Immunology and biology professor @Gordonbioprof tells us a little bit about the first vaccine, and how they “work” today. This article is meant to serve as an overview, as an introduction for future discussion.
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Thanks. I especially appreciate the explanation of herd immunity, and how vaccines don’t primarily protect those vaccinated alone, but the weaker among us.
One primary reason for refusal of vaccines has been 'But I never get sick–and if I do, I’m over it quickly." That’s not the point–as this puts very clearly. I think that when people understand it’s altruistic, they will be more willing to help others by taking the shot.
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From one teacher to another, thanks for chunking this article to make it easier to understand. Loved this article and I learned more about vaccines.
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I’m very glad you enjoyed the article @LoriS It was fun to write and I always love talking about vaccines!
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Ok, I am sure you don’t mean to talk down to your
readers, but could you and others stop using the word "scary " to discribe any concerns that people have over the vaccines. That is a word used with grade schoolers. People can sense when you are looking down on them. Thank you.
Thanks for your feedback.
We want to make sure the reading level is accessible for people of all ages, but try avoid using words like that most generally, as we are not in the business of fear-mongering communication. It was used one time in the first sentence of this extensive piece. Hopefully people might be encouraged that even though it is long, they won’t be overwhelmed.
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I think the word as used here as a a descriptive is certainly accurate, as there is a lot of things on the internet written purposefully to incite fear. In contrast, there are legitimate concerns that can be argued on their merits without appealing to emotions. It is easy to get offended when ones position is criticized, but we must try to rise above that to look at the reality of the situation.
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Thanks for this article. Continued education - especially at the “lay level” for people like me is always appreciated. And regarding the need for an educated public, I’d like to share this to get people’s reactions and further illumination.
Twice now (maybe more), I’ve personally encountered people who were convinced that a cure for their cancer was being witheld by nefarious large interests who (in the view of my two acquiantances) were deliberately witholding cures that they knew about, but were just wanting to keep secret while they make all their money on ongoing treatments instead. Probably I’ve encountered a whole lot of people that think like this, but these two were memorable for their emphatic insistence and even efforts to do something about this. One was a man, who has since passed away from that cancer, but who while he was alive tried to commission me to “attack the establishment” and publish his personal research in order to expose what the medical establishment was doing (or not doing). And he had been a Nasa employee who had worked on shuttles and such during the prime of his life, so he was highly educated in his own way and quite at home with the idea that he was personally well-equipped to “see through” such things. And the second was a man I don’t know as well, but who in a long and rambling revelation of personal problems during prayer and sharing at church, just casually mentioned along the way that he had been made aware of the cure for all sorts of different types of cancer, and he was happy that he had been able to publish this treasure of information on the internet, since again - big companies are allegedly working to keep these things secret.
It seems to me that if I’ve personally encountered this “claims of cancer cures” twice, then this must be the experience of legions across the world - and I mentioned this to a veterinarian friend of mine who has been involved with research and data analysis for big companies on the national and international scene. Her response was something like as follows - and here is where I think others here could chime in with clarification, affirmation, or further insight.
It isn’t that large companies have effective cures, so much as that it takes a lot of investment effort - research grant funding and such to pursue certain lines of inquiry in the first place. So yes - it is very dollar-driven, but in the sense of deciding what will be pursued. Cures aren’t generally something that are just accidentally stumbled on. And private-sector funding dollars for research will always be directed toward programs and pursuits that are aligned with corporate interests, and thus very market driven. It will probably only be public sector (government-sponsored research) that might have the most chance of being aligned with some general “for-the-good-of-society” agenda. So there is that from government, at least - bumbling and inefficient as it is. But corporate interests will predictably pursue agendas according to their own bottom line. And this inevitably means that some things just will not be targets for sustained, private-sector research-funding effort.
[Those were her remarks about cures for things in general … I’m sure that cancers specifically have not suffered from a lack of immense research effort toward cure - at least that’s my impression, though I don’t have much to base that on either - and hence my curiosity for more insight here from those closer to this industry than I am.]
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NORD (the National Organization for Rare Diseases) is a good place to look to put her words in perspective. I found it, when I was looking during long nights at the hospital for information (and survival rates, etc) about the huge pilocytic astrocytoma that my kid had just had removed from her cerebellum. No one wants to have a life-threatening condition that’s on that list, because the research of causes and development of treatments for rare diseases serves so few people that it’s hard to justify prioritizing the limited funds available that would serve larger groups of people and save more lives. As well as pay back the organizations and companies involved in the R&D.
When you look at the category of Cancer, the way the lay-person conceives it as one disease is misleading. It’s a category for many different diseases, rather than one single thing, and that means that researchers are researching many different diseases, not just one single thing. My brother-in-law was recently expressing skepticism about the competence of medical research: “And to think they haven’t found a cure for cancer yet.” I tartly retorted, “Which one?”
This is where we see (and squirm) the morality involved in economic decisions. It’s not (merely) greed and profit, but actually being able to stay in business to continue to do R&D that will continue to save lives.
This is a case where the “tyrrany of the majority” is not a matter of oppression but the bare facts of what can actually be accomplished and how priorities must be set.
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I have noticed that the American Museum of Natural History in Manhattan, renowned for its scientific research, uses very simple English for its displays. Suitable for children, as well as for the scores of visitors who don’t speak English as their primary language. An important mission of the museum is to educate.
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It does take a LOT of money to bring a new drug to market. A quick google search suggests an average of $350 million dollars, with some sources suggesting even higher costs. Drug companies are not going to pay for developing a drug that they can’t make money off of. This is why we see these companies developing eczema drugs instead of anti-malarial drugs. They are not incentivized to develop drugs that affect poor people.
Biosimilars is an interesting attempt to at least reduce the cost for patients:
https://www.fda.gov/drugs/therapeutic-biologics-applications-bla/biosimilars
However, publicly funded research is one possible path for developing treatments in a more ethical manner. Sadly, it isn’t very efficient for a lot of reasons.
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And they are unlikely to develop new drugs that are for episodic use like antibiotics but more likely to put their research dollars into chronic meds. You might take an antibiotic for 10 days one time, but you take your blood pressure or diabetic meds the rest of your life.
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I have worked on pharmaceutical grants using different animal models, so antibiotic development does exist. It isn’t uncommon for drug companies out outsource some of their R&D. What antibiotic develpment looks like relative to the development of other classes of drugs, I’m not sure.
I’m also not sure what the calculus looks like for antibiotics. Antibiotic stewardship is a big thing now, so the newest antibiotics are rarely used in order to prevent widespread resistance. This also means these antibiotics are super expensive, something like 2-3K per treatment (e.g. linezolid).
What I think matters the most is the bottom line: how many pills can we sell * how much does each pill sell for = profit. If blood pressure meds cost 2k per 10 days I don’t think they would sell, but that math works if it is the last defense for an otherwise untreatable bacterial infection.
On the lower end of the ethical ladder (IMHO) are small reformulations and new usages. This has happened with insulin where they slightly alter the molecule so they can sell the drug under exclusivity and patent protection at a higher price than the “old” insulin.
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