Page 11 - Boca Club News - February '21

Boca Club News, Page 11
Medical Matters: Vaccines

By Richard Nagler, M.D., a member The Spanish flu pandemic in 1917-1918 was the deadliest brief period of time, which offers the promise of bringing
of Broken Sound Club and retired in human history. It infected 500 million people (one third this catastrophe to an end.
physician. After graduating from of the world’s population) with 50 million deaths. In the The two vaccines currently authorized by the CDC and
the University of Pennsylvania U.S.A. there were 675,000 deaths, many of whom were NIH, with several others currently being evaluated, are
and New York University’s School in the 20-to-40 year age group. It was caused by an avian very different from previous antiviral vaccines that are
of Medicine, Dr. Nagler served flu known as H1N1. There was no effective treatment and basically made from attenuated killed viruses. It involves
his internship and residency at no vaccine. The pandemic ceased after two years due to a methodology of using messenger RNA (mRNA), a major
Baltimore City Hospital and Johns the development of herd immunity as survivors developed achievement in immunology which teaches our cells to
Hopkins. He followed that with a antibodies which offered protection against the virus. make a protein that triggers an immune response with
Fellowship in Gastroenterology at Yale University School However, it never entirely disappeared, morphing into antibodies and T cells against the spike protein on the
of Medicine, and was then Chief of Gastroenterology at various strains that today are represented by seasonal flu. surface of the corona virus that is responsible for its ability
Fitzimmons General Army Hospital in Denver. He returned Over the past 10 years, depending on the year, there to penetrate our body’s cells and cause infection. The risk
to the Yale Medical School for one year as an Assistant have been in the U.S.A. 9-45 million flu illnesses, 140,000- of the vaccine causing viral infection is zero as there is no
Professor of Medicine before opening his own successful 810,000 hospitalizations and 12,000-61,000 deaths virus in it.
private practice in Internal Medicine and Gastroenterology. annually. While there is no cure, there are antiviral drugs The two vaccines currently approved are 95 % effective
During that time, he also served for ten years as Chief of such as Tamiflu which, if taken early in the course of the in preventing disease when given in two shots several
Medicine at Huntington Hospital in Huntington, N.Y. disease, can lessen the severity and duration of it. weeks apart. In the 5% who still get the infection it is
In this century, through extensive research and advanced A flu vaccine was first developed and introduced in milder, with a lower incidence of complications—namely,
technology, effective medical care has advanced to a 1945-1946. It is made from killed or inactivated viruses pneumonia. The duration of lasting immunity is unknown,
remarkable degree. Much of it has been due to prevention as a trivalent vaccine containing three strains of the A and but estimated to be at least two years. There are side effects
of disease, and it is the development of safe and effective one of the B. There is also a quadravalent vaccine available, more evident with the second dose, which include pain and
vaccines that is mainly responsible. In order to understand which includes a fourth strain of the B virus. Because of redness at the injection site, low grade fever, fatigue, chills,
how important vaccines are, a review of several pandemics a weaker immune response to the vaccine by seniors, they headaches, muscle aches and joint pain subsiding after two
that have afflicted humanity is instructive. are advised to get a dose four times higher than the standard days. In very rare cases, anaphylactic reactions which can
In the 20th Century, small pox caused by a virus killed amount. The risk of getting the flu from the vaccine is zero. be life threatening have been observed in persons who have
300 million people worldwide before being eradicated after The vaccine has proven to be effective in preventing the flu had such reactions in the past. This usually occurs within
the development of a vaccine in 1979 by Edward Jenner. in 40-60% of people each year depending on whether the minutes of inoculation; they must be watched carefully for
It was made from a live virus (cow pox), which is similar circulating strains of the virus that year are included in it. 30 minutes and EpiPen injectables must be kept available.
to small pox, but does not cause disease and produces But immunity weakens after a year and new mutated The goal is to vaccinate as many as 85% of the
completely protective antibodies against it. strains appear, so it must be revised and administered population in order to achieve herd immunity, which is
Polio is a viral disease that afflicts mostly children. It is annually. For those in whom it fails to prevent the illness, a massive logistical undertaking that will take months to
spread from person to person, mainly from contaminated most of them will get a milder disease with far fewer achieve. A major problem is the fact that as many as 35%
food or water. Although only 2% (500,000) of those afflicted complications, especially pneumonia. Unfortunately, each of people in the U.S.A. have indicated they will not take
either died or were permanently paralyzed when the virus year an average of only 48% of Americans get vaccinated, the vaccine. There are many antivaxxers in this country
attacked the central nervous system, it was particularly which is why there are so many hospitalizations and deaths. who have long protested against such tried and proven
devastating for those who were resigned to life in an iron For example, in the 2018-2019 epidemic in the U.S.A., 35 vaccines as measles, pertussis (whooping cough), chicken
lung. In 1953, Jonas Salk introduced an injectable vaccine million people got the flu, 490,000 were hospitalized, and pox, mumps and both hepatitis A and B. The reasons behind
containing a formaldehyde-inactivated virus approved in there were 34,200 deaths. Interestingly, fears of the flu these objections include a distrust of the government, drug
1955 that proved to be 99% effective in preventing polio. occurring simultaneously with COVID-19 this year—which companies, science in general, and even doctors. Denial of
This was followed by the introduction of the equally would complicate making a correct diagnosis—has proven the COVID-19 pandemic, failures of some vaccines to be
effective Sabin oral vaccine in 1960, which has since been to be unfounded because the incidence of the flu has been effective and safe, religious beliefs, and misinformation—
mostly abandoned. remarkably low. The reason is likely to be the result of all especially the debunked link of vaccines to autism—
However, in 1955, 200,000 children in the west and the mitigation efforts against Covid-19 with wearing masks, contribute. They are joined by those who adamantly refuse
Midwest were given the Salk vaccine and 40,000 developed social distancing and good hygiene. to abide by the mitigation recommendations of wearing
polio from it, of whom 10 died and 200 developed paralysis. On a positive note, there is active intense research going masks and practicing social distancing. The hope is that
The cause was a defective process of inactivation of the on in an effort to develop a universal flu vaccine, which many of these objectors will be assuaged to reconsider being
virus in the vaccine, and as a result all polio vaccinations would be effective against all strains and mutations of the vaccinated once the efficacy and safety of them have been
were suspended temporarily. This was a major factor in the virus and provide long-lasting immunity. It is estimated that established all over the country. Hopefully, we can then
public’s fear and distrust of vaccines and led to strict federal this may be achieved in two years. bring an end to this terrible affliction that has so adversely
regulation of all vaccines, which as a result now enjoy an As of this writing, we are in the midst of a COVID-19 affected our lives and killed family members and other loved
unmatched record of safety as compared to any other medical pandemic, which has already infected more than 80 ones.
product. Polio has not been eradicated, which is why it is million people worldwide and killed nearly two million.
strongly recommended that all children are vaccinated with In the U.S.A. there have been close to 20 million infected
four separate Salk vaccine injections starting at two months, with almost 400,000 deaths and many more expected.
and then up until entering elementary school. Fortunately, vaccines have been developed in a remarkably

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