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HEALTHFUL HINTS

Frank Bures: Thanks for all the vaccines

From the COLLECTION: 10 recent Healthful Hints columns by Dr. Frank Bures series
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It’s that time of year when we traditionally count our blessings, as well as our turkeys. With the current viral maelstrom that is engulfing us all, perhaps the best medical blessings for which we can give thanks are the COVID vaccines that blunt the severity of COVID infections and subsequent deaths.

In the same breath we should also recall the incredible amount of disease, death, and misery that has been averted by the vaccines developed since Edward Jenner did his landmark 1796 experiment on 8-year-old James Phipps. He used the cowpox blister fluid from a milkmaid, Sarah Nelmes, to infect the boy. In a matter of days he inoculated the boy with smallpox blister fluid. The boy did not develop smallpox. He published his famous paper “An Inquiry Into the Causes and Effects of the Variolae Vaccinae.” The notion that infectious diseases could be prevented by vaccination was born. The tale of the eradication of an infection that is estimated to have killed more than 300 million people in the 20th century alone is long and amazing. The word vaccine derives from the Latin vacca for cow and was coined in 1800.

An elegant perspective paper in the Mar. 25, 2021, New England Journal of Medicine recounted the discovery of the different mechanisms for vaccine development and the vaccines created based on each. The first technique was Jenner using an animal virus to prevent human disease, even before microorganisms were discovered. A vaccine for rotavirus using a cow/bovine viral strain was introduced. Rotavirus causes childhood diarrhea and annually 215,000 deaths worldwide.

The second breakthrough came a century later in 1885 when Louis Pasteur injected rabies virus into spinal cords of rabbits. These spinal cords were extracted and dried. After 15 days the virus was no longer infectious. On July 6, 1885, he inoculated a series of suspensions of the dried, infected rabbit spinal cord material into Joseph Meister, a 9-year-old boy, who had been attacked by a rabid dog 2 days earlier. It saved the boy’s life from a disease that is virtually 100% lethal. This opened the door for vaccines made from physically or chemically inactivated ”killed” viruses. These included an influenza vaccine in the early 1940s, the famous Jonas Salk polio vaccine in 1952 and a hepatitis A vaccine in 1991.

The third major advance in creating vaccines came with the yellow fever vaccine in 1932-37. It involved weakening or attenuating that virus by growing it in non-human cells to make less capable of causing disease but still able to induce immune protection. The scientist, Max Theiler, received the 1951 Nobel Award for it. Other attenuated virus vaccines include Sabin’s polio in the early 1960s, measles in 1963, mumps in 1967, rubella/German measles in 1969, varicella/chickenpox in 1995 and rotavirus in 2008.

A fourth innovation in 1980 was to program mammalian cells to make bacterial proteins and not the whole microbe, which became recombinant DNA technology, a revolution in all medicine. Vaccines made with viral surface proteins this way were hepatitis B in 1986, human papilloma/wart virus in 2006 and influenza in 2013.

The most recent breakthrough is the messenger or mRNA vaccines we have come to know and love from Pfizer and Moderna companies. It took from the discovery of mRNA in 1961 until a couple years ago to produce the first usable vaccine. Other mRNA trials go back to the late 1970s, late 1980s, and 1990s. The COVID-19 mRNA vaccines have proven to be effective and remarkably safe. They are totally unable to produce an actual COVID infection in anyone.

The New England Journal article is entitled “On the Shoulders of Giants…,” which symbolizes the giant contribution vaccines have made to the health and wellness of humans. A Wikipedia timeline of human vaccines lists all those produced and their introductory year. I think I counted 46 individual ones. For some of us, who recall the illness and dread of it from such infections like measles, mumps, polio, etc., before vaccines, the relief post vaccines is easy to remember.

Vaccines are not perfect in their protection, except for a few like smallpox and measles. Speaking to today’s viral terror, we are currently in another wave of infections and deaths. In the Nov. 17 Minneapolis Star Tribune, an article by Laura Yuen about her son being quarantined after a school exposure said, “COVID doesn’t care that we are over it, or that we have managed to side step it for the past 20 months. It has humbled us all..” The virus is still trying to teach us. A Nov. 17 Associated Press article listed Minnesota’s total COVID deaths as over 9,000 with 51 on Nov. 16. It said, “Health department figures show the vast majority of patients hospitalized with COVID were unvaccinated.”

With some Minnesota counties’ vaccination rates at 40%, Michael Osterholm, well-known infectious disease expert from the University of Minnesota said, “There’s a lot of human wood out there to keep the virus burning.”

In the face of medical tragedy it is sometimes hard to count blessings. But these vaccines are truly blessings for our survival and health. I hope you can give thanks for them this Thanksgiving (a pointed remark-needle, syringe, get it?).

Dr. Bures, a semi-retired dermatologist, since 1978 has worked Winona, La Crosse, Viroqua, and Red Wing. He also plays clarinet in the Winona Municipal Band and a couple dixieland groups. And he does enjoy a good pun.

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