Vaccines (Part 1)

Halleluiah.  Praise Dan Andrews.  Praise Scott Morrison.  Praise Oxford University and the University of Queensland because we are going to have a COVID-19 vaccine by the end of the year and everyone is going to be able to get their lives back to normal.  In case you hadn’t noticed, I was being sarcastic.

 

The rosy, triumphant spin that the politicians give you is a big old pile of bull****.  The chances of it all working the way they want it to is a million to one.  Stay with me and I’ll tell you why.

 

The first reason is because it is bloody difficult.  Not running a marathon difficult but accomplishing something that has never been done before difficult.  Think Hillary or Armstrong not your Sunday afternoon fun runner.  Let’s face it, corona viruses have been around as long as humans.  Afterall, the common cold is a corona virus and we haven’t found a vaccine for that but the fact that a cold is not much more than an annoyance means that the desire has not outweighed the necessity.  SARS and MERS are also corona viruses and we started trying to develop a vaccine for them but luckily, the problems seemed to peter out by themselves.  Unfortunately, when they did, so did the necessity for a vaccine.  

 

When it comes to COVID-19, even with an abundance of necessity the task is monumental.  I don’t think that our politicians realise that there is an extremely high chance that the first few attempts won’t work.  It’s really important that we don’t look at these as failures though.  Every attempt is a learning experience and one step further to the result we so desperately need.  I have no doubt there will eventually be a safe effective vaccine, just don’t expect it straight away.

 

Part of developing a vaccine is the trial process.  With any drug or treatment there are a number of phases that needed to be completed in order for a new treatment to be approved.  First is the pre-clinical work.  This normally involves having a hypothesis.  This hypothesis needs to be tested which normally happens by benchtop research or during animal models.  I’ll use the example of a trial I know quite well, HSCT for Multiple Sclerosis, very similar to my HSCT that was for CIDP.  They started with animal models and guess what.  The first experiments failed.  This was due to the selection criteria and once this was resolved, the experiment succeeded. 

 

After this we can move to phase one, which is where we test a small number of people (Anywhere from 5 to 80) normally one at a time to gage safety.  Phase two is a larger cohort and starts to look at the efficacy of the treatment.  If both these trials are successful then a phase three trial would be conducted scrutinising both safety and efficacy.  If that is successful, we have a new treatment that can be marketed to the people.  In the case of HSCT for MS, this process took 20 years.

 

What worries me is that a process that normally takes years is now taking months and that means cutting corners.  When I was a participant it the phase two trial of HSCT for CIDP I had follow up studies every year for five years.  There is simply no way to test the safety and efficacy of a treatment over time, other than to test it over time.  I understand that it is possible to speed up the clinical trial process by increasing sample size, increasing staff to help with lab work and processing results but all the money and resources in the world cannot speed up time.  We’ll effectively be finishing these trials on approved vaccines and if we find any nasty surprises we’ll be in real trouble.

 

Assuming we do tick all the boxes, we then have to worry about mass producing the thing.  If we want to get any vaccine to everyone in the world, we need to make at least 7.5 billion doses.  We can’t even get fresh drinking water to that many people.  In Australia we will need at least 25 million doses and don’t think that we can administer this easily.  We still don’t even have antibiotics available to every Australian community.

 

We also have to acknowledge that we’re not just baking bread.  Developing a vaccine is difficult and upscaling manufacturing to meet demand is even harder, then there are logistical and distribution issues to consider.

 

Next time I’ll be talking about other issues of vaccines.

 

Until then,

 

Stay well 

Vaccinations

My goodness me, it has been a while since my last post.  Apologies.  I don't have a really good excuse, I have just been lazy.  But hey, I'm writing now so good for me!

A great deal has been happening recently and for once it is not he who has been the focus of the medical interventions.  That honour goes to my son who broke his arm (which I blogged about last time) went to hospital for a minor dental procedure and managed to scrape all the skin off his index finger which then became infected and needed to be treated with antibiotics.  Aside from the dental procedure, which was purely cosmetic, the other two were just a nine year old boy being a nine year old boy.

After saying all that the doctors have not completely eluded me either as the juggernaut, which is my medical story rolls on.  I had blood work done recently which finally showed my blood levels had returned to normal.  This meant that it was time to revisit my immunisation regime and my oh my there are a lot of them.

Now for most HSCT patients this is nothing more than procedure but with a patient that had HSCT for an auto immune disease this process is much more complicated.  I will elaborate.

Auto immune diseases do not just happen.  Some people may have a genetic predisposition to contracting one of them but there is always an environmental trigger that starts the process.  There are many things that can be the trigger.  A virus or infection, a toxin, a medication or allergic reaction... The list is almost endless but one of the biggest suspects is a vaccine.

It is really quite logical.  A vaccine is designed to trigger an immune response that means if a person is exposed to the disease that has been vaccinated against, the persons immune system will attack the disease.  If the immune system misinterprets the vaccine it could end up causing an autoimmune (AID) disease.  The problem is most medical professionals will refute this link but there are sufferers of autoimmune diseases that swear black and blue that the vaccine was their "trigger".

Personally, I believe that a vaccination could be responsible for causing an AID.  But the question is whether the benefit of me having a vaccine is worth the risk of having a relapse.  Since I am fairly sure that a vaccine didn't trigger my AID in the first place I think that a vaccine won't do it to me this time.  However, I'm going to go pretty slowly with it just to be safe.  My program will be on and off for over a year.

Just so you know, this is a decision I have taken very seriously.  I let you all know how I go as I progress.  Until next time, stay well:)

To Immunise, or not to Immunise?

To immunise or not to immunise?  That is the question.  And once you have forgiven me for shamelessly ripping off Shakespeare, you might actually think it is a very important question.  Given that most of the stuff I write about I normally have quite a strong opinion on, I am going to buck the trend here.  I am going to be as neutral as Switzerland and sit right atop the fence.

Why?  Simple.  Because that is where I genuinely feel I belong.  I fully respect an individuals choice to choose whether they are immunised or not.  Yes, I have made a personal choice as to whether I and my children are immunised (and I will tell you at the end) but I don't feel as though I must be right and others should follow suit.  It is a personal choice and people should be free to make up their own minds.  However, I do believe your decision should be made based upon an informed opinion.

You might also ask why I decided to write about this if I am not that passionate about it?  Well I was on a CIDP forum the other day and some one asked the question of how did you get CIDP.  For a lot of people, like me, we have theories, but it is still a mystery.  However, some people are convinced that it was from a reaction to a vaccine.

Which does make sense.  A vaccine is supposed to alter the immune system.  If something goes slightly astray during the process, the immune system might incorrectly teach itself to attack itself.  So I loosely studied the effects of vaccines when my doctor recommended I get a flu shot and made my decision from there, but given the topic thread in the forum I decided to investigate further.

The main arguments against vaccinations are first, they don't work, and second, they can cause other problems.  Problems can be mild and include, rash, mild fever, nausea or aches.  They can also be major, like severe allergic reaction or an autoimmune disease.  They have also been related to mental health disorders like autism, schizophrenia and depression.

Let me briefly argue for both sides.  I'll take the pro immunisation side first.  Vaccination has a pretty impressive rap sheet.  It has beer responsible for the elimination of smallpox, is very close to eradicating polio and has significantly decreased the potential for diseases like measles, mumps, rubella, chicken pox, hepatitis, flu etc.  Or has it?

Another big plus for the pro immunisation lobby is that most governments and medical professionals will sing the praises of vaccinations.  Check out the following link from the US department of health and human services who have found yet another angle to promote the benefits of vaccination.

Community Immunity

However, you have to remember that doctors have been wrong in the past and they will be wrong again.  The question is are they wrong now?  As for the government they will come at you with 1001 different statistics to promote their message.  Anyone that has studied statistics knows that they can be illustrated in different ways to either confirm or counter an argument.  So are they just using propaganda to avoid potential mass hysteria in regards to potential epidemics, or do they have a legitimate health concern?  You decide.

And now the anti immunisation argument.  As with any drug that you might take, vaccinations are not immune from side effects, and the more minor side effects are listed by the drug companies.  But this is not the issue.  Mild short term side effects may be a small price to pay if you receive a long term immunity from a potentially debilitating or fatal illness.

The issue is the major side effects.  There have been a few high profile cases of autism potentially caused by a vaccine, such as the ones cited by Andrew Wakefield in a 1998 issue of the Lancet.  However, these claims were partially retracted in 2004 by the Lancet, and Andrew Wakefield was found guilty of manipulating evidence and ethical code violations.

When it comes to autoimmune diseases, there is strong evidence that vaccination may have been a cause.  But another source of autoimmune disease is the disease that the vaccine is trying to protect us from.  Apparently, you are much more likely to contract an autoimmune disease from a virus than a vaccine.  For example, peripheral neuropathy was diagnosed in about 10% of all diphtheria cases, and a major trigger for Crohn's disease is the flu.  The following journal is an interesting look at vaccines and autoimmune diseases.

Vaccination and Autoimmune Disease

Anti vaccination lobbyists would also have you believe that vaccinations are ineffective.  In the book titled "Fooling Ourselves", by Greg Beattie, many arguments are put up and illustrated with statistics as to why vaccinations simply don't work, including the graph below:

The graph showing cases of diphtheria in Australia between 1870 and 1970, clearly shows that the disease had stopped killing people before the vaccine was introduced.  And all the credit the vaccine took was misplaced, and the real hero was proper hygiene, better health care and antibiotics.  But what it fails to illustrate is the number of cases contracted and successfully treated.  We learnt how to stop people dying from diphtheria, but we don't know how effective the vaccine was in stopping people contracting the disease in the first place.

The argument for both sides can be validated and rebutted.  What is important is that you decide which argument resonates better with you and act upon that.  I think bigger arguments are whether governments should be allowed to insist that people should be vaccinated in order to be eligible to work in certain jobs, children must be immunised to attend schools or people must be immunised in order to enter a country are much bigger issues.

Well now, what have I done?  I have chosen to be immunised.  Personally I think that although there is a slight risk of the vaccine, there is a much bigger risk of the diseases they are trying to protect us from. But that is my choice.  You too should make your own.  Until next time, stay well:)