was all that vaccination meant. But later, Louis Pasteur gave vaccination a whole new array of meanings.

In 1930 cell culture practice was allowed for the production of the viruses for research purposes and hence the development of vaccines against diphtheria, anthrax, cholera, plague, tetanus, polio and many other were developed through the 1930s.

In 1979 the world health organization announced the complete eradicated of small pox globally and in 1988 the assembly vowed to eradicate polio. and the case of polio decreased from 350,000 per year globally to 187 in 2012.

Advances were made using the available and growing technology and in the last two decades or so we have been able to devise vaccines for common childhood diseases such as measles, mumps, rubella, hepatitis. Vaccines are considered as one of the important public health achievements of the 20th century. Advances are still being made, researches are still being conducted and many vaccines are being developed each day as we thrive for a disease free world. Hard work and dedication is being poured to find the cure of chronic diseases such as HIV, tuberculosis, Alzheimer’s.

Experiences with Vaccines

Now, my fear of needle goes long back to my childhood. I remember the time the Hepatitis vaccine group was at my school. I was terrified thinking about what came next but it was inevitable. My parents paid for the vaccine shot and well, I cried when I got one. As I reflect, I clearly

remember that some classmates of mine didn't get the vaccine, mainly because their parents were concerned about the side effects of vaccine or they simply couldn't afford it. At that time, I felt those class mates were the lucky ones not getting the vaccine but now I can truly acknowledge how privileged I was. I don't know where those childhood friends are right now, but I hope they are living well without the Hepatitis B in their system. Here in Nepal there are parents who want to protect their children but can't afford to. There are around 315,000 people infected here in Nepal with numbers increasing steadily with time. In a country, where over 30% population lives on less than $14 per month, the idea of eradicating the virus needs greater effort from government. Although, there are government funded vaccine programs, the reach is limited. Most child births still occur in homes, leaving these children venerable their entire life.

Apart from poverty, there are people who firmly don't believe in the science behind the vaccine. People still fear about injecting a live virus in their children. I had this friend in my fourth grade, he was from a wealthy family but even he was not on the list of getting the Hepatitis B vaccine. It seems to me that it was mainly because of the influence of western idea of vaccine being cause of the autism in children. This isn't the truth though; no peer reviewed research has ever found any link between vaccination and autism. People need to be well aware about these serious issues. The lives of children cannot simply depend on the superstitious judgment of their parents.

Recent developments in Vaccines

In order to understand the recent developments in vaccination, we need to first understand how exactly vaccines develop. We’ve already covered the part where vaccines are miracles to the world and how they are magic and they might as well be the chemical x that helped create unicorns and the power puff girls. Vaccines are solutions to our health problems. Now, as any basic problem solving goes, it requires an in depth understanding of the problem first. That is, we need to acknowledge the sickness that has been acquired through various sources (not judging you, don’t worry). So, first we go into studying the type of infection we wish to develop immunity against, may it be bacterium or virus, with an intention of essentially copying the type of organism because by definition, vaccines are mimicked bacterium or viruses either killed or attenuated. And with that done, they infect you with it. Yes. You read that correct. They infect you with the thing they were trying to prevent from killing you. But there’s a catch! This time, the infection is only mild. That is, you get infected with a level of the organism which is bearable to your immune system and can be kept in check. Or perhaps the substance it produces that gets you sick is injected. Either way, it is kept in check. So, now that your body knows what it is up against, the next time the same infection tries to get you sick, your body will be ready. And viola! The vaccine is created. But wait, not so early!

This is not your underwear. Just because it fits you, does not mean everyone can wear it. A strange metaphor but you get my point. Now, this is the part where it gets really sick. They do it to a lot of people; ‘It’ being the vaccination. There are usually phases of testing. The first phase is when the vaccine is tested on as less as half a dozen people and it advances to the second phase where the vaccine is tried out on 1000s of individuals. The first phase sees whether the vaccine works or not. And once it passes phase I, it’s on to phase II when the vaccine is tested for any side effects and consistency. Finally it reaches phase III where it is tested on 10’s of thousands of individuals for specific side effects on the basis of genetic make ups and way of living. After it has been tested thoroughly, there is still the question of ethics and approval from the community. What I found is that there is a clear protocol for testing vaccines and these methods are made quite aware to all the vaccine developers so there is less problems with approval and moral standards.

Now let us get into the real stuff; the examples which serve as pictures for vaccine developments.
In recent years with genetic engineering growing at a rapid pace, all vaccines are said to be formed from some sort of genetic engineering method. With the ability to clone entire viral genomes into yeast vectors and bacterial vectors, and manipulate the genes before they are extracted, the vaccine formation process has now become easier and more open to experiments.

For example, The influenza virus with the surface protein having circulating strains are cloned into plasmids and co expressed with a group of backbone genes which has the property of high growth in eggs but attenuation in humans and thereby the ability for safe production and high yielding vaccine.

Also, there are these undesirable qualities within the genes which can be sorted out at the level of the DNA thus making it more effective. In addition, various range of methods including the molecular cutting and recombination are available which allow complete control on he modification thus taking out various redundant processes in the way. A variety of virus types, engineered by these methods to be safe in humans, are being used to express immunogenic foreign proteins outside of the context of the virulent parent organism. As an example, adenoviruses in which critical virulence genes are deleted have been used to express proteins from HIV and are being utilized in clinical trials for many other pathogens such as the Ebola virus and malaria.There are just a few examples. There have been many more advances in the field which are unaccounted for.

CONCLUSION

I’m going to keep this short. After all the work that has gone to it, vaccines can be seen as the reverse Batman; the hero we need but not the one we deserve. But all jokes apart, humanity is indebted to vaccines for its victory over death(somewhat). It needs to be given the recognition and appreciation that it deserves.