10 embarrassing questions about vaccinations: pediatrician Fyodor Katasonov answers

In this series articles, well-known experts answer questions that are usually awkward to ask: it seems that everyone already knows about it, and the questioner will look stupid.

Today we are talking with pediatrician Fyodor Katasonov about why we need vaccinations and what will happen if we refuse them.

1. How do vaccines work?

Vaccines rely on the body's natural defense system. When vaccinating, our task is to provoke a response from the immune system and train it to fight a specific infection. This is due to the fact that, simply put, each pathogen - virus or bacterium - contains some unique protein or group of proteins.

Fats and carbohydrates are the same in all animals, but proteins are what distinguishes us, and not only different species, but also different individuals. For example, division into blood groups is precisely a division based on red blood cell proteins, which some people have and others do not.

So, these unique proteins - we call them antigens - are the sign by which the immune system distinguishes what is dangerous from what is not dangerous. And they are what are contained in vaccines.

One of the main weapons of the immune system is antibodies. These are proteins that bind to antigens. To produce antibodies and fight an infection, the immune system needs time - from several days to two weeks. And this is precisely the point of vaccination - so as not to waste this time.

If antibodies are produced to the antigen as part of the vaccine, then while this process is going on, the body is not in danger.

If they are produced in response to an antigen in the pathogen, the pathogen conquers the body, causing the disease and its outcomes, including death.

Once the immune system is trained, it can “knock down on the fly” those viruses and bacteria for which the vaccine was vaccinated.

Therefore, vaccination is training our natural defense to fight a specific pathogen in favorable conditions - in the absence of this very pathogen. And this is a gain of time (and tactical advantage) in the battle against infection, because learning during battle can be delayed.

2. Vaccines contain mercury, aluminum and other poisons. Is it dangerous?

Firstly, mercury and aluminum themselves are not poisons. Poison is generally an everyday term; in medicine, everything is determined by the route of administration and dose. For example, mercury is bad to breathe, but safe to drink.

Secondly, modern vaccines do not contain mercury salts, despite their safety.

Aluminum is also not always used in vaccines, but sometimes it is necessary. The fact is that our immune system is not so stupid as to react with a systemic reaction to any little thing. When it is enough not to put the whole organism on the spot, but to deal with the invasion on the spot, “issues are resolved” at the local level. And some vaccine antigens are not a sufficient irritant to induce systemic, durable protection.

In order for the immune system to notice them, you have to attach “beacons” to them - irritants that will attract immune elements to themselves, and at the same time introduce them to the antigen. Without them, the vaccine will simply dissolve in the thickness of the muscle and will not have any effect.

As for the harm, as I said, the question is in the dose. Aluminum is the third most abundant element on Earth, and traces of it are found in drinking water (1–2% of daily aluminum consumed), food (95% of daily aluminum consumed), air, deodorants, cosmetics and so on. Through the mouth, 4,000–5,000 mcg per day enters the body (up to 5 million mcg per day in those taking antacids), through breath 4–20 mcg per day (up to 25,000 mcg in those living in industrial areas), 50,000–70,000 when used deodorant.

One vaccine contains several hundred micrograms of aluminum (depending on the vaccine), which are administered once. It is clear that in overall aluminum consumption this is a drop in the bucket.

The third known “poison” in vaccines is formaldehyde. It may indeed be found in trace amounts in vaccines. It remains there after the vaccine has been disinfected, meaning it ensures its sterility.

But formaldehyde is not only not a poison in itself - it is a participant in our metabolism, that is, the body has all the means to utilize it.

The total dose of formaldehyde that a child receives with vaccination over 2 years is up to 0.8 mg. At the same time, the natural content of formaldehyde in the body of a healthy five-kilogram child is approximately 1.1 mg, which is 1500 times more than in any vaccine.

In 2 years, a child will not receive even as much in vaccines as he already contains at the age of 2 months.

3. Do vaccines cause complications, including autism and allergies?

Complications are not quite the correct term for vaccination. Vaccination is not a disease. We say "adverse reactions."

The fact is that the reaction to the vaccine itself is not only desirable, but is also the essence of vaccination. Therefore, we are concerned not about the presence of a reaction, but about its redundancy in rare cases. And if we talk about the most severe reactions, which are extremely rare and even more rarely lead to death, then these are mainly anaphylactic reactions - that is, a violent allergy to one of the components of the vaccine. Most pediatricians who vaccinate children every day for years never encounter such a reaction. But it is precisely because of this that you need to have an anti-shock first aid kit in the vaccination office and it is not recommended to vaccinate at home.

An allergy to a vaccine is quite possible, although extremely unlikely.

And the development of an allergy to something else after vaccination - this can be imagined in theory (allergy is an immune process, and vaccinations work on the immune system), but this is no more likely than the development of an allergy, for example, after an acute respiratory viral infection, which also affects the immune system system.

As for autism, this issue is really quite shameful in the 20s of the 21st century. Autism - a congenital condition of the nervous system, which is caused by genetics and, to a small extent, harmful factors during pregnancy. Over the past 30 years, no matter how hard they tried, they could not find any connection between autism and vaccinations. I think that this myth can already be written off; there is not even a grain of common sense in it, unlike the same immune failures that, in extremely rare cases, can be associated with vaccination. But these cases are so rare and so multifactorial that it is practically impossible to associate them with the vaccine.

4. Are live vaccines dangerous?

All vaccines are safe - they are the safest drugs in medicine. Live vaccines containing weakened viruses or bacteria cannot cause illness in a healthy child. However, there are some situations where we prefer not to administer live vaccines or delay them. The fact is that in an organism with weakened protection, vaccine microorganisms can again acquire pathogenic properties.

To such cases we include diseases (immunodeficiencies, congenital or acquired), conditions (immunosuppression due to drug treatment), as well as the period of intrauterine development. Live vaccines are best administered 3 months before the intended date. conception, and then take a break until childbirth. During breastfeeding, you can be vaccinated with live vaccines if necessary.

An important difference between live vaccines is their combination with each other: they are given either on the same day or with an interval of 28 days. Non-live vaccines have no such restrictions.

5. Why get vaccinated if you can get over the disease and get more lasting immunity?

First of all, this is not true. The durability of immunity often differs slightly.

Secondly, the vaccination is easily tolerated and does not force you to change plans. Illness is not only an emergency change of plans, but also the likelihood of complications, hospitalization, and death. This is the spread of the infection and its transfer, including to people for whom it is even more dangerous - those who are immunocompromised or pregnant.

This question is not asked by parents who are faced with measles, severe chickenpox, whooping cough, meningococcus, influenza, etc.

I'm not talking about hepatitis B, which you can only get once in your life. The risks of vaccination and the risks of disease are so disparate that vaccination is one of the most uncontroversial types of medical intervention. No one else has pills or surgery, as far as I know, there is no such striking risk ratio.

6. If you vaccinate your child, will he definitely not get sick?

It depends on the disease. Vaccinations are specific; they do not “raise immunity” in general. They only protect against what they are intended to protect against.

The effectiveness of vaccines varies, usually from 40% (failed vaccine against flu) up to 99% (rubella). Efficiency is also considered differently. A vaccine can protect against illness, severe disease, complications, hospitalization, the need for antibiotics, death, and the spread of the disease. All these points are used to calculate your effectiveness.

But in general, we can say that with timely maintenance of vaccination status, a child or adult is protected quite well.

7. Can a child definitely tolerate that many vaccinations? Will his immunity weaken?

Vaccinations are dumbbells for the immune system. They do not weaken it at any stage, only making it stronger. There are practically no additional risks when administering multiple drugs at once.

What limits the number of vaccinations is not the ability of the immune system to process them (and it can handle them even if we do 100 vaccines in one go), but the stress the child receives.

We will not give 10 injections at a time, but will spread it over 2-3 visits, so that the child, in principle, will once again enter the medical facility of his own free will.

8. Is it necessary to vaccinate against diseases that no longer exist in the country?

No, only when traveling. For example, yellow fever or Japanese encephalitis are not found in Russia, so there is no need to do them.

But all the diseases that exist in vaccination calendar, in the territory of the former USSR they exist and bloom (except for wild polio).

9. Can medications or any procedures replace vaccines?

No, no medicines or procedures can replace vaccines.

The only thing that is similar in action is immunoglobulins, that is, antibodies that are introduced into the body from the outside. This is called passive immunization (we give the body ready-made antibodies, rather than teaching it to produce them). It is not always effective, and not all diseases have drugs. But sometimes it is used when active immunization (that is, vaccination, when the body itself produces antibodies and remembers how to do it) is already too late.

However, in terms of preventive effect, nothing compares to vaccinations.

10. What will happen to the child and society if we refuse vaccinations?

Remember the pandemic - it will be the same thing, only raised to a power. Massive full-time education will become impossible, child mortality will increase exponentially, and then adult mortality too. The increased need for antibiotics will take us into the pre-penicillin era, because antibiotic resistance will increase. The population of the Earth will begin to decrease, the economy will experience a huge blow.

Fortunately, this is simply impossible. It's like blowing up nuclear bomb over my hometown. No one will take such a step into the ancient past.