Thanks to universal vaccination programs, we are no longer afraid of such dangerous diseases as smallpox or polio. Undoubtedly, vaccines have saved millions of lives in the world. So why are they still so doubtful? Are vaccinations safe? And why should we really get vaccinated?
There are ongoing discussions aboutvaccine effectivenessandthat vaccines are safe . We talk to Dr. n. med. Paweł Grzesiowski, European expert onvaccinations , member of the Board of the Polish Society of Wakcynology.
What is a vaccine?
Paweł Grzesiowski: It is a preparation of biological origin, which is designed to stimulate our immune system to produce immunity against disease, usually infectious, although we think more and more often about cancer, allergies or autoimmune diseases. A classic vaccine contains all weakened microorganisms or their purified fragments. The latest vaccines contain only those microbial components that are responsible for the production ofimmunity , and the so-called adjuvants to control the immune processes following administration of the vaccine.
What scientific discoveries led to the development of vaccination?
P.G .: The most important observation is that infectious diseases are caused by microscopic microorganisms. The second was the discovery of human immune cells in the mid-twentieth century, which gave rise to modern immunology, the science of immunity and its role in the fight against infectious diseases. Without the knowledge of microbes and immunity, the global success of vaccination as the most effective method in history for the prevention of diseases against which there are no effective drugs would not be possible.
Vaccination is the perfect tool to fight disease?
P.G .: There is no real ideal, every medical intervention has weaknesses. Vaccines are among the safest drugs, but it all depends on the person. Because it is a biological product that only works when the body reacts to it properly. It is not a painkiller or an antibiotic that works by itself. The immune system plays a major role in vaccination, and the vaccine forces you to exercise. The effect of this is an immune memory so that the vaccinated person does not get sick when exposed toa microbe that is circulating in nature.
In 1998, the Lancet published a study that showed that a combined vaccine against rubella, measles, and mumps causes autism in children. This information was later denied, but the fear remained with many parents.
P.G .: It's true, we waited 12 years for one of the biggest vaccine scandals to be resolved. Today we know that the author of this famous publication devised an almost perfect crime. He fabricated evidence of vaccine guilt, then colluded with lawyers to extort money from pharmaceutical companies, preying on parents of children with autism. Unfortunately, many of them believed that their children had been harmed by vaccines, which caused fear and refusal to vaccinate. We didn't wait long for its effects - measles is now raging again in many Western countries, not only damaging children's he alth, but causing deaths. This vaccination refusal movement was also delayed in Poland, despite the fact that the perpetrator of all the confusion was convicted of fraud by a court and its infamous publication was wiped from scientific archives around the world.
What adverse reactions do we have to be aware of when receiving vaccinations?
P.G .: Post-vaccination reactions depend on the type of vaccine and the individual characteristics of the immune system. Those containing live microorganisms generally induce a stronger stimulation of the immune system as the virus or bacteria in the vaccine reproduce in the body for days or even weeks, which can trigger a fever, rash, enlarged lymph nodes or other purulent inflammation at the site of the injection of the vaccine, such as when vaccinating against tuberculosis. Vaccines containing killed microorganisms or their purified fragments are better tolerated and less likely to cause adverse reactions. Among them, the fewest reactions are caused by those that contain one specific component of the bacterium or virus, e.g. the hepatitis B vaccine.
ImportantTypes of vaccines
Some contain live microbes, others - dead or their purified fragments. The response to live vaccines is usually stronger and therefore fewer doses will give sustained immunity. But they cannot be given to people with an abnormal immune system.
Vaccines are also divided into monovalent (single ingredient) and combined (multi-ingredient) vaccines. In the former, there is one component that protects against one disease, in the latter, there is more immunity against several diseases (from 3 to 6). Combined vaccines improve the effectiveness of vaccination and reduce the number of bites. Another division concerns the function of vaccines: prophylactic vaccines prevent infections,therapeutic methods are used in the treatment of allergies or cancers.
How long does vaccine immunity last?
P.G .: There is no vaccine that gives life-long immunity after one dose. The minimum number of doses is two, even for live vaccines. Thanks to several doses, the immune memory develops, which means that information about the microorganism contained in the vaccine is stored in our body for many years. If we are attacked by such or a similar microbe from the environment, thanks to this information, our immune system is quickly activated, which protects against acute infection. Occasionally, immunization will not prevent illness, but in such situations it will protect against severe disease or complications.
Doctors have different opinions: some encourage vaccinations, others advise against. Who to believe?
P.G .: A doctor who advises against vaccinating because of personal belief should not practice. This is not an ethical or religious question, but a question of ignorance and of putting the patient at risk. And our primary duty is to do no harm. Emphasizing the harmfulness of vaccinations in order to advise against them can be compared to being against the seat belts in the car because someone has suffered because of it. The bill is clear - both vaccinations and belts save the lives or he alth of millions of people. Which does not mean that 100 percent. their use is risk-free. Therefore, maximum care must be exercised to identify those people for whom vaccination is contraindicated at a specific point in time or throughout their lives. I am not convinced of the rightness of advertising vaccinations in the media, we should first of all train doctors and nurses to be able to substantively separate false theories from the truth. First of all, the society should be sensitized to the problem of threats posed by infectious diseases.
How do Poles follow the vaccination schedule?
P.G .: In Poland, its implementation is very good, especially among children. Vaccines provided for in the compulsory, i.e. free vaccination calendar, are adopted by over 97 percent. children, and this is one of the highest rates in the world. In many countries they envy us for such a good implementation of vaccinations, but this is mainly due to our right and efficiency of doctors, nurses and sanitary inspection. It is definitely worse with paid vaccinations, the so-called recommended, because at best one-fifth of children receive them. Unfortunately, the meager budget of the minister of he alth does not allow for the quick introduction of new free vaccines, which causesthat we are falling further from European countries, even from our region.
What are the most urgent issues to address?
P.G .: Currently, the biggest problem is the lack of universal vaccinations against pneumococci and chicken pox. Pneumococcus kills at least 200 children up to 5 years of age annually, and at least 15,000 children. seriously ill with sepsis or meningitis. Chickenpox is mild in most cases, but annually over 140,000 are sick. children, which creates a serious epidemiological, financial and medical problem, because with such a large number of cases, the incidence of complications increases significantly. The Ministry of He alth has promised to introduce vaccines against pneumococci and rotaviruses into the vaccination calendar. Nothing came of it.
According to an expertdr. n. med. Paweł Grzesiowski, European vaccination expert, member of the Polish Society of VaccinologyI believe that vaccinations should be as widely available as possible, preferably free. We must remember that they are the most effective medical intervention in the history of medicine. Therefore, this direction will continue to develop, in the coming decades we will get to know not only new prophylactic, but also therapeutic vaccines. We are getting closer and closer to vaccines against chronic diseases, such as Alzheimer's disease or certain cancers. I think that in 20-30 years, thanks to vaccinations, we will overcome some of the diseases that are incurable today.
Why? Out of money?
P.G .: Yes, we have very big problems with obtaining additional funds for vaccinations from the central budget. The Minister of He alth has repeatedly asked for an increase in the vaccination budget, to no avail. In this light, I consider it necessary to open up additional financing opportunities for vaccinations, the more so as the offer in this area will increase significantly in the coming years, but the new preparations are more expensive, which is due to the space technologies that are used to produce them. Governments of many countries struggle with the same problems, which is why modern solutions are necessary, because the richest can afford self-financing, but the majority of society expects support from the state.
Some parents are staunch opponents of not only recommended but also obligatory vaccinations. What do you say?
P.G .: Among my patients there have not been those who would radically refuse vaccinations, which does not mean that some of them did not delay them or had no doubts. However, calm and rational arguments will convince the most scared. I have the impression that many of them are unaware of the real consequences of not vaccinating. What is the threatan unvaccinated child? First of all, getting sick with this disease, against which it has not been vaccinated. The fact that many infectious diseases in Poland have been almost eliminated is the effect of common vaccinations, but it is not so good everywhere. So if we plan to travel with a child abroad, it may become infected during such a trip. There is another aspect, the ethical one - an unvaccinated child may ask his parents one day why they have denied him this safety policy. More and more often, parents of other children in kindergartens or nurseries ask if all children are vaccinated because they do not want to expose their children to contagious diseases. In some countries, unvaccinated children are not admitted to kindergarten or nursery. This is also worth considering. But it's not about restrictions, everyone has the right to make decisions about their baby, but is not vaccinating a good decision?
ProblemVaccines under a magnifying glass
How they work The vaccine stimulates the immune system, so it is administered to he althy people or during periods of relative peace - in the case of chronically ill patients. That is why a medical examination before vaccination is so important. The vaccine protects against disease by sensitizing our immune system to the microbe. For this reason, normal post-vaccination reactions include discomfort, fever, swelling and redness at the injection site. Efficacy No vaccination is 100% effective. effective because in every society there are people whose immune systems cannot be mobilized to respond to vaccines. The more people who are vaccinated in a given group, the better the vaccination effect is - the phenomenon of group immunity arises, which eliminates the microbe from the environment.
Child vaccinations - contraindications
There are few contraindications to vaccinations. One of them is active tuberculosis, HIV infection, inherited immunity disorders. However, it often happens that even with such diseases, contraindications to vaccination may be temporary or only apply to certain types of vaccines.
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