What is a vaccine?
A vaccine is a suspension of weakened, killed, or fragmented microorganisms or toxins or of antibodies or lymphocytes that is administered primarily to prevent disease.
How are Vaccine made?
A vaccine is made by first generating the antigen that will induce a desired immune response. The antigen can take various forms, such as an inactivated virus or bacterium, an isolated subunit of the infectious agent, or a recombinant protein made from the agent. The antigen is then isolated and purified, and substances are added to it to enhance activity and ensure stable shelf life. The final vaccine is manufactured in large quantities and packaged for widespread distribution.
The First Vaccines
The first vaccine was introduced by British physician Edward Jenner, who in 1796 used the cowpox virus (vaccinia) to confer protection against smallpox, a related virus, in humans. Prior to that use, however, the principle of vaccination was applied by Asian physicians who gave children dried crusts from the lesions of people suffering from smallpox to protect against the disease. While some developed immunity, others developed the disease. Jenner’s contribution was to use a substance similar to, but safer than, smallpox to confer immunity. He thus exploited the relatively rare situation in which immunity to one virus confers protection against another viral disease. In 1881 French microbiologist Louis Pasteur demonstrated immunization against anthrax by injecting sheep with a preparation containing attenuated forms of the bacillus that causes the disease. Four years later he developed a protective suspension against rabies.
Edward Jenner: Smallpox Vaccination |
historical mass vaccination programs in the United States. |
Vaccine Types
The challenge in vaccine development consists in devising a vaccine strong enough to ward off infection without making the individual seriously ill. To that end, researchers have devised different types of vaccines. Weakened, or attenuated, vaccines consist of microorganisms that have lost the ability to cause serious illness but retain the ability to stimulate immunity. They may produce a mild or subclinical form of the disease. Attenuated vaccines include those for measles, mumps, polio (the Sabin vaccine), rubella, and tuberculosis. Inactivated vaccines are those that contain organisms that have been killed or inactivated with heat or chemicals. Inactivated vaccines elicit an immune response, but the response often is less complete than with attenuated vaccines. Because inactivated vaccines are not as effective at fighting infection as those made from attenuated microorganisms, greater quantities of inactivated vaccines are administered. Vaccines against rabies, polio (the Salk vaccine), some forms of influenza, and cholera are made from inactivated microorganisms. Another type of vaccine is a subunit vaccine, which is made from proteins found on the surface of infectious agents. Vaccines for influenza and hepatitis B are of that type. When toxins, the metabolic by-products of infectious organisms, are inactivated to form toxoids, they can be used to stimulate immunity against tetanus, diphtheria, and whooping cough (pertussis).
vaccination enhances the human immune system to fight against harmful pathogens |
Vaccines against human papillomavirus (HPV) are made from viruslike particles (VLPs), which are prepared via recombinant technology. The vaccines do not contain live HPV biological or genetic material and therefore are incapable of causing infection. Two types of HPV vaccines have been developed, including a bivalent HPV vaccine, made using VLPs of HPV types 16 and 18, and a tetravalent vaccine, made with VLPs of HPV types 6, 11, 16, and 18.
Benefits of Vaccination
In addition to the development of memory B cells, which are capable of triggering a secondary immune response upon exposure to the pathogen targeted by a vaccine, vaccination is also beneficial at the population level. When a sufficient number of individuals in a population are immune to a disease, as would occur if a large proportion of a population were vaccinated, herd immunity is achieved. That means that if there is random mixing of individuals within the population, then the pathogen cannot be spread throughout the population. Herd immunity acts by breaking the transmission of infection or by lessening the chances of susceptible individuals coming in contact with a person who is infectious. Herd immunity provides a measure of protection to individuals who are not personally immune to the disease—for instance, individuals who, because of their age or underlying medical conditions, cannot receive vaccines or individuals who received vaccines but remain susceptible. Herd immunity played an important role in the successful eradication of smallpox, and it is vital in preventing the spread of diseases such as polio and measles.
Adverse Reactions
Vaccination carries some risk of reaction, though adverse effects typically are very rare and very mild. The most common reactions to vaccines include redness and soreness around the vaccination site. More severe adverse reactions, such as vomiting, high fever, seizure, brain damage, or death, are possible for some vaccines. Such reactions are exceptionally rare, however—occurring in less than one in a million people for most vaccines. Severe reactions also tend to affect only certain populations, such as persons whose immune systems are compromised by preexisting disease (e.g., HIV/AIDS) or who are undergoing chemotherapy.
Claims have been made that vaccines are responsible for certain adverse health conditions, particularly autism, speech disorders, and inflammatory bowel disease. Some of those claims focused on thimerosal, a mercury-containing compound used as a preservative in vaccines. Some people believed that autism was a form of mercury poisoning, caused specifically by thimerosal in childhood vaccines. Those claims have been discredited. Still, misinformation and fear generated by false claims about associations between autism and vaccines had a significant impact on individuals’ perceptions about vaccine safety. In addition, most individuals in countries where vaccination is widespread have never personally experienced vaccine-preventable disease. Thus, the focus of concern for some people shifted from the negative effects of vaccine-preventable disease to the possible negative effects of the vaccines themselves.
Complacency about vaccine-preventable diseases, combined with concerns over the effects of vaccination, led to decreasing levels of vaccination coverage in some areas of the world. As a consequence, not only were individuals susceptible to vaccine-preventable diseases, but, at population levels, vaccination rates dropped low enough to cause losses of herd immunity, thereby allowing outbreaks of disease. Such outbreaks brought high costs to societies, especially in terms of health and medical care, disability and economic strain, and loss of life. In the 20th century in Japan, England, and Russia, for example, numbers of children vaccinated against whooping cough dropped sufficiently low so as to enable outbreaks of disease that involved thousands of children and resulted in hundreds of deaths.
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