Mar 05 2010
A Welcome Upgrade to a Childhood Vaccine – PCV 13
Children aren’t supposed to die. That so many of us accept this statement without a blink is remarkable and wonderful, but it is also a very recent development in human history. Modern sanitation, adequate nutrition, and vaccination have largely banished most of the leading killers of children to the history books. Just look at the current leading causes of childhood death in developing countries to see how far these relatively simple interventions have taken us.
As we have systematically removed the leading infectious killers of children from prominence, other organisms have naturally risen to the top of the list. This has lead some to the fatalistic (and mistaken) conclusion that we are simply opening up niches to be inevitably filled by other virulent organisms. This assumes that there is some mandated quota of say, meningitis, that children must suffer every year, and if one organism doesn’t meet this quota then another will fill it. Were this the case, after vaccination we’d expect to see a shift in the causes of meningitis, but at best a transient drop in the total number of cases per year as other bugs step in to pick up the slack of their fallen, virulent, meningitis-inducing brethren. Such is not the case.
Though new organisms are now the leading causes of invasive bacterial infections in children, and we have indeed seen some increases in non-vaccine targeted strains, as I’ll discuss below, the total number of such infections has dropped precipitously. It’s fair to say that the vaccination program has done a remarkable job improving a child’s chance of surviving to adulthood in good health. However, no one in their right mind would argue that the current state of affairs, as good as it is, is good enough, and so we have shifted our sights to the current leading cause of invasive bacterial infections in children, Streptococcus pneumoniae (S. pneumo, or pneumococcus).
The Need for a Pneumococcal Vaccine
S. pneumo is a challenging bug to prevent and treat. Its 90 different serotypes together cause a variety of infections, from the relatively mild such as otitis media (ear infection) and sinusitis, to the far more serious including pneumonia, sepsis, meningitis, and osteomyelitis. Much of this versatility and the primary factor determining each strain’s virulence comes from the polysaccharide capsule surrounding S. pneumo. This gel-like substance hides many of its antigens from exposure, and is itself a poor target for the immune system.
Increasing antibiotic resistance in some strains of S. pneumo certainly doesn’t help the matter, but neither is it the primary cause of S. pneumo’s current position of infamy. The majority of strains are susceptible to good old penicillin, and even resistant strains are susceptible to other classes of drugs. The problem is that in a small minority of cases the infection spreads so aggressively that children die or suffer complications in spite of rapid medical care and appropriate antibiotics.
This is why in children prior to 2000, and in spite of modern medical care, S. pneumo caused around 13,000 cases of bacteremia, 2500 cases of pneumonia, 700 cases of meningitis, and 200 deaths (not to mention 5,000,000 cases of otitis media). As always, prevention would be better than treatment, and in 2000 the first vaccine against S. pneumo for children under the age of 2 was licensed in the US (an earlier vaccine, PCV-23, existed for adults but was incapable of generating a good response in children). PCV-7 (Prevnar) targeted only 7 of the more than 80 known serotypes, but the seven were well selected, accounting for 80-85% of the cases of invasive disease and a majority of penicillin resistant strains.
Coverage Gaps and Moving Targets
The subsequent 10 years have been almost exactly what you would hope for from the vaccine. Invasive pneumococcal disease in children has dropped by 76% (including non-targeted serotypes), and disease from targeted serotypes, which recall made up 80% of all invasive disease before the vaccine, dropped 99%. We’ve even seen a modest but significant decrease in the incidence of S. pneumo disease in the elderly, which is most consistent with the effect of herd immunity. This is an outstanding success.
Though PCV-7 is effective, it’s also far from perfect. Predictably, the strains not targeted by PCV-7 have persisted in the population and become more common. Some of these strains are less pathogenic, but a few have shown themselves capable of virulence, and so in the last decade we’ve seen a shift in the behavior of infections caused by S. pneumo. One such example of this may be seen in the increased rate of empyema.
Occasionally during a pneumonia bacteria can also infect the space between the lung and the wall of the chest, causing an accumulation of pus that is difficult to treat with antibiotics alone, and usually requires some form of drainage. Typically this is done with a tube inserted between the ribs or thorascopic surgery, and usually includes a prolonged hospital stay. Needless to say, an empyema is undesirable, and the rate of this complication from pneumonia seems to be increasing.
This concerning trend has been most recently demonstrated by an article appearing in Pediatrics. Between 1997 (3 years pre-PCV-7 licensure) 2006, the authors found an approximate 50% drop in invasive pneumococcal disease in general, pneumonia, meningitis, and bacteremia, consistent with the existing literature confirming the general efficacy of PCV-7. However, they also were able to demonstrate a subtle increase in the rates if empyema during the same amount of time. This means that with a near halving in the total number of pneumonias, but an increase in a complication of pneumonia, the risk of developing an empyema during a pneumococcal pneumonia has roughly doubled in the last decade.
Now comes the hard part: Why? Well, frankly, we don’t yet know. This study doesn’t establish the causative mechanism behind the increased incidence of empyema; it simply establishes that it has increased in spite of pneumococcal vaccination. The increase could be part of a previously occurring trend, after all, the incidence of empyema was already increasing before the vaccination was implemented. It could be from a shift toward serotypes that are more prone to cause empyema, but aren’t targeted by the vaccine. Unfortunately this particular study isn’t designed to look at involved serotypes, and the other literature to support this hypothesis is currently mixed. I find it compelling to note that this very study also demonstrates a nearly identical increase in the rate of empyema associated with Staphylococcal pneumonia, suggesting an unidentified common factor between the two.
We Can Do Better
We know that PCV-7 is effective at controlling most infections from targeted serotypes, that non-targeted serotypes are beginning to thrive, and the increased rate of empyema has not been curtailed by the current vaccine. The next logical step is to broaden our coverage to include the non-targeted pathologic strains within the vaccine.
This is precisely what has been done. Several vaccines with a broader scope have been in development, and on February 24th the FDA licensed the first of this next generation of pneumococcal vaccines. PCV-13 targets all seven prior serotypes and includes an additional six that together comprise the most common and pathological serotypes currently in circulation (serotypes 1, 3, 4, 5, 6A and B, 7F, 9V, 14, 18C, 19A, 19F, and 23F). It is slated to replace the current PCV-7, will follow the same 4-shot 2, 4, 6, and 12-15 month schedule, and can be used to complete a series of PCV-7 vaccinations.
This vaccine, like every other one, has undergone extensive testing for both safety and efficacy. It is built on the identical technology as PCV-7 that has a decade’s worth of excellent safety, and will, as with all other vaccines, undergo even more rigorous post-release surveillance.
Based on PCV-7’s success, we have every reason to expect an even greater reduction in the burden of serious infections suffered by our children. If we’re lucky, we’ll soon have to declare a new bug the leading cause of invasive bacterial infections in children, not because of its success, but because of S. pneumo’s fall.
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126 Responses to “A Welcome Upgrade to a Childhood Vaccine – PCV 13”
I recently read a book about the development of the polio vaccine. As someone who grew up after that vaccine, I never gave polio much thought. Reading that book made me want to hug my child and weep for the generations of parents before me who must have stayed up nights summer after summer worrying about whether their children would succumb. And now we have another weapon against the awful fear of childhood disease. Bravo Science.
I’ve seen rejection of these vaccines based on serotype replacement and the reported increase of empyema. Given that anti-vaxers don’t have the grasp of the science they think they do, I suspected that this information was twisted to support their conclusions. Furthermore, on a pure emotional level, I could reject their argument. Sure the vaccine doesn’t cover ALL the causes of meningitis, but why not protect children from some if the causes? I could only conclude that anti-vax is indeed pro-disease.
Thank you for explaining why they are wrong in a more scientific way.
So, should children who have been vaccinated in the last few years get another vaccination when the new form is available?
“Modern sanitation, adequate nutrition, and vaccination have largely banished most of the leading killers of children to the history books.” Err, no, they haven’t. All you have to do is follow your own link to find out that your assertion is false. Diarrheal diseases kill more than 1 and a half million children every year. Malaria kills more than a million and measles still gets half a million. 138,000 kids just flat starve to death.
Progress, yes, but banished to the history books? Not hardly.
@cervantes
Are you citing worldwide stats? If so, I think that Dr. Albietz specifically pointed to the dichotmoy betweeen developed and developing nations in regards to preventative healthcare and its effects elsewhere in the article. I believe in the quoted passage it’s implied that he’s refering to developed countries with widespread access to proper healthcare.
No he isn’t. He specifically says “developing countries.” I can read.
@cervantes
I think mikerattlesnake is correct. Joe is pointing out how sanitation, nutrition, and vaccination have banished many childhood diseases to the U.S. history books. He is using the W.H.O. stats to point out the discrepancy between the Americas and developing countries (which is inferred to have less sanitation, nutrition, and vaccination).
You can read, but maybe you did not comprehend what you read.
@ cervantes
“Children aren’t supposed to die. That so many of us accept this statement without a blink is remarkable and wonderful, but it is also a very recent development in human history. Modern sanitation, adequate nutrition, and vaccination have largely banished most of the leading killers of children to the history books. Just look at the current leading causes of childhood death in developing countries to see how far these relatively simple interventions have taken us.”
Developing countries do not usually have good sanitiation, nutrition or vaccine programs, but modern countries do. This is the point that Dr. Albietz is making, hence the link to statistics of “developing countries”.
KathyO, was the book splendid solution? i also loved it. the part where the book told about how they decided to test the polio vaccine against a placebo made me think of the anti-vax claim that vaccines are never tested against a placebo.
great post! the initial media reports on the pediatrics study you talked about were terriblo imo, citing percentage increases for empyema and %age decreases for pnemonia that made it sound like the situation was a wash. definitely provided some fodder for the anti-vax crowd and probably just confused average parents.
(typing w/ 1 hand while nursing, sorry !)
@cervantes
Yes, he presents data from “developing countries” in an attempt to contrast that with developed countries. The article shows a marked decrease in childhood death in developed countries when compared to developing countries (who have not benefited as much from “Modern sanitation, adequate nutrition, and vaccination”).
These measures /have/ “largely banished most of the leading killers of children to the history books” in the Americas. Childhood mortality is still very high in the developing world.
@ cervantes:
Some forms of diarrheal illness are prevented by vaccination – the rotavirus vaccine. Also, adequate sanitation prevents outbreaks of diarrhea by helping to prevent contamination of drinking water by feces. Measles is prevented by…the measles vaccine.
Unfortunately, malaria has evaded vaccination developers for so many reasons, the life cycle of the bug being one of the most significant problems.
And, isn’t starvation prevented by adequate nutrition?
Did I miss something here? I think the statement ‘just look at the current leading causes of childhood death in developing countries to see how far these relatively simple interventions have taken us’ means to compare developed versus developing countries.
Cervantes, you seem to be misunderstanding his point. The fact that these diseases are rampant in developing countries (where adequate nutrition, sanitation, and vaccination is lacking), suggests that these interventions are responsible for the low prevalence of these diseases in developed countries. It’s an ecological assessment, but a fair one.
Social justice is also a powerful player that is often left out.
So if it isn’t happening in the rich countries, it’s been “banished to the history books?” Sorry, that may not be what he meant to say but he said it.
@Desiree
Yes it was. Great book. I’m listening to ‘The Demon under the Microscope’ right now, which is about antibiotics.
I just couldn’t imagine how many more healthy children will be devastated let alone suffer from this newly invented vaccine.
gr8blessings,
“I could only conclude that anti-vax is indeed pro-disease.”
Wrong conclusion. You and the vaccinators are the ones responsible for deliberately infecting naive immune cells of healthy newborns with hideous antigens. Get your facts straight.
Troll1Troll2:
What evidence do you have that the vaccine causes harm? Since you say we need to get our facts straight, provide some of those “facts” with real evidence. Until you show some real evidence to support your opinion you should be ignored.
The evidence of harm a.k.a. adverse reactions if you know what that means or where to find it. (Hint: package inserts). You can begin reading them before we can go to court judgments, understand?
Does the word NAIVE sound familiar? Maybe you can explain what vaccine antigens do to a naive cell?
Oh my friend Th1Th2. We have had this discussion before regarding the difference between antigen, infection and disease. I see that you are still grasping to understand these concepts.
The pneumococcal vaccines are conjugate vaccines. As such, these vaccines do not cause an infection since the vaccine does not contain any live bacterial cells. Furthermore, they are not given to newborns. The schedule is 2, 4, 6 and 12-15 months.
Once again, Th1Th2, it seems that you are the one with your facts out of order.
gr8blessings,
“As such, these vaccines do not cause an infection since the vaccine does not contain any live bacterial cells. ”
The initial stage of pathogenesis begins with the introduction of antigens to naive immune cells regardless whether the antigen is live or inactivated. This is called infection. And infection can occur naturally (natural infection) or artificially (vaccination). Replication then follows infection (except for inactivated antigens).
“Inactivated vaccines are not alive and cannot replicate.
The entire dose of antigen is administered in the injection.
These vaccines cannot cause disease from INFECTION, even in
an immunodeficient person.” (Emphasis added)
http://www.cdc.gov/vaccines/pubs/pinkbook/downloads/prinvac.pdf
Since these healthy newborns are NAIVE to these antigens then why are you promoting contamination of their immune system in the first place? Antigens do not protect. Even my 3 year old niece knows that.
“The initial stage of pathogenesis begins with the introduction of antigens to naive immune cells regardless whether the antigen is live or inactivated. This is called infection.”
Now we know that you don’t know what an infection is.
th1th2
(thick and thicker)
I will make this really simple:
Prevnar is made up using only parts of the pneumococcal bacteria.
It is an inactivated vaccine.
It cannot cause disease.
It protects against disease.
It stimulates the body to produce an immune response that protects against infection with the live bacteria.
No real evidence presented that the vaccine is harmful by the troll. Ignore it.
BillyJoe,
1. “Prevnar is made up using only parts of the pneumococcal bacteria.”
So? It is still an antigen.
2.”It is an inactivated vaccine.”
It limits spread of infection.
3.”It cannot cause disease.”
It can cause infection that can cause the disease.
4. “It protects against disease.”
Dream on. Antigens do not protect. On the contrary antigens can provoke infection, allergy and disease. It is the job of the body to eliminate antigens.
5. “It stimulates the body to produce an immune response that protects against infection with the live bacteria.”
Read number 4.
Chris,
Understandably, you have never vaccinated before that’s why you are nescient that every vaccine comes with package insert.
thick and thicker,
“It is the job of the body to eliminate antigens.”
You win one!
Amazing!
Yes, correct, the body’s immune system eliminates the injected antigens by producing antibodies so that, when the antigens of the live virus arrive, it is primed and ready to eliminate them as well.
Give the doggie a bone.
“This is why in children prior to 2000, and in spite of modern medical care, S. pneumo caused around 13,000 cases of bacteremia, 2500 cases of pneumonia, 700 cases of meningitis, and 200 deaths (not to mention 5,000,000 cases of otitis media”
Thanks for an informative post. I would like to add that aside from the risks of death from the above diseases there is a risk of long term consequences.
One of my son’s classmates (school for children with hearing/speech impairments) has profound hearing loss, and delays in gross and fine motor control all due to a meningitis infection. He’s a sweet and inquisitive kid who is going to have a really tough road for a long time to come.
I do not know if this new vaccine would have prevented his particular case of meningitis, but it is good to know that it will prevent some cases like his.
My question would be, like the above commenter. Is it recommended that children already vaccinated receive the new one. Would it be a booster or a new set of shots?
@T-helper cell 1 T-helper cell 2
A quick introduction to how an infants immune system works can be found here: http://www.immune.org.nz/site_resources/Professionals/Vaccinology/The_infant_immune_system_and_immunisation.pdf
from http://www.immune.org.nz/?t=904.
If and when you read some background on how the infant immune system responds to antigens and vaccines, we can continue having a discussion. Until then, adieu adieu adieu.
@ TH1/TH2
I am confused by your statements. Is activation of the immune system by vaccines bad?
If so, what is your opinion of the thousands of antigens that our bodies encounter “naturally”? Are those antigens dangerous too, or is it just vaccine antigens?
BillyJoe,
“Yes, correct, the body’s immune system eliminates the injected antigens by producing antibodies so that, when the antigens of the live virus arrive, it is primed and ready to eliminate them as well.”
Wrong. The immune system does NOT eliminate antigens through the production of antibodies. In fact, antibodies do NOT kill and dispose of antigens. So who does the job? Come back here if you know the answer.
Draal,
So what’s your point with the Sesame Street-like handout?
watso359,
@ TH1/TH2
“I am confused by your statements. Is activation of the immune system by vaccines bad?
Terribly bad and abnormal.
“If so, what is your opinion of the thousands of antigens that our bodies encounter “naturally”? Are those antigens dangerous too, or is it just vaccine antigens?”
Extraneous antigens occurring naturally are mediated through non-specific immunity (skin barrier, mucosal, enzymatic destruction, pH balance, nutrition, etc.) provided these antigens do not take another route or port of entry which infringes and corrupts that innate physiologic defense in contrast to vaccination which is the intentional and intrusive way of inoculating the body with disease particles.
Antigenic exposure and reaction varies and depends on several factors: age, health status, nutritional level, allergy, intact skin barrier, etc. Susceptibility occurs in malnourished and immunocompromised people which can predispose them to infection, allergy, diseases and even death.
watso359,
You realize you were just answered by a person who doesn’t even know what an infection is.
weing,
At your level of understanding (or the lack of it), here’s might suit you:
http://diseases-viruses.suite101.com/article.cfm/how_does_my_immune_system_work
How does Infection get into your body?
Your body has many defence shields to prevent infection:
* Tears protect the eyes
* Your skin
* Cell layers that cover the mouth, vagina, nose and alimentary canal
* Acid in your stomach
* Clotting mechanism in the blood
If the infection gets past any of these and ANTIGENS INFECT and reproduce within your bloodstream then there are two further processes that can destroy the pathogen – your immune response and phagocytosis. (Emphasis added)
Now go on and enjoy the weekend.
So, you read that and still haven’t learned what an infection is. Amazing. Simply amazing. Deliberate ignorance.
weing,
There’s no hope for you.
“The initial stage of pathogenesis begins with the introduction of antigens to naive immune cells regardless whether the antigen is live or inactivated. This is called infection.”
No. This is called ignorance.
Th1/Th2
Again I’m a little confused….
If most healthy immunocompetent people are protected by innate defenses and rarely see internal antigens, why is it that almost all people have so many antibodies and memory B cells in their blood and lymphatic circulation?
This fact seems contradictory to how you explained the natural immune system functions. How does one reconcile this?
Thanks
Weing
Do you know Socrates?
watso359,
I do not see any conflict. Before I proceed, are you inferring that the only chance antibodies and memory cells are produced is through encounter with antigens?
I wasn’t inferring anything, only asking questions based on the conversation between you and other posters.
Th1/Th2
Please continue
Troll1/Troll2: I have been vaccinated many times, starting with smallpox, typhus, polio, yellow fever and other vaccines as an infant (born overseas) to recently getting the H1N1 vaccine. I have read the inserts.
The big difference between us is that I actually understand them. I know the difference between an antigen and the full bacteria.
Now provide real evidence that getting the new PCV 13 vaccine is worse than getting the diseases. Explain clearly (with actual documentation and not your misinterpretation of lawyer written inserts) why we should go back what it was like before the PCV-7 was available as described above by Dr. Albietz:
Package inserts are not acceptable as evidence. Actually cite real literature.
Otherwise, go back under your bridge.
watso359, you will not get any real data or information from Troll1/Troll2. He has done the “read package inserts” bit before when asked for real evidence, and has demonstrated multiple times that s/he/it does not understand anything beyond a University of Google education. See previous encounters here:
http://www.sciencebasedmedicine.org/?p=1296 .
watso359,
First of all, as you know antibodies are produced through plasma B cells and plasma B cells originate in the bone marrow. Even at birth, neonates have self-derived immunoglobulins. But this ability to produce antibodies occurs in a stepwise fashion. This is an inherent physiologic process—we are born with it.
In addition, memory B cells are formed after primary exposure to infection such as in vaccination. However, memory B cells does not ‘protect’ like plasma B cells.
The humoral-mediated response is not the primary and ultimate function of the immune system.
Chris,
“I have been vaccinated many times,”
I don’t care if you were vaccinated, my point was if you have ever vaccinated a living creature with your own hands.
I read too fast, so sue me. I only spend the minimum time required to read your idiocy. You are not worth the time.
You have also never vaccinated anyone. Now answer the question, or go back under your bridge.
Chris,
You are wrong. I work in the medical field and have administered vaccines on all ages. And at the same time, I have taken care of vaccine-damaged patients.
GTG for awhile.
Everyone,
Please look at this exchange:
Troll1Troll2: “It is the job of the body to eliminate antigens.”
BillyJoe: “Yes, correct, the body’s immune system eliminates the injected antigens by producing antibodies so that, when the antigens of the live virus arrive, it is primed and ready to eliminate them as well.”
Troll1Troll2: “Wrong. The immune system does NOT eliminate antigens through the production of antibodies. In fact, antibodies do NOT kill and dispose of antigens. So who does the job? Come back here if you know the answer.”
I produce a statement which is correct but incomplete. The troll says it’s wrong, implying that I was saying that it is the antibody – and only the antibody – that is responsible for eliminating the antigen!
I’m afraid that in our exchanges with this troll, we are going to find that, unless we write book length responses – and even then – the troll is going to find fault. On the other hand he himself will be allowed to write incomplete responses and pose questions and expect us to scurry off and find the full text somewhere else.
Troll, you have been exposed!
@Th1/Th2
Sorry for asking so many questions, but this material is complicated…
So you are saying that plasma cells are always producing antibodies, regardless of whether or not they have ever actually been “activated” by an antigen? That is not the way it is explained on internet sites, could you help elaborate on that for me?
Same thing with the memory cells…internet websites say that they are the reason why you don’t usually get the chickenpox twice. You are saying that there is a different defense system responsible for that? How does it work and where can I learn about it?
Thanks again
BillyJoe:
Again. Which is why s/he/it should be ignored.
Regarding the Troll:
Why does the troll think that antigens infect?
Because, when he googled the internet, the troll found this quote:
“If the infection gets past any of these and ANTIGENS INFECT and reproduce within your bloodstream”
(The CAPITALISATION is his of course)
Yep, “expertise” via the internet!
All we have in that quote is loose langauge, nothing more.
Antigens don’t infect – and they don’t reproduce either.
The micro-organisms that contain these antigens infect and reproduce.
Unless of course you are humpty dumpty – then you can make word mean exactly what you want them to mean!
Troll, you have been exposed!
There is another exchange between the troll and watso that I could expose but I’m laughing so hard I can’t get my fingers on the right keys.
It’s coming out something like this:
MAS kygtq TURB dbzjs ATION
So he is attending the University of Google, and plagiarizing a blog written by a fiction (and sometime health) writer, who occasionally teaches English as a foreign language. Her health books are listed on Amazon, but they range from 100 to 160 pages long, not exactly deep books.
Share, BillyJoe, share!
Th1Th2, define what an antigen is and what an infectious agent is for the rest of the class. Come on, go ahead.
I’ll give you a hand. The definition of an attenuated vaccine is a live pathogens that has lost their virulence but are still capable of inducing a protective immune response to the virulent forms of the pathogen.
Do you know what virulence means? The letter of the day is V, V for virulence. Virulence is the ability to cause disease. Lost virulence means the opposite. Do you know what an antonym?
The bonus round is brought to us by the letter I, I for infection. An Infection is defined as an invasion by and multiplication of pathogenic microorganisms in a bodily part or tissue, which may produce subsequent tissue injury and progress to overt disease through a variety of cellular or toxic mechanisms.
Can an attenuated virus multiply? No, because it is not virulent. So can an attenuated vaccine cause an infection? No, because it’s made up of attenuated virus.
Does Th1Th2 care to be spoon fed some more? Open wide!
BillyJoke,
“I produce a statement which is correct but incomplete. The troll says it’s wrong, implying that I was saying that it is the antibody – and only the antibody – that is responsible for eliminating the antigen!”
You appear so dyslexic. Read your statement again. Are antibodies (circulating or induced) capable of eliminating injected antigens? Just answer yes or no.
“Antigens don’t infect – and they don’t reproduce either.
The micro-organisms that contain these antigens infect and reproduce.”
Naturally, exogenous antigens do not cause infection if they don’t bypass the body’s physiologic and physical barriers. The inoculum (pathogen or pathogen parts) in the vaccine is introduced directly to the bloodstream and enters the cell (antigen-receiving and presenting cells), hence, the term infection. The infection of the host cell must occur to trigger effector immune cells, otherwise, the vaccine would be considered ineffective. The inability to replicate (inactivated vaccines) only limits the spread of infection.
Th1Th2, it is really sad that you haven’t realised it yet but…the game is up.
watso359,
“So you are saying that plasma cells are always producing antibodies, regardless of whether or not they have ever actually been “activated” by an antigen? That is not the way it is explained on internet sites, could you help elaborate on that for me? ”
Hence the question I raised earlier. All naive B cells (B cells that have not been exposed to antigen) are capable of expressing immunoglobulins in their cell surface. Antigenic stimulation will later enhance B cell maturity and thereby differentiation into plasma or memory cells along the way.
Plasma B cells can be activated either by antigen alone or with the help of T cells.
“Same thing with the memory cells…internet websites say that they are the reason why you don’t usually get the chickenpox twice. You are saying that there is a different defense system responsible for that? How does it work and where can I learn about it? ‘
Well, a memory cell can either be a T- or B-memory cell, so it depends. Which one are you referring to?
BillyJoe,
You don’t have to flinch, just answer the question. It’s so simple that my 3 year old niece knows the answer.
Draal,
Even though your argument sounds so rudimentary to me, it does not invoke critical thinking and logical relevance to someone who actually works in the medical field. You’re way better off explaining that to non-medical people and I guarantee you will not receive any rebuttal.
Troll1/Troll2 continues to post without any evidence. Still to be ignored.
BillyJoe, please share the link if you can stop laughing long enough!
Th1Th2 said, “The inoculum (pathogen or pathogen parts) in the vaccine is introduced directly to the bloodstream and enters the cell (antigen-receiving and presenting cells), hence, the term infection.”
That is not the consensus for the definition of infection. You’ve redefined the term to suit your needs.
Have you heard of an autoimmune disease? The same process you described of how an antibody response is triggered by a pathogen is the same process that results in an autoimmune disease. One’s own body is not an infectious agent. Therefore, the antibody response does not equal an infection.
Bacteria can cause an infection. The bacteria do not rely on the immune system to infect. An infection does not require white blood cells or an antibody response.
Th1Th2, are you employed as a RN, LPN, PA, NP or a custodian that happens to work in a hospital aka medical field? You should throw that argument from authority around a little more. I’m so close to realizing I should just believe everything you say is true.
Th1/Th2
Thats interesting.
So what would be the outcome if a person didn’t have the humoral branch of the immune system? (Antibody production)
@ Th1/Th2
Th1/Th2
“All naive B cells (B cells that have not been exposed to antigen) are capable of expressing immunoglobulins in their cell surface.”
Would that result in free secreted gamma immunoglobulins in the blood plasma?
“Well, a memory cell can either be a T- or B-memory cell, so it depends. Which one are you referring to?”
Is one more important for an overall immune response than the other?
Draal,
“An infection does not require white blood cells or an antibody response.”
According to the dogma of the Church of Modern Medicine that is considered a heresy.
“The same process you described of how an antibody response is triggered by a pathogen is the same process that results in an autoimmune disease. One’s own body is not an infectious agent.”
Yes I do concur that an autoimmune reaction can happen but this physiologic event is tightly controlled and regulated. However, the introduction of vaccine appears to disturb this homeostatic balance with destructive consequences.
watso359,
“So what would be the outcome if a person didn’t have the humoral branch of the immune system?”
The same thing that would happen for a person without a bone marrow.
watso359,
“Would that result in free secreted gamma immunoglobulins in the blood plasma?”
Yes, hence the name plasma B cells, as it matures.
“Is one more important for an overall immune response than the other?”
Yes.
Did anyone see the latest episode of the Office where every time Erin ask’s Kevin a question he answers with a one-word answer without furthering the conversation? I’m reminded of that here …
Yes, it is one of the more bizarre exchanges I’ve seen on SBM.
Th1/Th2
This has been fun, but it’s getting old.
“In addition, memory B cells are formed after primary exposure to infection such as in vaccination. However, memory B cells does not ‘protect’ like plasma B cells.
The humoral-mediated response is not the primary and ultimate function of the immune system.”
No one is claiming that antibodies are the ultimate or even primary action of the immune system, but rather an integral part, much like innate, cytotoxic components, and etc of the whole immune system working together.
You are claiming that antibodies play a decreased role in healthy individuals, yet you admit “The same thing that would happen for a person without a bone marrow.” in patients with agammaglobulinemia; indeed this is what is seen, and with intravenous antibodies derived from donors, they can live relatively healthy lives.
Even YOU do not believe your own crap.
A bored trolling undergrad biology student is all you are.
watso359,
“No one is claiming that antibodies are the ultimate or even primary action of the immune system, but rather an integral part, much like innate, cytotoxic components, and etc of the whole immune system working together.”
That’s precisely the reason why vaccines are CRAP, in and on itself. Well, does that hurt your ego?
“indeed this is what is seen, and with intravenous antibodies derived from donors, they can live relatively healthy lives. ”
Because eating an apple a day to keep doctors away is quite boring nowadays, isn’t it? We need a little excitement like Ig therapy and even bone marrow transplantation and still live a “healthy” life. Well, good luck with that.
“A bored trolling undergrad biology student is all you are.”
Sign of defeat.
Th1/Th2
“Sign of defeat”
You’re funny : ), I think we are gonna be good friends.
Excellent, I will recommend to the next agammaglobulinemia patient that they should eat apples instead of getting that exotic plasma transfusion.
Could you please show me the double blinded clinical trial showing apples prevent the hereditary agammaglobulinemia/ ablated bone marrow systemic infections? I can’t seem to locate it on PubMed….
Cheers my new pal!
http://itodyaso.files.wordpress.com/2008/03/duty_calls.png?w=450
http://www.instructables.com/files/deriv/F4E/CVG5/FD80X33E/F4ECVG5FD80X33E.MEDIUM.jpg
The troll is clearly an incompetent sadist or psychopathic killer. He said he gives vaccines to kids. He knows they are bad for them, giving them deadly diseases, and he does it anyway.
Cute cartoon, Draal!
I like xkcd.
watso359,
‘Could you please show me the double blinded clinical trial showing apples prevent the hereditary agammaglobulinemia/ ablated bone marrow systemic infections? I can’t seem to locate it on PubMed….’
If you can’t find it, try oranges. Gee whiz. SBM is really amazing.
weing,
“The troll is clearly an incompetent sadist or psychopathic killer. He said he gives vaccines to kids. He knows they are bad for them, giving them deadly diseases, and he does it anyway.”
Pathognomonic sign of a loser. There’s nothing else I can do.
Or he’s just full of stool and doesn’t believe his own crap. I mean, nobody could be that stupid, could they?
“Pathognomonic sign of a loser. There’s nothing else I can do.”
You could always quit.
Troll1/Troll2:
I submit that this clueless troll is also a liar. A very bad liar who plagiarizes blogs by using the University of Google.
Ignore the troll.
“BillyJoe on 06 Mar 2010 at 6:05 pm:
MAS kygtq TURB dbzjs ATION
”
I trust everyone can decipher the message now.
The poor guy obviously needs a helping had but….
Th1Th2,
Your B cell biology is god-awful.
“B cells and plasma B cells originate in the bone marrow”
There are two types of B cells. B1 and B2 cells. B1 cells reside mostly in the peritoneal cavity and are not bone marrow derived. B2 cells are derived from B cell-precursors originate in the bone marrow (or fetal liver) and go through several maturation stages in the bone marrow. It is during these initial steps that VDJ/VJ recombination occurs (pro/pre Bcell stages) and the cells are on their way to becoming a B cell. Following these steps you have an immature B cell, one still not yet prepared for antigenic stimulation. That Bcell then leaves the bone marrow and migrates to the periphery (i.e. spleen) and finishes its maturation process.
Plasma cells are not derived from the bone marrow. They are derived from splenic or lymph node residing B cells that are stimulated with antigen. After antigenic stimulation the B cell becomes activated and proliferates rapidly. During this process there are other events that can occur (i.e. germinal center formation, class switching, affinity maturation) but the end result then is differentiation into either a memory B cell or an antibody producing cell (i.e. plasma cell). Plasma cells do not originate in the bone marrow, but rather in the site of activation. Plasma cells will return to the bone marrow, however, following their creation where they will continue to produce antibody.
“Plasma B cells can be activated either by antigen alone or with the help of T cells. ”
Plasma cells are terminally differentiated cells. They do not get activated by antigen at all, as they are the result of B cells (either naive or memory) being previously activated. Plasma cell function is to produce antibody. No further activation is needed.
“All naive B cells (B cells that have not been exposed to antigen) are capable of expressing immunoglobulins in their cell surface.”
That is a correct statement, but the antibodies produced that reside on the cell surface and very different from antibodies that are produced for secretion. The similarity is that they contain the same heavy and light chain sequences that confer antibody specificity, but the FC region of the antibody is quite different. For example, cell surface immunologlobulins are built to associate with signaling molecules in order to provide the requisite cell signaling to induce cell activation. Secreted immunoglobulins have difference FC types dependent on their function (IgM, IgG, IgA, IgE).
“The inoculum (pathogen or pathogen parts) in the vaccine is introduced directly to the bloodstream and enters the cell (antigen-receiving and presenting cells), hence, the term infection.”
No vaccines are delivered directly into the bloodstream. Vaccines are given subcutaneously, intra-muscularly, intranasally, or orally, but not intraveneously.
Troll1/Troll2:
Troll/Troll2:
Sorry I missed s/he/it saying the vaccine goes directly into the bloodstream. It is obvious the troll is a liar. If not, then s/he/it is a med-tech who has damaged those that have had their vaccines given to them wrong!
Th1Th2:
Correct, antigens do not protect. They educate. I realize this concept may be unfamiliar to you.
Archangl508,
1. “B1 cells reside mostly in the peritoneal cavity and are not bone marrow derived.”
This is why SBM is full of crappy so-called experts in medical science but in reality, just a load of Scientific Wild Ass Guess.
Now, I know this is just a ruse of your persistent ego-tripping on this board as I am giving you a chance to revise your ego-derived STUPID statement before you get mortified.
2. “Plasma cells are not derived from the bone marrow. They are derived from splenic or lymph node residing B cells that are stimulated with antigen….Plasma cells do not originate in the bone marrow, but rather in the site of activation.”
So you are saying these plasma cells did not originate from the B2 cells which were derived from B cell-precursors that originated in the bone marrow ? You know B cells do migrate, right?
3. ‘Plasma cells are terminally differentiated cells. They do not get activated by antigen at all, as they are the result of B cells (either naive or memory) being previously activated. Plasma cell function is to produce antibody. No further activation is needed.”
Correct. I was referring to naive B cells being activated directly by antigens or with the help of T-cell based from my previous paragraph. Thanks for bringing that up.
4 “That is a correct statement, but the antibodies produced that reside on the cell surface and very different from antibodies that are produced for secretion… Secreted immunoglobulins have difference FC types dependent on their function (IgM, IgG, IgA, IgE).”
So what?
5. “No vaccines are delivered directly into the bloodstream. Vaccines are given subcutaneously, intra-muscularly, intranasally, or orally, but not intraveneously.”
Yes, not INTRAVENOUSLY per se, otherwise it will be a QUICK KILL, kwim?
That is the reason there are other ‘humane’ routes of administration for a slower process of directing the inoculum to the blood stream. Physiologically, blood vessels consist of the veins, arteries and capillaries and the bloodstream is the blood which flows through the circulatory system of an organism, meaning you. The circulatory system or the cardiovascular system consist of the heart and the blood vessels (arteries, arterioles, capillaries, venules, veins and SINUSES) and the lymphatic system (lymph capillaries, lacteals, LYMPH NODES, lymph vessels and main lymph duets (thoracic and right lymphatic duct).
Therefore, the inoculum in the vaccine, whether injected intramuscularly or subcutaneously, administered intranasally or orally, are picked up by the capillaries which carry the material into the larger vessels of the circulatory system and even to the lymphatic system. So, the vaccine contents are introduced into the blood stream and the lymphatic system. Do you think humoral mediated immunity can occur elsewhere?
Anyone who’s going to disagree with this physiologic process should go back to basic anatomy and physiology class.
Calli Arcale,
“Correct, antigens do not protect. They educate. I realize this concept may be unfamiliar to you.”
I am more familiar of vaccine-induced infections as part of your so-called ‘education’. At least you knew that vaccines, which are antigenic preparation, do not protect at all.
Vaccine apologists will call your statement a heresy. They do not like to hear such blasphemy. Just reminding you.
Th1Th2 has dropped a significant load of misinformation on this thread, much of which has already been addressed. I thought it might be helpful to give a summary of the ignorance to date:
The “naive immune cells” of newborns are exposed to millions of antigens (hideous and non-hideous) with the first breath (and often even before the first breath). I’ll deal with Th1Th2’s eccentric definition of “infection” later, but not even all live virus vaccines infect immune cells.
“Infection” – in the real world – involves replication of bacteria, viruses or eukaryotic parasites within the body of an organism (not necessarily within the cells, although all viruses and some bacteria do replicate within cells). By definition, inactivated (i.e. “dead”) viruses, bacteria, etc. cannot cause “infection” because they cannot replicate.
Th1Th2’s perseveration on this error is pathognomonic of someone who is incapable of accepting correction. Clearly, he/she is not as educated in biology/medicine as he/she thinks.
Th1Th2 is again showing his/her ignorance. Non-specific immunity (innate immunity) is a combination of phsyical barriers, humoral factors (e.g. complement, coagulation factors, lactoferrin/transferrin, interferons, interluekins, lysozyme, etc.), and cellular components (e.g. macrophages, neutrophils, NK/LAK cells, eosinophils). Many components of the innate immune system interact with the adaptive immune system (which includes, but is not limited to, antibodies) in a synergistic fashion.
The innate immune system is also involved in the production of a long-lasting (anamnestic) immune response to vaccination (e.g. macrophages presenting antigens).
It is worth noting that vaccination is no more “intrusive” than getting a splinter or an insect bite. If our immune systems weren’t up the that challenge, we would have perished as a species long ago.
For starters, if Th1Th2 is telling the truth when he/she said “I work in the medical field and have administered vaccines on all ages.”, then we must assume that he/she is grossly incompetent. Vaccines are not injected into the bloodstream.
Notice – again – the eccentric definition of “infection”.
I’m sure I’ve missed some of Th1Th2’s misinformation, but I think those are the highlights.
I don’t do this with any hope of educating Th1Th2 – he/she clearly is suffering from the end stages of the arrogance of ignorance. However, I thought it important to reinforce – along with everyone above who has bravely tried to stem the tide of ignorance that is Th1Th2 – that most of what Th1Th2 has said about vaccines, infection and the immune system is wrong.
Prometheus
Moderator,
I am missing a post. What gives?
(this is a repost, about an hour ago)
Archangl508,
1. “B1 cells reside mostly in the peritoneal cavity and are not bone marrow derived.”
This is why SBM is full of crappy so-called experts in medical science but in reality, just a load of Scientific Wild Ass Guess.
Now, I know this is just a ruse of your persistent ego-tripping on this board as I am giving you a chance to revise your ego-derived STUPID statement before you get mortified.
2. “Plasma cells are not derived from the bone marrow. They are derived from splenic or lymph node residing B cells that are stimulated with antigen….Plasma cells do not originate in the bone marrow, but rather in the site of activation.”
So you are saying these plasma cells did not originate from the B2 cells which were derived from B cell-precursors that originated in the bone marrow ? You know B cells do migrate, right?
3. ‘Plasma cells are terminally differentiated cells. They do not get activated by antigen at all, as they are the result of B cells (either naive or memory) being previously activated. Plasma cell function is to produce antibody. No further activation is needed.”
Correct. I was referring to naive B cells being activated directly by antigens or with the help of T-cell based from my previous paragraph. Thanks for bringing that up.
4 “That is a correct statement, but the antibodies produced that reside on the cell surface and very different from antibodies that are produced for secretion… Secreted immunoglobulins have difference FC types dependent on their function (IgM, IgG, IgA, IgE).”
So what?
5. “No vaccines are delivered directly into the bloodstream. Vaccines are given subcutaneously, intra-muscularly, intranasally, or orally, but not intraveneously.”
Yes, not INTRAVENOUSLY per se, otherwise it will be a QUICK KILL, kwim?
That is the reason there are other ‘humane’ routes of administration for a slower process of directing the inoculum to the blood stream. Physiologically, blood vessels consist of the veins, arteries and capillaries and the bloodstream is the blood which flows through the circulatory system of an organism, meaning you. The circulatory system or the cardiovascular system consist of the heart and the blood vessels (arteries, arterioles, capillaries, venules, veins and SINUSES) and the lymphatic system (lymph capillaries, lacteals, LYMPH NODES, lymph vessels and main lymph duets (thoracic and right lymphatic duct).
Therefore, the inoculum in the vaccine, whether injected intramuscularly or subcutaneously, administered intranasally or orally, are picked up by the capillaries which carry the material into the larger vessels of the circulatory system and even to the lymphatic system. So, the vaccine contents are introduced into the blood stream and the lymphatic system. Do you think humoral mediated immunity can occur elsewhere?
Anyone who’s going to disagree with this physiologic process should go back to basic anatomy and physiology class.
I see that Th1Th2 has been leaving droppings all over this thread. Again. And again. Not the first time, won’t be the last time. Some people just never learn.
Prometheus, Archangl508 and all others who have bravely taken on this troll, kudos to you. You are a better person than I am. The egregious misinformation spread by Th1Th2 needs to be corrected so that anyone stumbling across this page gets to be acquainted with accurate information.
Well put. If you search for Th1Th2’s username for prior threads, you’d notice that his/her posts are conspicuous by the total absence of any substance.
is there a specific logical fallacy that is oriented to labeling any random set of ideas as a religion? T1000 has evoked the crap out of that one.
argumentum ad religio?
Archangl508,
“No vaccines are delivered directly into the bloodstream. Vaccines are given subcutaneously, intra-muscularly, intranasally, or orally, but not intraveneously.”
Prometheus,
“Vaccines are not injected into the bloodstream.”
My answer: Both of you should take remedial class in basic anatomy and physiology.
Yes, not INTRAVENOUSLY per se, otherwise it will be a QUICK KILL, kwim? That is the reason there are other ‘humane’ routes of administration for a slower process of directing the inoculum to the blood stream.
Physiologically, blood vessels consist of the veins, arteries and capillaries and the bloodstream is the blood which flows through the circulatory system of an organism, meaning you. The circulatory system or the cardiovascular system consist of the heart and the blood vessels (arteries, arterioles, capillaries, venules, veins and SINUSES) and the lymphatic system (lymph capillaries, lacteals, LYMPH NODES, lymph vessels and main lymph duets (thoracic and right lymphatic duct).
Therefore, the inoculum in the vaccine, whether injected intramuscularly or subcutaneously, administered intranasally or orally, are picked up by the capillaries which carry the material into the larger vessels of the circulatory system and even to the lymphatic system. So, the vaccine contents are introduced into the blood stream and the lymphatic system. Do you think humoral mediated immunity can occur elsewhere?
Anyone who’s going to disagree with this physiologic process should go back to basic anatomy and physiology class.
Moderator,
So my missing comments are still awaiting moderation for the past 4 hours? Good job SBM.
“argumentum ad religio?”
Contrarian?
http://www.skepdic.com/contrarian.html
Jackass?
8 year-old?
Th1Th2,
The crux of your argument is based on that vaccines cause infections. You’ve incorrectly defined what an infection is. Thus, the rest of your argument is worthless . Address this issue and stop your diarrhea of the mouth. Else your higher education degree isn’t worth the paper it’s written on and you should use it for toilet paper.
Here’s a couple sources that contradict your idea that an infection does not require replication.
1. infection The invasion of any living organism by disease-causing microorganisms (see pathogen), which proceed to establish themselves, multiply, and produce various symptoms in their host.
“infection” A Dictionary of Biology. Elizabeth Martin and Robert Hine. Oxford University Press, 2008. Oxford Reference Online.
2. infection The invasion of a susceptible host by a disease agent (a pathogenic organism) that can develop and proliferate and usually, but not necessarily, causes overt disease.
“infection” A Dictionary of Public Health. Ed. John M. Last, Oxford University Press, 2007. Oxford Reference Online. Oxford University Press.
I wanted to comment on the whole childhood-deaths-being-reduced topic, but watching Troll1/Troll2 play semantics is too entertaining. I think y’all should keep stringing along Troll1/Troll2 because as he she it gets more involved, the responses start to sound more strange.
“I will give you one last chance, Earthling,” etc.
Mods: please don’t hold back on Troll1/Troll2, unless the name-calling crosses the line. The old saying is: give them enough rope…
PS: Troll1/Troll2: the Janeway text seems to come out with a new edition each year. It would not be that difficult for you to quickly jump in and update a widely read immune system text. Many otherwise well-educated, intelligent people are obviously suffering for lack of your wisdom. -MVT
Th1Th2,
I am well aware of anatomy and physiology, however you stated:
““The inoculum (pathogen or pathogen parts) in the vaccine is introduced directly to the bloodstream and enters the cell (antigen-receiving and presenting cells), hence, the term infection.””
Directly into the bloodstream means just that. DIRECTLY…also known as intraveneously. I know you have difficulty with word definitions (as infection seems to have thrown you for a loop), but injecting into another tissue is not the same as injecting directly into the bloodstream. If one takes an oral vaccine and the vaccine is adsorbed through the gastrointestinal tract and eventually enters the bloodstream, it is entering the bloodstream or lymphatic system indirectly, not directly. I would suggest reading up on the definition of directly:
http://www.thefreedictionary.com/directly
The two most relevant definitions are:
“1. In a direct line or manner; straight: The road runs directly north.
2. Without anyone or anything intervening: directly responsible.
3. Without delay or hesitation; with no time intervening”
Nowhere did I suggest that vaccine contents do not, at least to some degree, get into the blood stream. But “directly” implies that all of the contents of the vaccine will end up in the blood stream with no intervening action. That is not true, especially given that many antigens are picked up directly in the tissues by antigen presenting cells like dendritic cells. In fact, immunizing directly in the bloodstream does not always produce a good immune response and the response is dependent on the structure of the antigen:
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1578848/pdf/clinexpimmunol00355-0074.pdf
“I was referring to naive B cells being activated directly by antigens or with the help of T-cell based from my previous paragraph.”
But that is not what you said. What you said was:
““Plasma B cells can be activated either by antigen alone or with the help of T cells. ””
Therefore you are incorrect as plasma cells are not activated by antigen. The B cells are activated and then become plasma cells. The correct statement would be “Plasma cells can be produced by activation of B cells either by antigen alone or with T cell help”. It is a subtle difference and it is quite obvious that you often miss the subtleties of immunology.
You were right about one thing though, I will amend my above statement to be as I intially intended, “B1 cells reside mostly in the peritoneal cavity and are mostly not bone marrow derived.” I left out the word mostly as there is a very small percentage of B1 cells derived from adult bone marrow, although the main method for B1 cell homeostasis is self-renewal and not the production of new cells as is seen with B2 cells. Somehow I doubt you will admit your mistakes anywhere near as readily.
“So what?”
You made the original statement
“All naive B cells (B cells that have not been exposed to antigen) are capable of expressing immunoglobulins in their cell surface”
in response to Watso’s question about plasma cells producing antibodies without antigenic stimulation. I was simply pointing out that the immunoglobulins produced that reside in the cell surface are different in function from those produced for secretion, providing clarification for Watso. In fact, I did state that your statement was correct as you will notice. Don’t blame me if you are unable to take a compliment.
My, my, my! Th1Th2 is just so precious!
After saying:
and being called on his/her misunderstanding of basic vaccination practices (despite claiming to be a medical professional), he/she tries to cover the mistake:
Now, I could say that humoral immunity actually happens in the lymph nodes and spleen, but I’m sure that Th1Th2 would subsequently say that since the spleen has a blood supply and since lymph nodes “filter” lymph which is derived from blood, it’s all happening “in the blood”.
Here’s a tip for Th1Th2 – when you’ve decided that the hole you’re in is deep enough, the best thing to do is stop digging.
The funny thing is that I’m not an immunologist, and yet I know more about the immune system than Th1Th2, who arrogantly proposes to teach us about the immune system.
Thus we come to the first lesson of the day: don’t take instruction from people who don’t know the subject.
Google (and Yahoo) is a wonderful thing, but it is not a substitute for education. One of the paradoxes of education – shown most eloquently in a study by Kruger and Dunning (1998) – is that the less people actually know about a subject, the more they think they know about it. (see also: http://photoninthedarkness.com/?p=140)
I’ve taken undergraduate and graduate level courses in immunology and my research touches on immunology, but I know that there is much that I don’t know about the immune system that the real experts do. Th1Th2, in contrast, knows little about immunology and yet thinks that he/she can lecture us all on the subject.
I can’t think of a better confirmation of Kruger and Dunning than that.
Prometheus
Prometheus,
“I’ve taken undergraduate and graduate level courses in immunology and my research touches on immunology, but I know that there is much that I don’t know about the immune system that the real experts do. ”
That is a very good point. But even the real experts don’t know all of the information and the further down you go into specifics the more specialized people become and have a more limited knowledge of those specific details.
I have been researching in the field of immunology about 10 years now and think I have a very good grasp of the basics and some of the specifics, for example I work on asthma models now, so have a better understanding of asthma pathology and many of the details of the asthmatic response. But there are many other areas, even within the subject of asthma, that I would have to further research to get full understanding of the details, for example, cell signaling pathways (who can keep track of all those kinases).
But the importance factor is the ability to understand that you can be wrong or can make incorrect statements and have the ability to amend such statements. Also, one must demonstrate a full understanding of the basics within any discipline before one attempts to delve into the specifics as science very strongly builds on itself. The subtleties and nuances of the subjects can also not be glossed over as they are often very important.
There you go. I guess some vaccine apologists and experts here really should need to take a remedial class in basic anatomy and physiology. Honestly, they have gone too far in deceiving innocent people, helpless children and naive babies proclaiming that vaccines will confer protection. This the biggest lie that I have heard and so far I am glad that someone in this board readily acknowledges the truth:
“Correct, antigens do not protect.”—–Calli Arcale.
Thumped1Thumped2
(Chronicle of a death fortold)
He started off boldly with this statement:
Post1: “I just couldn’t imagine how many more healthy children will be devastated let alone suffer from this newly invented vaccine.”
Then came the accusation and his introduction of the words “infection” and “naive”:
Post 2: “You and the vaccinators are the ones responsible for deliberately infecting naive immune cells of healthy newborns with hideous antigens. Get your facts straight.”
Warming up, he made a clever play on the word “naive” and asked his first question:
Post3: “Does the word NAIVE sound familiar? Maybe you can explain what vaccine antigens do to a naive cell?”
Then the maestro launched into his educational session:
Post4: “The initial stage of pathogenesis begins with the introduction of antigens to naive immune cells regardless whether the antigen is live or inactivated. THIS IS CALLED INFECTION.”
…and it was all down hill from there.
Calli Arcale: “Correct, antigens do not protect.”
Thumped1Thumped2: “I am glad that someone in this board readily acknowledges the truth”
Now for the complete quote:
Calli Arcale: “Correct, antigens do not protect. THEY EDUCATE.”
So, let’s hope that you, Th1Th2, get a load of those antigens so they may educate you['re immune system so that they help eliminate the real pathogens when they arrive]
Th1Th2 retorts with (unintended?) humor:
Seriously, Th1Th2, the only way to keep the hole you’re in from getting any deeper is to put down the shovel!
Here’s my second life-tip for the day:
If one person disagrees with you, there is a chance that you’re right and they’re wrong. When dozens of people (and immunology texts) disagree with you (and nobody agrees with you), the smart money will bet that you’re wrong.
And here is where I show my Karnak-like ability to peer into the future: I predict that Th1Th2 will be back to post yet another comment saying that he/she is right and everybody else needs to go back to school.
Prometheus
Quoted by Th1Th2:
That is correct. Antigens do not protect – they stimulate the development of antibodies and adaptive cellular immunity that does protect. That’s how vaccines work and why they work.
It’s passing strange how Th1Th2 could get that right and miss all the rest.
Unless, of course, he/she is completely uneducated in the field of immunology.
Ah, the Arrogance of Ignorance!
Prometheus
Pretty sure that’s a misquote. At least in the nature in which she meant it.
Prometheus,
“That is correct. Antigens do not protect – they stimulate the development of antibodies and adaptive cellular immunity that does protect. That’s how vaccines work and why they work.”
And so is antigenic exposure from natural infection, “they stimulate the development of antibodies and adaptive cellular immunity that does protect”. And the circular reasoning continues…blah..blah..blah
Ergo, vaccines, which are antigenic preparation, DO NOT protect. The final nail in the coffin.
I know that Th1Th2 was trying to misquote Ms. Arcale in order to make it look as though she was agreeing with him/her, but I elected to carry it through in the sense that Ms. Arcale meant it.
Prometheus
Oh I know
I was more just calling Th1Th2 out on the fact that they’re utilizing subterfuge and misdirection to backup their argument.
Troll1/Troll2 keeps saying:
And yet s/he/it never provides any evidence to support its statements. S/he/it claims children are injured by vaccines, yet does not provide evidence. Only argument by assertion.
Of course unless it is properly referenced, we can assume that anything the troll says is worthless.
Th1Th2, proving my powers of prognostication:
I think I finally get it! Th1Th2 is making the argument that it’s the immune system that protects us – the antigens just stimulate the immune system, which does the protecting.
Of course, this is just empty sophistry. The antigens in vaccines stimulate the immune system to mount a protective immune response (both humoral and cellular) without actually causing the disease.
Thus, vaccines allow us to have a protective immune response, preventing disease, without the risk of the actual vaccine-preventable diseases.
I suppose it is possible that Th1Th2 is so dense that he/she doesn’t realise that is the whole point of vaccines – to develop a protective immune response to diseases without the mess and bother (and death and long-term disability) of contracting the actual disease.
Now, to preempt an argument I can see forming in Th1Th2’s head, while the immunity produced by vaccines may generally not be as strong or as long-lasting as that obtained by having the diseases, it is “good enough” – as proven by centuries of experience.
And, just to throw another “monkey wrench” into Th1Th2’s “logic”, there are some diseases, such as tetanus, where so little of the toxin produced that no significant immune response is generated even with a life-threatening infection”. Even if someone survives tetanus, they are not immune to tetanus toxin. The vaccine has enough of the inactivated toxin (toxoid) to stimulate the immune system and produce long-lasting immunity.
There are also some diseases – smallpox and yellow fever some to mind – where the mortality, even with modern medical care, is so high that nobody in their right mind would take the risk. There are also some diseases – rabies, for instance – where the mortality rate without vaccination is nearly 100%.
Doubtless, Th1Th2 will come back and make retorts about “circular reasoning” and nails in coffins, but it’s pretty clear to me (and many others) that his/her arguments are as hollow as his/her head.
Prometheus
“Now, to preempt an argument I can see forming in Th1Th2’s head”
You shouldn’t look inside Th1Th2’s head….like a black hole, it could potentially suck the intelligence right out of your own head.
Prometheus,
“Thus, vaccines allow us to have a protective immune response, preventing disease, without the risk of the actual vaccine-preventable diseases.”
Somehow I find it really entertaining to discuss the principle of vaccination without the aid of imaginative thinking to muster the scattered ideas and twisted logic of these so-called experts.
“Stimulate” sounds benign and innocuous but in reality, it means the intentional creation of a deep wound puncture to a previously intact skin, all the way down the uncharted muscle tissues and fats, assaulting its innate physical integrity and intactness with the use of a calibrated vector for the inoculation of both legacy and novel antigens derived from hideous diseases thereby causing the cardinal signs of infection like pain, swelling, redness and inflammation and other symptoms of the disease while the damaged tissues try to recuperate from the injury it had received. Therefore, to claim that vaccines have prevented diseases and protected the people is just effing retardation and delusion.
No wonder such inane question like the one below still exists:
“If so, what is your opinion of the thousands of antigens that our bodies encounter “naturally”? Are those antigens dangerous too, or is it just vaccine antigens?” —from watso359
Keep digging, dude!
Vaccines have greatly raised the standard of human health throughout the world. I feel fortunate to be protected against many diseases that used to afflict people in great numbers such as polio, mumps, measles, rubella, and smallpox. Due to infrastructural problems, it is often difficult to provide adequate and sustained treatment for people suffering from infections in many areas throughout the developed world. Vaccinations not only prevent deaths but also reduce the burden on medical services dispatched to remote areas. Even in the first world, with bacterial resistance growing and the development of new antibiotics lacking, developing new vaccines will help maintain a critical line of defense in preventing many deaths and severe infections in children.
Thanks for enlightening me about recent developments for a new pneumococcal vaccine. Los Alamos has developed a new kind of vaccine that is showing promise for protecting against viruses exhibiting considerable genetic diversity such as HIV and HCV (see http://www.hiv.lanl.gov). A mosaic vaccine is a synthetic cocktail of peptides generated by computer simulation. With enough computing power, one can simulate a very large number of vaccine designs until a desirable coverage of epitopes is realized. It would be great to see this work adapted to design other vaccines, such as S. pneumon.
Troll1Troll2.
““Stimulate” sounds benign and innocuous but in reality, it means the intentional creation of a deep wound puncture to a previously intact skin, all the way down the uncharted muscle tissues and fats, assaulting its innate physical integrity and intactness with the use of a calibrated vector for the inoculation of both legacy and novel antigens derived from hideous diseases thereby causing the cardinal signs of infection like pain, swelling, redness and inflammation and other symptoms of the disease while the damaged tissues try to recuperate from the injury it had received. Therefore, to claim that vaccines have prevented diseases and protected the people is just effing retardation and delusion.”
Okay, I’m back to calling s/he/it a troll.
What else could explain the idiocy contained in the above paragraph?
More importantly, the immunity produced by having the disease requires, well, having the disease. So this comparison is only interesting if we consider the odds of getting the disease a second time, but at that point the vaccinated and non-vaccinated individual are both benefitting from the immunity produced by having the disease.
Odds of getting the disease once: Much less for the vaccinated.
Odds of getting it a second time, given a first episode: Effectively the same – arguably a bit less for the vaccinated, but apparently the vaccine didn’t work well for them anyway.
So such an argument would be not at all to the advantage of getting the disease, even if vaccine-produced immunity were NOT “good enough.”
To quote Th1Th2:
To quote Shakespeare:
I’m done.
Prometheus
I just wanted to remark I really enjoyed this blog post because it had nothing to do with CAM. Most typical blog postings on SBM focus on criticizing CAM therapies. Sometimes this gets a little too old, perhaps because I’m entirely unconvinced of the evidence in support of CAM. I agree exposing, and creating awareness of, quackery is very important work, however it is refreshing to see posts that talk about the current state of non-CAM medical research. I’d be delighted to see more variety on this blog including more non-CAM posts.
Scott,
“More importantly, the immunity produced by having the disease requires, well, having the disease.”
That is the immunological memory you’re talking about. The primary immune response to the first dose of vaccines does not confer protective immunity but to facilitate an infectious process.
“but at that point the vaccinated and non-vaccinated individual are both benefitting from the immunity produced by having the disease.”
Technically, non-vacinnated individuals are the ones who are naive to disease antigens unless they acquire these antigens through natural exposure or inoculation with vaccine antigens.
“So such an argument would be not at all to the advantage of getting the disease, even if vaccine-produced immunity were NOT “good enough.””
Vaccination plays the opposite role of immunity. There are neither protection nor prevention; there are consequences.
Thich1Thick2
“The primary immune response to the first dose of vaccines does not confer protective immunity but to facilitate an infectious process.”
Your sentence structure is rubbish.
You can choose from the following:
1) The primary immune response to the first dose of vaccines is not to confer protective immunity but to facilitate an infectious process.
2) The primary immune response to the first dose of vaccines does not confer protective immunity but facilitates an infectious process.
Whichever you choose you will be grammatically correct, but you willl still be wrong. Bummer.
“Technically, non-vacinnated individuals are the ones who are naive to disease antigens”
Okay I will give that as a typo. Aren’t I generous. But you sure love that word “naive”. Not once have you mispelled it either. I’m willing to bet, though, that your pronunciation is off the planet.
“Vaccination plays the opposite role of immunity. There are neither protection nor prevention; there are consequences.”
You now have three choices:
1) you are naive
2) you are ignorant
3) you are completely stupid
Enjoy yourself.
BillyJoe,
I will never trust an English teacher to discuss vaccination.
All right, Th1Th2, I’ll bite.
You stated:
“I will never trust an English teacher to discuss vaccination.”
Evidently, you don’t trust an Assistant Professor of Pediatric Critical Care to discuss vaccination either.
So, whom do you trust to do so?
One informative link will do, I think.
“I will never trust an English teacher to discuss vaccination.”
I am not an English teacher.
And, let’s face it, you are not an expert in the immune system.
Let’s look critically at what is known about Prevnar starting with the 2 prelicensure trials. Here is the main one http://tinyurl.com/ybnc3xp
Look at the study design first of all. What are they measuring and does it make sense clinically? The primary outcome is IPD caused by the serotypes in the vaccine. Secondary outcomes include all cause IPD, but wouldn’t it more relevant to include all invasive bacterial diseases? Would it be a success if we replaced IPD with other pneumonias, ear infections, bacteremia etc? Notice how after 3 years and 17 cases of IPD the randomization period was stopped by design and then less than a year later there were 56 cases to review.
There are other concerns with the study design. Since pneumococcus is normal flora in children, addressing long term effects of altering the normal flora is critical. Again, are there other bacteria replacing the infections prevented from these few serotypes of pneumococcus? What about the remaining 80 something serotypes of pneumococcus? Are we getting more or less virulent bacteria in the normal flora because of prevnar? What about the antibiotic resistance of these replacement serotypes? The initial 2 studies didn’t look at this but post after mass vaccination, we do have some studies looking into what happened.
http://www.ncbi.nlm.nih.gov/pubmed/17456820
Initially we have this:
(from 403.2 per 100,000 in 1995-2000 to 134.3 per 100,000 per year in 2001-2003, P<.001)
Then after the initial dramatic decrease in IPD, the replacement serotypes fill the partial void:
"However, between 2001-2003 and 2004-2006, there was an 82% increase in invasive disease in Alaska Native children younger than 2 years to 244.6/100,000 (P = .02). Since 2004, the invasive pneumococcal disease rate caused by nonvaccine serotypes has increased 140% compared with the prevaccine period (from 95.1 per 100,000 in 1995-2000 to 228.6 in 2004-2006, P = .001)"
What other bacteria are replacing the vaccine specific serotypes?
JAMA 2004 Aug 11;292(6):716-20
"CONCLUSIONS: Streptococcus pneumoniae carriage, specifically of vaccine-type strains, is negatively associated with S aureus carriage in children. The implications of these findings in the pneumococcal vaccine era require further investigation"
Lancet 2004 Jun 5;363(9424):1871-2
"These findings suggest a natural competition between colonisation with vaccine-type pneumococci and S aureus, which might explain the increase in S aureus-related otitis media after vaccination."
Anyone in clinical practice recall an explosion of MRSA in children since 2000? It's no fun holding down a 3 month old to drain an abscess.
There seems to be an accepted causal relationship between prevnar's eradication of its 7 serotypes and the emergence of serotype 19A as the dominant pathogen of IPD. Serotype 19A which is responsible for multidrug resistant IPD. Meaning children requiring quinolones to clear their ear infections.
The fact is, we don't know what effects Prevnar 13 will have any more than we knew what Prevnar 7 would do. If you want to look at the studies of clinical efficacy on Prevnar 13, we can; but it's rather disturbing seeing how the bulk of the research was done outside of the US and often on those living in extreme poverty. The new vaccine has been tested on populations which aren't intended to get the vaccine after licensure.
The mechanism for pneumococcus evading the antibodies from prevnar 7 , capsid switching, is a well accepted characteristic of the bacteria. Prevnar 13 will simply add another 6 antibodies and we have no reason to believe that this slightly enhanced selective pressure will give us anything other than a more robust version of 19A.
Prevnar has been the most lucrative pharmaceutical for Wyeth some of the years between 2000 and now. What benefit did we receive? Prevnar wasn't able to get an indication for preventing meningitis (bacterial meningitis in infants practically vanished in the years prior to prevnar's release). Maybe prevnar decreases IPD including pneumonia in older children and adults, but again all cause pneumonia and invasive bacterial infections would be a proper comparison AND the mothers who consented to have their infants vaccinated with prevnar weren't consenting to protect older children and adults.
Any benefit on ear infections would have to be looked at in the context of all cause ear infections and longitudinal serotype replacement phenomenon. Also the ear infection outcome has to be looked at in the context of more recent recommendations to allow the majority of clinical otitis presentations to resolve without antibiotic therapy.
http://www.news-medical.net/news/20100224/FDA-approves-Wyeth-Pharmaceuticals-Prevnar-13-pneumococcal-disease-vaccine.aspx
Look at how they compared prevnar 13 to prevnar 7 in the US trials and only looked at immunology not any clinical outcome.
Pretend Prevnar is a pill for a minute, a pill like Zetia. If it were a pill to be given to 2 month olds and the long term impact were uncertain would you recommend it to every 2 month old in the nation and "hey we'll figure out what went right and what went wrong a decade later"…..
Any preventive test or intervention is capable of doing more harm than good. We must be extremely careful mucking with the normal flora of children. The bright minds reading the articles on this site are capable of critical thinking. Now ask yourselves who has more to gain financially by manipulating people, the makers of homeopathic snake oil or Wyeth.
"Prevnar sales surged 24% in 2007 to $2.4 billion, making it the first vaccine to exceed $2 billion in annual sales."