To Vaccinate Or Not To Vaccinate? That Is The Question
We have gotten to know each other pretty well over these past few weeks, and I am impressed with how smart and eager to learn you all are! I certainly think you guys are ready to handle one of the tougher subjects out there, the immune system. So get comfortable because today’s lesson is on the immune system, how vaccines work, and what the general recommendations for MSers are.
It all begins with the White Blood Cell. White blood cells circulate in your blood stream and they are constantly on patrol looking for foreign cells. All cells have Antigens on their surfaces, and the body recognizes which Antigens are your own, and which are not. They have been taught about “stranger danger” and as soon as they spot a foreign Antigen they immediately react by engulfing it, which is essentially like handcuffing a suspect and pinning him to the ground. They then call for backup, and millions of immunologic cops come running to the fight. They subdue the suspect, chop of his antibody and take it back to your lymph nodes like an angry mob with their enemy’s head on a stake.
At this point the police captains which are the T cells from your thyroid, and the B cells from your bone marrow join the fight. T cells circulate and kill any of your own body’s cells that were infected during the fight . They also act as traffic cops directing the other cells to the right place. B cells take the Antigen that was chopped off and use it to create a weapon known as an Antibody, which is specifically designed to kill that particular Antigen. Then the B cells create drones covered in those Antibodies and send them hunt down and kill any Antigens on sight.
Once your immune system can send out Antibodies faster then the infectious cells can replicate and invade, then your body is able to successfully eliminate the infection. In the future if your body ever encounters the Antigen again your T and B cells remember what Antibody to use and the infection is quickly and swiftly suppressed before it can cause any trouble. Fool me once shame on you, fool me twice shame on me!
Alright smarty pants, now that you’ve got that down lets talk about how vaccines work…
Vaccines trick our immune system, but it’s all for a good cause! They contain weakened or inactive viruses in order to force the body into making Antibodies for the particular Antigen that we want to vaccinate against. These viruses are incapable of dividing or causing an actual infection, but the body doesn’t know the difference because all it cares about is that a foreign Antigen has stormed the gates of the castle.
Live vaccines mount the best immune response, and are easy to manufacture for some infections like the flu, measles, mumps, or rubella. In a person with a healthy immune system the viruses in the vaccine are so weak that they can not divide and infect their host, but in someone with a suppressed immune system giving a live vaccine is too risky. Additionally, those close to or who live with someone with who is immunosuppressed should talk to a doctor before receiving a live vaccine because it may put their loved one at risk. A common example of this would be a child of someone who has MS receiving the live nasal flu vaccine.
Inactive vaccines are further weakened with heat, chemicals, or radiation and can’t mutate back into their active form under any circumstances. These vaccines are safe to give to anyone, immunocompromised or not. Flu shots are inactive (but the nasal mist is live) and therefore safe for those with MS. Studies have shown that being infected with the flu is a significant cause of MS relapses and flu shots are highly encouraged for those with MS (unless you have some other reason why you can not receive it). Flu vaccines are manufactured differently every year, and are made to protect against the strains of the flu that were the most prevalent from the year before. The flu is a very smart virus that constantly mutates and there are hundreds of strains out there, so the vaccine won’t protect you against every strain but it gives you the best chance there is of avoiding it.
You may know that doctors do blood work before putting you on a medication, such as Tecfidera and Gilenya, that will suppress your immune system. They are checking to see if you have Antibodies against certain infections, like the chicken pox, so that they can vaccinate you if necessary before suppressing your immune system. Always check with your doctor about what vaccines they recommend, and before receiving any vaccinations prior to traveling.
Recommendations are always evolving, so I turn to the MS Society to stay up-to-date. You can find their recommendations for vaccines for people with MS here.
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