Mark Moyad, MD, University of Michigan
You have probably heard every vaccine conspiracy theory or just unsubstantiated vaccine rumor in the book over the last few years. Yes, apparently with so many side effects, why even get them?! Well, not only did all of the conspiracy theories and rumors not hold any H20 (aka water) because they were boneheaded unscientific predictions that caused a lot of damage (okay I like to be honest), but what you never got a chance to hear in all the cacophony was the Moyad SIDE BENEFITS OF ADULT VACCINES. So, let me just mention 5 vaccines but first 5 simple reasons off the cuff (I could provide 30+ reasons but we do not have the time or paper space) why getting these 5 vaccines soon is smart and comes with side benefits.
1. Not just prevention but preventing things from getting worse!
Vaccines can protect you from a life threatening disease and even if you get that disease it can reduce the severity of that disease. This gets missed all the time when individuals tell me they got the vaccine but still got the disease! We forget that the disease itself could have been far worse and may have even put you in the hospital or worse, had you not received the vaccine. And, in the future, you at least have memory immune cells, so you have some protection in the future. So, just because you still got the condition you were vaccinated against, that does not mean you still did not directly benefit now or in the future.
2. The Price is Right Bob Barker/Drew Carey and Everyone Else!
Cost is cheap to the patient and most insurance companies will cover them under your plan. If you have to pay out of pocket for some reason, then most vaccines are still reasonable in price in terms of what they can provide for you long-term (a better and longer life).
3. Vaccines=Unsung Heroes of Medicine and Should Have More Nobel Prizes Than Michael Phelps (he attended the University of Michigan by the way-shameless and shameful plug) & Mark “at least he has a great first name” Spitz (but not so attractive surname-but could be worse and his last name could have been lipspitz or something) combined have Olympic Medals!
Vaccines are perhaps one of the greatest medical success stories in terms of simply saving lives and allowing many individuals to live out a full life expectancy. The problem is that researchers lost count after it had saved millions of lives, so it is kind of like McDonalds advertising and the amount of hamburgers served and after a while people lost count, and we now assume and know millions of lives have been saved or made better with vaccines (but that kind of boring advertising gets missed-we become desensitized just like with the McDonalds advertising and number of people and burgers served).
4. Herd What? Herd Immunity! Be Selfish and Selfless-it is okay!
Vaccines can provide “HERD IMMUNITY”, which can save the lives of individuals of all ages especially the most immunologically vulnerable such as the very young and the very old and those with severe immune suppressive diseases. Herd immunity occurs when enough individuals in a community get vaccinated so that there is little chance that a virus can be transmitted to the most vulnerable individuals of the herd (aka community). For example, one reason I get the flu vaccine is because it reduces the risk of transmitting the virus to my nephews or other young children or my father and mother that could result in a life-threatening flu and pneumonia! In other words, getting vaccinated is not just a wonderful selfish act, but it is also a wonderful “SELFLESS ACT” because of herd immunity.
5. Provides protection even against major diseases not advertised on the label (aka: the real anti-inflammatory miracle).
There is new research to suggest that adult vaccines also reduce the risk of getting or dying from multiple diseases that do not appear to be related to the vaccine itself! For example, there is new data to suggest vaccines could reduce the risk of cardiovascular disease by controlling short- and long-term inflammation. There is even new research to suggest some adult vaccines could enhance the effects of some cancer treatments (google tetanus shot and glioblastoma or brain cancer immune therapy) and you get a ton of this http://www.nbcnews.com/health/cancer/tetanus-vaccine-boosts-cancer-therapy-n321596 and other accurate and boring past stories…YES! SIDE BENEFITS RULE!!!)! The sooner you get the vaccine when it becomes available to you the better the potential result for you and those around you! It is because all vaccines take time to generate a response. It takes time to recruit new and old members of your Army, Navy, Air Force and Marines and then it takes more time to deploy those immune soldiers near or at the site of battle (man-I love military analogies!) so the longer you wait the less chance you have of getting the full military benefits!
Do I want a live attenuated vaccine (LAV) or inactivated vaccine?
Before choosing a vaccine, it is important to know that it may come as a live and weakened vaccine (also known as LAV or “live attenuated vaccine”-we like to use big words and big abbreviations in medicine because it boosts our/my big egos-most of us med geeks were not great athletes so we need something to sustain us) option or “inactivated vaccine” where it is not live at all. LAV vaccines such as MMR (measles, mumps, rubella), Flu-Nasal, Shingles, yellow fever…get flack for being a LAV and folks worry that they might cause the disease that they are trying to prevent, but this is inaccurate (aka “false”-once in a blue moon it could cause some illness). In a perfect world we would all LOVE TO GET LAV because a LAV causes both major arms (“cellular” or immune cells and “humoral” or antibodies) of our immune system to work better. Inactivated vaccines improve only one part of our immune system (humoral) primarily but not as much the other (cellular). So, would you rather have 2 major competent armies fighting an enemy or just one!? Okay, I would love to have 2 very different and big friends next time I am dealing with a bully on the playground versus one (I like my odds better with two). Now, since some of our immune systems are weakened by some diseases and aging, it is possible for a LAV to cause problems in extremely vulnerable populations or even in those that it has not been adequately tested on, so this is why they cannot be given to everyone. Many conditions do not have a LAV invented so we have to stick with the inactivated vaccine (regardless-take what you qualify for and you can win big).
So, lets review some of the important adult vaccines for 2016 that I get asked questions about and some quick facts about each of them to inspire you to be up-to-date! Let’s just focus on 5 vaccines you should be thinking about now: 2 types of pneumonia vaccines, 1 flu shot, 1 shingles shot, and 1 tetanus booster.
FLU VACCINE (Seasonal Influenza-many types now, but just pick one)
One of the most common causes of pneumonia is this dang virus, which is one of the top causes of hospitalization and death in the U.S. It also has great impact on the very young and old.
Influenza is the “most frequent cause of death from a vaccine-preventable disease in the U.S.” YIKES!!! One vaccine type covers 3-strains of flu virus and a newer one covers 4-strains (Quadrivalent/Fluarix for example=one I got this year folks from GSK and they gave me a tootsie roll right after the pharmacist injected me—talk about side benefits!!!). The nasal spray flu vaccine (LAV) provides protection against 4 flu viruses and it is approved for those ages 2 through age 49 years. Individuals with egg allergy should not receive this vaccine. It rarely can make someone ill (I would get this in a second but unfortunately, I became 50 last year and no longer qualify).
Primary Non-Obvious Side Benefit: Potentially reduce your risk of a cardiovascular event by controlling long-term inflammation.
PNEUMONIA VACCINES (2 Types)
Pneumonia is now one of the top 5 or 6 causes of death in U.S., and both vaccines are now recommended if you are age 65 years and older. Also, both vaccines are non-live or “inactivated” vaccines.
1. PCV13=13-Valent Pneumococcal Conjugate Vaccine=Prevnar 13® (from Pfizer-the ones that brought you the overly—and now ridiculously— high-priced “little blue pill” aka Viagra®-it can eliminate your erection right after you see how much you paid for it). Actually the FDA licensed the use of it for adults 50 and older.
2. PPSV23=23-Valent Pneumococcal Polysaccharide Vaccine=Pneumovax® (from Merck-the ones that originally brought you Miralax®-before Bayer bought it-so no one can get too full of themselves). Recommended for all adults 65 years or older and for people 2 to 64 years who are at high risk for pneumonia. If a 65 years or older adult with a normal functioning immune system (“immune-competent”) has NEVER received Pneumovax in the past, then get the Prevnar vaccine once and then get PPSV23 at least 1-year afterward. If a 65 years or older adult with a normal function immune system (immune-competent) HAS ALREADY received the Pneumovax in the past (before age 65 years) then get Prevnar once at least 1-year after the PPSV23, and then get PPSV23 at least 1-year after PCV13 (if 65 years or older remember).
I am often asked why it is best to get the Prevnar pneumonia vaccine first and then get the Pneumovax second a year or so later… compared to why not the other way around (Pneumovax first and then Prevnar second) and the reason is that there was a study that showed a better immunological response if the sequence was to first get Prevnar and then later get Pneumovax versus vice versa. It is still just fine if you were given Pneumovax first but I just wanted to present the ideal scenario.
Primary Non-Obvious Side Benefit: May reduce the risk of hospitalizations and is currently being investigated for its ability to reduce the risk of cardiovascular events (heart attack, stroke, etc..) by controlling inflammation long-term after infection.
SHINGLES (1 type, and it is a good one now but a new and potentially amazing Shingles vaccine could be available soon)
This is a LAV or live attenuated vaccine from Merck also known as “varicella-zoster” vaccine. All individuals 60 and over qualify…one injection (but many folks get it at age 50 years and older. I am waiting at age 51 because I think a new and better shingles vaccine will be available soon). Vaccine is less effective in those that are 70 and above (but still effective). Yes, you should even get it after you have had shingles because once you’ve had shingles you and I both know that you want to do everything possible from never seeing that movie sequel come out!!! There is also a chickenpox vaccine (also known as just “varicella” vaccine) now and the Shingles vaccine is a much stronger dose than chickenpox vaccine but if you are not old enough to qualify for the Shingles vaccine and you never had chickenpox then ask your doctor about the chickenpox vaccine. I had chickenpox and I remember it like yesterday because my kindergarten girlfriend broke up with me after she saw me with it! Man, sometimes a guy can’t get a break even in kindergarten.
There is a potentially new shingles vaccine from GSK pharmaceuticals that could hit the market where 1 dose is given and approximately 2 months later another dose is given and it could be well over 95% effective at all age groups 50 years and older!!! This would be amazing!! KEEP BOTH EYES OUT FOR THIS ONE!
Primary Non-Obvious Side Benefit: Preliminary research suggests shingles can increase the risk of stroke because this virus also appears to get into and around blood vessels. The vaccine is being studied as a way to prevent a stroke. And, new research is looking into whether less cold sores/fever blisters occur after being vaccinated because the cold sore virus is in the same family as chickenpox/shingles.
TETANUS, DIPHTHERIA & PERTUSSIS
Td booster single injection every 10 years for all adults (just 1 per 10 years)
Primary Non-Obvious Side Benefit: Already showed some preliminary research at Duke University that it might help boost the effects of some cancer treatments. This is exciting!
I hope you enjoyed Part 1 of Moyad Vaccine Side Benefits and now I will return you to your regularly scheduled program where some bone headed pseudo internet expert will try and convince you that all vaccines are evil and are responsible for everything wrong in society including global warming. And, they will also tell you that living in a technologically advanced world has been the bane of our existence at the same time they use a microwave and espresso machine, get on an airplane, buy a new car, and use the fancy toilet in their house that is connected to all those pipes…yeah…technology is terrible I agree now I need to walk my dog so I will just send this article to PCRI by email instead of the pony express like I usually use (that is called sarcasm).
Mark Moyad, MD, MPH, is the Jenkins/ Pokempner Director of Preventative and Alternative Medicine at the University of Michigan Medical Center, Department of Urology. He is the primary author of over 100 medical articles and many best-selling books on diet and supplements, and alternative medicine. He is the Moderator of our bi-annual Conferences