For many parents seeking the best for their child, the question of vaccination can be a difficult one. With plenty of information both for and against vaccines available across the web, there can be plenty of confusion about how vaccines work, what they in fact do, and what risks they pose to those getting the shots. Here, we will take a look at the impact of vaccines on recent history, how vaccines function, and answer some common questions regarding vaccinations, autism, reactions, and safety. We will also examine the history of the Anti-vaccination movement alongside common complaints.
A Short History on Vaccination and Disease
Like many things, vaccines were invented as due to a mix of innovation, observation, and a hint of desperation. While there had been quite a few individuals who were on the cusp of the idea of vaccinations (using a process called Variolation or Inoculation depending on details) for hundreds or even thousands of years, our story begins with a man named Edward Jenner, a naturalist and physician by trade.
While the act of Variolation was known to Jenner, so was the risk associated with it. In the case of smallpox for example, someone who would undergo the process (typically taking the scrapings of pus from one individual and placing it into the cut of another) 60% of patients would come down with the virus, and out of these, 20% would die. While shocking by our standards today, given the death tolls of the Black Plague which last visited about 100 years before, and the potential for smallpox to follow suit, it seemed the pragmatic solution. For Jenner though, there was an observation to be had. In towns which did suffer smallpox outbreaks, one group in particular would always be spared. Milk maids, whom often suffered a similar but significantly less harmful disease called Cowpox were rendered immune to the deadly cousin, as observed by both Jenner and several other physicians at the time. Jenner would take this information and test the use of cowpox fluids on the 8 year old son of his gardener, who also developed an immunity to smallpox. In the following years, the process by which vaccines were distributed and produced would improve, leading to protection against more diseases, and carrying less risk, and multiple types of vaccines, all covered below.
A History on The Anti-Vax Movement
While many consider the Anti-Vax movement to be a somewhat recent development, the truth of the matter is that opposition to vaccinations occurred before the word itself had ever been developed. In their book, The Life and Death of Smallpox, Ian and Jennifer Glynn quote Chinese Emperor K’ang speaking of what we would now call his inoculation strategy against smallpox. This strategy was to ( in 1661), take some fluids from those who were on the mend and likely to survive smallpox, and inject them into non-infected people, theoretically giving them the “strength” needed to resist the disease itself. In recounting this strategy, he would say that “when I had it tested on one or two people, some old women taxed me with extravagance, and spoke very strongly against inoculation.” This would prove to be the very first recorded case of protest against such measures, but by no means the last.
The next major motions against vaccination (though technically against the same process as before, formally named Variolation) would be in England just before the birth of Jenner. The complaints regarding this practice would be partially against the practice itself (as the bacterial model of microbiology had yet to catch on), and also in response to a general distrust of medicine at the time, which looking back can be understood due to the often horrendous and deadly treatments of the era. During this time, there were no legal measures to require this procedure to take place, so debates would often occur on a person to person basis and create no legal frameworks.
Now, after the invention of the vaccine by Edward Jenner, as discussed above, many individuals would again come out in protest against this new medical practice. Of those most vocal were the religious and political opponents, though there were also a limited number of groups who opposed Jenner’s method on sanitary grounds, and still those who did not believe that the underlying theory of disease (that bacteria caused disease) was in fact true. Lastly, there were a population of individuals who feared that the Cowpox vaccine (which protected against Smallpox) would end up giving those who took the vaccine cow like appendages. Finding this method both “unchristian”(due to the use of animal fluids in treatment) and unsafe at the time, there would be a series of protests, the majority of which occurred after the Vaccination Act of 1853. The largest of which would be the Leicester Demonstration of 1885, where nearly 90,000 came out to protest mandatory vaccination, and included both children’s coffins and a mock effigy of Jenner. Continued opposition of this type would eventually lead to the Conscientious Objector clause in the law, allowing individuals who did not believe in the safety or effectiveness of vaccines to decline their use.
Similar situations would also occur within the United States, with the creation of Anti-Vaccination Leagues across the country. These activities would mostly stay out of media spotlight until the 1970’s, during the DTP Vaccine Controversy, and again in the 1990’s with MMR. In the DTP case, 36 children would be hospitalized shortly after immunization with various neurological conditions. This would cause a massive drop off in vaccinations in both the United States and UK, laying the ground work for multiple Pertussis (Whooping Cough) epidemics. The latter, primarily pushed by gastroenterologist Andrew Wakefield, would be due to a study which attempted to form a link between vaccinations, bowel issues, and autism. While this study would later be discredited due to intentional data skewing and manipulation (such as including 2 patients out of 12 who already had developmental delays not recorded in study), his study would continue to be cited for years thereafter.
Most recently, there has been a backlash against vaccines for the use of Thiomersal (also known as Ethyl(2-mercaptobenzoatao-(2-)O,S) Mercurate(1-)Sodium ) as an ingredient in vaccinations. Though this ingredient will be mentioned in the What Are In Vaccines segment, it is important to note that this mercury containing compound has been limited in use since 2001, as to assuage public concern, both US Public Health Agencies and vaccine manufacturers have agreed to lessen or eliminate it from current shots.
What Are In Vaccines, and How Do They Work?
Before we get into what are in vaccines, we first should cover how vaccines work with your body, and what types there are. For this purpose, we will quickly go over the most common types of vaccinations, then how they work with your body to protect you, and how vaccine campaigns can help those who cannot or will not be vaccinated, as well as limitations.
Types of Vaccines
For most individuals, vaccination programs only have two or three types of vaccine, however there are seven that can be used depending on the specific disease characteristics. Below is a list and quick description.
Live-Attenuated : This form of vaccine uses a live pathogen (disease causing organism) that has been intentionally weakened to “train” the immune system.
Inactivated: Often used if there is a potential risk in applying the Live-Attenuated method, this vaccine completely kills the pathogen, and gives the immune system a chance to identify the pathogen. This is typically weaker in terms of immune response (and has a slightly lower effectiveness) but is safer for vulnerable populations.
Subunit Vaccines: Instead of using whole (or mostly whole) pathogens to get an immune response, these vaccines take only bits that the immune system react to the strongest. However, given the nature of extracting these antigens, this is an expensive process, and sometimes not as effective as Live vaccines, though often as safe as the Inactivated variety.
Toxoid Vaccines: In some cases, disease isn’t so much caused by the bacteria itself, but due to secreted toxins of the bacteria, and subsequent reaction. For these cases, the toxoid vaccine may be the best option. These take the toxins from the bacteria and inactivate them (typically using Formalin, a mixture of sterile water and enough formaldehyde to “lock” the toxin into a position where it can’t hurt the individual), allowing the body to learn how to fight off the toxin without harming itself.
Conjugate Vaccines: The truth of the matter is, sometimes even with traditional vaccinations it can be hard to protect young children from certain varieties of bacterial infection. One of the reasons is that some bacteria have evolved to incorporate a sort of stealth into their biology, through a coat of protective material made of polysaccharides. Now, while many adult immune systems can often dig under this coat and find out what the infection agent is and stop it, underdeveloped ones often cannot. In this case, we can use Conjugate Vaccines, which more or less attach antigens onto the top of these polysaccharide coats before introducing them to the immune system, allowing the body to learn to identify and fight off organisms with either the antigen or the coat itself.
DNA and Recombinant Vector Vaccines: At time of writing, both DNA and RV Vaccines are considered experimental and while offering quite a bit of promise, have yet to be fully vetted by the medical community for widespread use. Both use what is often considered “naked” DNA of a pathogen (through extraction or by copying down the DNA of a microbe) introduction to the body. This allows the immune system to get at the core of the infectious system quite easily, and in the case of RV vaccines (which use weakened, often non-pathogenic bacteria carrying the pathogen DNA) can even mimic a mild infection, giving the immune system the best simulation possible. This may prove to be a method for discovering vaccines against particularly difficult pathogens, including the HIV Virus, Rabies, and other such dangers.
How Vaccines Work, the Individual Perspective
Now that we’ve covered the types of vaccines, let’s talk about how they work when inside a patient. To do so, we also have to briefly dip into the wild and wooly world of immunology. So let’s get started, shall we?
The first thing that should be said is that vaccines do not provide a pre-emptive cure for everyone. What they do provide though, is a way for your body to learn about natural enemies, find their weak points (or how to shield itself from their attacks) and blow them away in a microscopic Armageddon. To do this, your body contains legions of immune cells (with 21 different types therein) which all serve distinct purposes from intelligence and reconnaissance, to surgical strikes, to cells that aid in signaling full on scorched earth tactics if need be. We will, sadly, not cover all of those here.
What we will cover is what happens when your body is invaded, and the first steps to surviving an invasion and developing immunity. To do so, let’s imagine a quick scenario. Say that while out picking up groceries, you happen to slip on a wet floor and cut your hand on the end of a shelf. While you brush yourself off and consider legal action against the store for not putting a sign up, several bacteria will have entered your cut, and found a paradise of nutrients and warmth just inside your hand. Quickly, they begin replicating, though to your billions of cells, there is nothing to be worried of, yet. Now, once the bacteria have grown sufficiently, they begin to alter the body around them to match their needs. This often attracts the attention of Macrophages, the first line of defense of the immune system. Much like the typical rank and file soldier, these Macrophages aren’t terribly specialized, but instead kill off invading bacteria by swallowing and breaking down the pathogens. For a vast majority of the time, this ends the story of infection.
However, there are other times where either the type or size of the infection can be overwhelming and do the responsible thing: Call for back up. Sending out proteins as a sort of “S.O.S.” into the bloodstream, their message is picked up by Neutrophils. In short, Neutrophils are the maniacs of the immune system. Not only will they typically kill a massive number of disease causing cells, but they release toxins so frequently that they also do damage to surrounding healthy cells and the Macrophages in an all-out toxic fury. These cells often die within days of creation to prevent widespread damage in the body.
If this line of defense also fails, the fighting immune cells send out yet another signal, this time to a more cautious player, the Dendritic cells. These cells will collect samples of the pathogen, chop them up and display them on top of their own cells as a way of identifying if the pathogen is bacterial or viral in nature. The Dendritic Cell will then retreat to a lymph node, and seek out what are called Helper T Cells, who can take some of the information displayed by the Dendritic cells, and then go into two different modes. The first is a memory T Cell, which helps “remember” the pathogen, and can make this response much quicker in the future. Remember, during this entire process, the infection is growing, and the battle between the infective agent and the immune system is causing plenty of collateral damage, though this is often fixed without individuals noticing the losses unless a severe disease takes place.
The second type of Helper T cell travels a little further on to interact with the weapons supplier of the body, the B Cells. These cells, once matched with a Helper T Cell, will start producing chemicals specifically tailored to take down the pathogen (called Antibodies), and shoot them into circulation in a hurry. These Antibodies will bind onto the pathogens, and either immobilize them or damage them enough en masse to turn the tide of battle, making it possible for the front line troops to win, and the body to survive. If the individual does survive the infection, then both Memory T Cells, as well as new Memory B cells will remain. These will essentially give the body a shortcut to this process, and instead of allowing all the risk of such a full scale attack to take place inside your body, both he Memory T and B cells will respond quickly, destroying a threat before you even notice.
Now, we covered what happens in a normal infection. What about in the case of Vaccinations? Essentially the same process, but with one key difference. Instead of the massive offensive and potential for severe damage or death as a result of infection, the pathogen is already damaged or dead, and is carried to the Memory Cells for processing, and creation of antibodies. While not perfect, this immune strategy does greatly increase the odds of surviving infection in the future.
How Do Vaccines Work in Populations?
For many unsure about whether vaccinations are safe or not, the idea of “herd immunity” seems an appealing idea, rendering all the benefits without any of the assumed risk. Unfortunately, this scenario can be rarely if ever achieved. But why is that? Let’s take a look.
As many of you already know, one key to not getting sick is not getting exposed to something (or someone) that makes you sick. Herd immunity is a concept where enough individuals are immunized that there is no reservoir for the pathogen to develop or stay, so even those without vaccinations to ensure their safety may walk around without risk. In some cases, like for diseases such as Polio and Smallpox, this is very possible for places
(thanks to the public health efforts of past decades). However, there are a wide variety of other diseases where the fact of the matter is the disease is still a high enough risk that even in the modern time we as a population need upwards of 90% vaccination rate to protect everyone sufficiently. This is due to two fundamental facts about the population and the pathogens. First, people tend to move around and interact a lot, while pathogens like to spread. This means that there has to be good enough odds that individuals who are vulnerable to infection do not meet someone carrying the infection either with or without symptoms. As one may expect, that is a very hard thing to account for without incredibly high vaccination rates, especially in urban and suburban areas.
What Do All These Chemical Names Mean?
A common claim amongst those opposed to vaccinations are that they are filled with plenty of harmful chemicals. And with long, potentially scary names such as the previously mentioned Thiomersal, there can seem to be plenty of reason to be wary. But let’s examine some of these chemicals, how they function, and what they do to the human body.
For most people, preservatives are a bit of a dirty word. In vaccines though, they are part of what insure that the vaccine stays clean of any unwanted pathogens, alongside the later mentioned residual antibiotics.
Thimerosal is one such preservative, that is now being phased out of vaccines due to public fears of it containing mercury. To be clear, Thimerosal does contain mercury, and can kill individuals with a dosage of 75 milligrams per kilogram. For the average baby (weighing around 3.3kg) this means they would need to ingest around 250mg. However, in low doses (like the 1 microgram in vaccines) it is harmless to the human body. It is also found in antivenom solutions, nasal spray products, and tattoo ink as a way to deter bacterial growth.
Glutaraldehyde is similar to Thimerosal in that it’s used to help remove the risk of contamination from a vaccine, and does so by reacting to proteins within bacterial and viral shells, stopping them from surviving in the vaccine. In much higher concentrations (between 100 and 1,000x) and doses, it can also be used to treat skin warts.
Formaldehyde is perhaps one of the more recognizable names on this list as its use as an embalming fluid and preservative. In the case of vaccines though, especially toxoid vaccines, this molecule of one carbon, two hydrogen and one oxygen is used to “lock” toxins made by bacteria into a molecular shape that cannot hurt individuals, but can be sought, destroyed, and reverse engineered by the immune system. While dangerous to ingest in large quantities, the human body does create its own formaldehyde as a result of breaking down proteins and other substances, and at any given time has over 60x more formaldehyde in it than a vaccination delivers. As a result, this is an insignificant difference and like the rest, routinely exits the body.
Tris (trometamol)-HCl is a chemical compound that should be familiar to those who have experience in molecular biology or microbiology. Tris is commonly used with several other chemicals to aid in keeping Nucleic Acids (DNA or RNA) protected from conditions that would otherwise destroy them. It can also be used on its own in some cases to treat Metabolic Acidosis.
Stabilizers are those ingredients that can help the vaccine by protecting it from damage due to processing (such as freeze drying) that allows for a longer shelf life and transport. There are several main classes of stabilizers that are also found in every day life.
Sugars: sucrose, D-mannose, D-fructose, dextrose, anhydrous lactose, and pure lactose are all examples of these. These can all be found in fruit, vegetables, meats, milk, and other everyday items.
Amino Acids: Typically named under this, Amino Acids a class of over 20 chemicals that are needed for most organisms to survive. They make primarily serve as the building blocks for proteins, and can thus be found primarily in meat and bean food products. The most commonly used Amino Acids are L-Histidine and Glutamic Acid.
Adjuvants are a particularly interesting group of ingredients that are added to vaccines. These chemicals essentially act as beacons to the immune system, beckoning Macrophages and other immune cells to respond quickly to the vaccine, ensuring a complete up take. These ingredients have been tested for over 6 decades and have proven to be safe, and are also usually found in trace amounts (though serving other purposes) in food and drinks. Some ingredients that aid in this are the following: Aluminum Hydroxide, Potassium Aluminum Sulfate, AS03 (Which is mainly composed of Vitamin E), and most other compounds containing Aluminum, Potassium, Phosphates and Sulfates.
Residuals: Cell Culture Materials, Inactivating Ingredients and Antibiotics
Residual materials are those that, while not intentionally part of the vaccine in the sense they don’t serve a direct purpose, are by no means there by accident. These ingredients are often used to grow the “stock” which are then disabled to be put into vaccines, used to keep the growing environment clear of other organisms, or to ensure the product is as safe as possible for individuals.
Antibiotics, though potentially a danger to those allergic to them, are safe for the general populace. The names of common antibiotics seen in vaccine ingredient lists are the following: neomycin, polymyxin B, streptomycin and gentamicin.
Cell Culture materials are bits of nutrients often used to grow bacteria in a large enough population to make viable cultures, and then vaccines from. These include Blood Cultures, Mullers Culture, human-diploid fibroblast cell cultures (WI-38), and Dulbecco’s Modified Eagle’s Medium. These pose no threat to humans in terms of health.
Inactivating Ingredients are those that, as the name implies, “shuts down” bacteria, toxins, or viruses, making them weaker and giving a home field advantage to the immune system. These include Formaldehyde, Formalin, Citrates, and Sodium Deoxycholate.
Is Vaccinating My Child Dangerous?
For a vast majority of children, the answer is not really. While vaccinations do carry some risk for even healthy children (the most common being irritation and slight inflammation at the injection site), it is in children with specific allergies or with immunocompromising disorders that parents should be especially concerned (A full list of individuals who should avoid being vaccinated is here ). If you are concerned about these, it is encouraged you go to the CDC Vaccine page (linked here ) and of course discuss concerns with the family physician. When considering the risk of a vaccine, one may also want to account for the risk of the disease it protects against, both for the individual and the population at large.
Now, for the past decade one question has lingered above all others for parents about to vaccinate their children, “Do vaccines cause Autism?” The answer is no. But what about all the theories and stories of children suffering from autistic symptoms soon after vaccination? Well, now that answer is somewhat more complex.
In the United States as well as many other countries, vaccinations often occur between 3 months of age through at least 2 years of age, with several boosters thereafter. During this time, both in vaccinated and unvaccinated children, studies and surveys of parents whose children are autistic have shown that “Time of First Concern” often occurred between 4 months and 2 years old, with a spike in Autism suspicion and subsequent diagnosis between 12 and 23 months of age (this data being taken from surveys completed by over 3,600 families sent out by the Interactive Autism Network in partnership with the Simons Foundation). When comparing the numbers, you see a similar climb and drop off in cases of autism, and times of vaccination. Now, it would be tempting to say that this is concrete proof that something is going on. However as mentioned before, unvaccinated children were also subject to the same increases and drop offs. So, what we have is called a correlation, where two unrelated circumstances occur in the same time frame and not causation, where one action elicits a response.
Lastly, one may wonder why there has been a marked increase in the cases of Autism. Well, this is due to a number of factors and there certainly is some ambiguity. Since the medical community has expanded the definition of what constitutes Autism to include Autistic Spectrum Disorders, there has been a climb partly due to the fact that more individuals are being counted as such. There is also a much greater awareness of autism, so both patient families and doctors are more likely to identify it than in previous years. And finally, there can be environmental and genetic factors that we as a community have yet to discover. However, vaccines, which have been vetted hundreds of times to be safe and not a cause in what is typically considered a disorder caused before birth, are not among these potential risks. If you are more interested in ongoing research on Autism, it is recommended you visit the CDC page on the subject, here .
We sincerely hope that this article has aided in your search for information regarding vaccines. As with all medical issues, consultation with a licensed physician is heavily advised to ensure the best possible option for you or your children. If you are curious about the recent Mumps outbreak, please also visit our article on the issue.