Points of Prevention John David Stewart
Points of Prevention
By John David Stewart
The Sharpest Arrows in Both Personal and Public Health Prevention
When you were born one of you first critical tasks that they probably did not tell you about was to inform and train your immune system to distinguish between the “good guys” and the “bad guys”. The good are the friendly helpful organisms that we now collectively call the “microbiome” and include your own tissues. The bad are the disease producing agents.
My Scottish grandfather a university professor used to lecture medical students saying that we you first get up in the morning you are to remind yourself because your eye can not see them, that the world is more or less covered by a thin film of little creatures, some of which are trying to kill you. Your job is to kill them first.
We are born with essentially two immune defense systems. A wonderfully useful so called “Innate System” that comes preprogrammed or prewired and a very sophisticated “Adaptive System” that can be informed and trained to defend you from relatively new or shall we say mutated agents, that you as part of the next generation could face.
So then how do we carry out the training of this adaptive immune system?
As infants we put almost everything into our mouths and thus begin to inform our defense system about the nature, which is the molecular structure of the micro-organisms around us. Also we begin to make “decisions” as to what is me, self and what is “other”, not me and to somehow identify the friendly, microbiome organisms.
As we were engaged in this important task our nurturing parents had us “vaccinated”, a very sharply focused, no pun intended, further training ground for your adaptive immune system. That by presenting unique cellular and molecular identifiers, structures that belong to a specific disease causing agent, akin to fingerprinting, to your defence system so that it “learns” to construct efficient cellular and molecular defences against the specific agent.
Your defense system also operates a library, where it develops so called “memory” cells that will be rapidly and automatically accessed should the “real” disease causing agent turn up in the future resulting in a pre-emptive strike against the pathogen.
Now for most of us who have been fortunate enough to survive to be seniors, for which there is no clearly defined nor accepted definition, our adaptive immune systems require further training against some notable pathological agents.
So, more directly to the point, what are the vaccinations/immunizations that are important for seniors?
The short version can simply be stated, Pneumovax, Tetanus, Diphtheria, Shingles, Influenza and possibly Polio.
We often forget about the diseases these vaccine injections prevent as they are customarily not in the daily news and no one you know has had any of them also if they did probably would not mention it.
Pneumonia, the disease commonly called pneumonia, is a serious lung infection, as you already know can be caused by many different agents including the Influenza Virus, Pneumococcus Bacteria and many other agents including some moulds.
Pneumovax 13 and Pneumovax 23 are the specific vaccines’ for the bacterial edition, the numbers 13 and 23 represent the number of subtypes covered by the injection, the 13 variety as currently given to infants in Ontario, the 23 variety is provided primarily for older folk. It is important for each of us to know which, if any, we have had.
Tetanus, immunization must be repeated every 10 years as there is a tendency for
our adaptive system to “forget” the prearranged attack/defense plans. The causative agent is found in soil, dirt so that people who have a ‘dirty’ wound from say gardening and are treated by a nurse practitioner, medical doctor or the like are often given the Tetanus booster as most people do not recall their Tetanus Shot. Diphtheria, Pertussis and Polio vaccines have been included in the single Tetanus shot from time to time with great variation over the years to the extent that most of us, including myself have no recollection of what has been included with the Tetanus Shots that I know I have had.
Pertussis, is the primary cause of what on the street is called “Whooping Cough”. Most commonly affects infants and young children and is sometimes fatal for those under one year. There was a resurgence in 2015 as a result new vaccines were developed. The primary reason for seniors to be revaccinated every ten years is that babies often got pertussis from family members including visiting or care giving grandparents.
Diphtheria, a bacterial infection that before vaccination 50% of those infected died. As a reminder the agent produces a toxin that destroys healthy tissues, primarily of the respiratory system so rapidly the within three days the dead tissue accumulates to the extent that it significantly interferes with swallowing and breathing. The toxin can enter the blood causing heart, kidney and nerve damage. Even with antibiotic treatment one in ten will die.
Polio, most adults do no need to be revaccinated accept under specific personal circumstances as they were well immunized as children. However, some Tetanus booster shots have also contained Polio vaccine over the years with no adverse effects.
Shingles, how this late manifestation of “Chicken Pox” got its name is shrouded in mystery and in fact is of little significance, the essential point is that there is an effective vaccine named after the causative virus, Varicella Zoster, “Zostavax”. This is the virus that in our younger days caused what we all called “chicken pox” or as one of my sons said it should be called “chicken spots”.
Zostavax, as many of you know is a single shot immunization that will for most prevent the disorder from becoming manifest, in others it will markedly reduce the acute severity and prevent the oft experienced chronic pain that many, who have had it call “debilitating”.
Of critical importance is that Shingles often recurs, some people have experienced the discomfort three and four times, so vaccination after the first episode will go a long way to preventing, mitigating a second. As many know Shingles is a result of, for some still uncertain reason the genetic information for building the Chicken pox virus that has been shall we say, hiding out in spinal nerve cells activates builds new virus particles that migrate down nerve tracts to the skin where their presence precipitates a very acute painful inflammatory reaction.
Now a different danger, folks who do not remember having chicken pox believe they are safe and do not need the vaccine. But they are at risk because in fact they experienced a very mild infection that was not explicitly diagnosed as chicken pox. Thus it is highly advisable to receive the Shingles Vaccine even if you have no record of nor can not recall being told you had it.
Influenza, known by most epidemic experts as the “King of Pathogens” for it’s record of worldwide pandemics, it’s persistence and rapid mutation. People will often tell you that “they got the shot and still got the flu”, studies of these events have shown that the agent or causative organism was most often not an influenza virus, sometimes the agent was in fact influenza but not the strain or variety that was included in that year’s vaccine.
There is work being done on developing a vaccine targeting part of the Virus who’s structure is relatively stable so that being immunized against this structure would most likely be a single injection lasting ten years.
Myself I am not prepared to play roulette with the wily Influenza Virus besides I want to increase my adaptive immunity system’s library whenever I can.
Finally a wise person has or will develop their own record of the Immunizations received, this is particularly important for international travel. The World Health Organization publishes the famous “Yellow Booklet” designed to keep all of your vaccination records in one place additionally it is internationally recognized. Your health care provider or travel clinic usually has supplies.
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