Tag Archives: vaccine

What is Flu Vaccine Anyway?

We spend a lot of time each fall talking about influenza and flu vaccine. A great deal of hard work by very smart people goes into making this magic fluid each year.

'Flu Vaccination Grippe' photo (c) 2010, Daniel Paquet - license: http://creativecommons.org/licenses/by/2.0/

The first thing you need to make flu vaccine is a flu virus. Those come in many different flavors, some old standbys trying to make a comeback, occasionally some new virus. Because the earth is tilted, our summer is the Southern Hemisphere’s winter. They are having this year’s flu season 6 months before we do. The best place to look for new influenza viruses are poor rural areas in Southeast Asia. In these areas, humans and animals frequently live close together. I’m sure you have noticed all influenza viruses have animal names (swine flu, bird flu…) – that is because the virus jumped from an animal to a person.

The World Heath Organization (WHO) is in charge of collecting flu viruses. They culture a bunch of sick people (nasal swab) to find the new and dominant viruses that season. They get pure cultures of the three worst viruses.

Now the magic begins.

Each virus is combined with a harmless standard lab virus. The result is a new virus that looks like the bad influenza virus on the outside, and like the harmless lab virus on the inside. That is important because the human body generates antibodies to the outside of the virus (it can’t see the inside). Now we have a copy of the virus that can’t make people sick, and grows well in chicken eggs. All this happens at the WHO labs.

Next it’s off to the vaccine manufacturers.

This harmless copy virus is injected into fertilized chicken eggs that are 9 to 12 days old. Three days later there are almost countless copies of the virus in the egg white. The virus is then separated from the egg white. Now it’s time to kill the virus with chemicals as we don’t want anyone being infected by this new virus (even though it is harmless). Now the virus is broken up to get a solution of the surface proteins (those on the outside).

This solution, called antigen, is then diluted to the proper concentration for use.

Next, it’s sterilized and packaged in vials and syringes.

There are hundreds of quality assurance tests done at each step of the process.

So your flu vaccine contains just the proteins from the outside of the original bad virus. It doesn’t have the ability to infect you as there is no living virus in the vaccine.

When you get your flu shot, these proteins (antigens) in the vaccine stimulate your body to make antibodies against this interloper. These antibodies will attach to the original virus and destroy it. In about 9 days you have enough antibodies to fight off an assault by the original virus.

It takes six months from finding a new virus to mass-producing the vaccine. That original virus was found in our spring (the Southern Hemisphere’s fall) and is ready for use by our fall season – just in time for flu season.

Producing the new trivalent (3 viruses) vaccine each year is one of the things the human race does very well; it requires worldwide cooperation to pull it off.

So, when you get your flu shot this year (and do it soon to maximize your protection), appreciate the “magic” that half cc of vaccine represents.

Take care

Dr B

Plenty of Good Reasons to Get Flu Shot This Year

'Finally Got A Flu Shot $25.' photo (c) 2010, Jake Metcalf - license: http://creativecommons.org/licenses/by/2.0/
So far, it’s been a pretty uneventful flu year with no scary new strains. We picked the right flu virus to make vaccine out of, so it’s a one-shot year.

When discussing the flu, “same old-same old” means 41,000 people will die in this country of the flu this winter. That’s as many people as get killed on U.S. highways in a year. It would be nice to be able to vaccinate against automobile deaths, wouldn’t it?

Most of the flu deaths will be people 65 or older. Most of them will catch the flu from younger people around them.

We get the flu vaccine or not according to our own private equation, weighing our health, the chance of getting the flu, our memory of last winter, and the hassle factor of both illness and getting the vaccine. All this is almost unconscious, and steers us either toward or away from opportunities for vaccination. Public health folks tear their hair out trying to convince us of the benefits of herd immunity.

I recently came across some data that looked at flu vaccination from a different perspective. The study looked at respiratory illness rather than just flu. Respiratory illness includes anything that makes you congested and cough, presumably 20 dozen different cold viruses and the flu. They vaccinated a bunch of healthy working adults and watched what happened. Those vaccinated adults had 25 percent fewer respiratory illnesses, 43 percent less sick days from respiratory illness, and 44 percent fewer visits to a physician for a respiratory illness. The savings on average for each person vaccinated was almost $47.

At first glance it appears that the flu vaccine helps protect you against a bunch of cold viruses as well as influenza. That would be a heck of a flu shot – sign me up. Sadly, it doesn’t.

What it actually means is there are a bunch more cases of flu going around than anybody realizes. And the flu is a much bigger part of what makes us cough in the winter. One would suppose from this data that a third or even a half of our winter respiratory illness is flu based. Who knew?

So maybe you get vaccinated for some noble reason, like saving an elderly person’s life, or trying to keep the kids healthy this winter, or missing less work, or simply to save a buck (or $47) — it all works.

There is plenty of vaccine, and winter is coming, so what are you waiting for?

Take care,

Dr. B

Vaccines for Grown Ups

I was just sewing up a patient’s lip when I asked about his last tetanus shot. He shrugged and mumbled something about childhood, which it turns out, is a pretty common response.

We worry about vaccinating our kids, but what about us? Vaccines prevent disease in big people too. With that in mind, here are the major ones you need to be sure are up to date:

Vacuna influenza / Flu vaccinephoto © 2009 El Alvi | more info (via: Wylio)

Until recently, we knew adults needed protection from tetanus and diphtheria, but pertussis is mainly a childhood disease, so we didn’t vaccinate for it. Trouble is, it can be fatal to kids, and usually kids catch it from an infected adult. So this vaccine is a 3-in-1. You get great immunity from tetanus, diphtheria and pertussis with a single Tdap vaccination. This vaccine should be received every 10 years.

Flu vaccine is next in importance. There are more than 40,000 influenza deaths per winter in this country alone. This is a yearly vaccine and is another 3-in-1. The Center for Disease Control and Prevention and World Heath Organization closely monitor the various strains of influenza circulating around the world. They pick the three stains of flu most likely to hit the U.S. this winter and make a new vaccine against all three. Because there are different influenza strains every winter, you need a new flu shot every fall or early winter. The flu vaccine is recommended for almost everyone.

Pneumococcal pneumonia is still a very serious disease. This bacterial pneumonia was called “the old man’s friend” as it commonly caused death in the elderly. That’s no kind of friend I like. Pneumonia is most dangerous to those who have less robust heath due to age, disease or smoking. For that reason, this one-time vaccine is recommended for those over 65, people with heart or lung disease, or smokers.

Chicken Pox/Shingles
Varicella vaccine – this is marketed as either the chicken pox or the shingles vaccine. It protects against both because both diseases are caused by the same virus. Because it is a herpes-type virus, the virus lies dormant in the nerves for decades after active infection. If your immunity against this virus goes down, the virus can travel down the nerves and cause painful blisters in one area of your body (shingles). This is another one-time vaccine, and most adults should consider receiving this.

Prevention is always easier than facing the disease. In many ways, children are stronger and healthier than the grown ups who take care of them because they get vaccinated. Give yourself the same chance, and take a minute to talk to your doctor about these vaccines.

Take care,

Dr. B

Dr. Baxter Talks Flu Shots in Dallas

Our own Dr. Shiu-yeh Baxter of our Carrolton office was featured on KSKY-AM 660 in Dallas yesterday, and she even gave host Jon-David Wells his flu shot for the season. Check out a video of the show here – Part 1 (drag the dial to fast forward to 1:40:16) and Part 2.

Hit Me with Your Best (Tdap) Shot

We’re all aware of the importance of tetanus shots, and now there’s a vaccine to prevent tetanus while also fighting other serious ailments at the same time.

Multiple health organizations are now recommending that adults have a one-time dose of something called Tdap. This is a combination vaccine that contains tetanus, diphtheria and pertussis vaccines. The Centers for Disease Control and Prevention (CDC), the American Academy of Pediatrics (AAP), and the American Academy of Family Physicians (AAFP) all recommend this vaccine.

As usual, something prompts me to think about certain topics. Why this one? Ok, I admit it…I was not paying attention and I grabbed some papers with a partially closed staple in them. As it ripped through the tip of my finger, I knew I would need to recall when my last tetanus vaccine was. And, as a healthcare worker, I did know that I had not yet had a Tdap. So, my weekend included a sore arm….

There is no vaccine for just pertussis alone, and this ailment, like tetanus, is one I’m sure we’d all like to avoid. Pertussis is known as the “whooping cough,” and this bacterial infection is passed from person to person. It’s generally not serious in adolescents and adults, but can be very dangerous to young children.

The symptoms of whooping cough come in 3 stages:

• The first begins much like your common cold – runny nose, sneezing and coughing. The cough will last 1-2 weeks, getting worse instead of better.
• In the second stage, you will have uncontrollable coughing spells, frequently vomiting after coughing, and you will emit a “whopping” noise when you breathe in. Patients can even stop breathing or turn blue in the face from lack of air during these cough episodes. This can last 2-6 weeks.
• During the last stage, the symptoms actually start to lessen. The coughing spells decrease in frequency and severity.

The course of this illness can be 6-10 weeks. Adults, teens and vaccinated children will generally have milder symptoms, like those of bronchitis.

Pertussis is spread by the “spray” of our secretions in the air, when we sneeze, cough or talk. We can also get it from sharing our cups and silverware. Initial symptoms will appear in 7-10 days after the exposure, and we will be contagious from 2 weeks prior to the start of the cough until 3 weeks after the cough starts, or until we have completed a 5-day course of appropriate antibiotic therapy.

Here is an information sheet on Tdap from the CDC. It discusses who should and shouldn’t have the vaccine, as well as the side effects.

If you are due for a tetanus vaccine and have not had your Tdap, consider receiving one at your nearest U.S. HealthWorks center. Then the only whooping you will hear is out of glee because you know you’ll be pertussis and tetanus-free.

– Alesia J. Wagner, Regional Medical Director, Southern California

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