SLCo Employee Wellness Wellcast
The SLCo Employee Wellness Wellcast is a fun, entertaining, and enlightening look at health and wellness. It breaks down complex health topics and interviews experts in the wellness field to help participants live healthier lives.
SLCo Employee Wellness Wellcast
Vaccine Myths Busted: A Nurse's Perspective
Vaccines represent one of our most powerful tools for disease prevention, yet they remain shrouded in misunderstanding and controversy. Nurse Troy Davis, a supervisor with Salt Lake County Health Department's immunizations program, pulls back the curtain on how vaccines actually work and why they matter.
Have you ever wondered about the extensive journey a vaccine takes before reaching your doctor's office? Troy walks us through the comprehensive 10-15 year development process, explaining how vaccines move from initial discovery through animal testing and three phases of human clinical trials before receiving FDA approval. Safety isn't just a consideration—it's the absolute priority at every stage, with multiple surveillance systems continuing to monitor vaccines even after they reach the public.
The science behind different vaccine types comes alive as Troy explains how inactivated viruses, live-attenuated vaccines, mRNA technology, and subunit vaccines each work to teach our immune systems to recognize and fight pathogens. He clarifies why some vaccines require boosters while others provide lifetime immunity, and addresses the critical importance of following recommended vaccination schedules based on years of research showing optimal timing for immune response.
Perhaps most compelling is Troy's explanation of community immunity—how our vaccination decisions affect not just our own health but protect vulnerable individuals who cannot receive certain vaccines due to medical conditions. Through clear examples and thoughtful analysis, he dismantles common misconceptions about "natural" immunity and vaccine safety, reminding us that diseases like measles and polio remain just "a short plane trip away" despite their current rarity in the United States.
Ready to separate vaccine fact from fiction? Listen now to gain clarity on this essential public health tool and understand how vaccines continue to evolve to meet tomorrow's health challenges.
Hello listeners, this is Kirsten Philpott, your health educator from the Salt Lake County Employee Wellness Program, and you're listening to the Salt Lake County Employee Wellness Wellcast, the podcast that breaks down complex health topics and interviews experts in the wellness field to help participants live healthier lives. Today we we have a guest and we are speaking with one of our very own nurses from the health department Troy Davis. Troy, do you mind introducing yourself to our listeners?
Speaker 2:Thank you, kirsten. Hello everyone, my name, as she said, is Troy Davis. I'm a nurse supervisor with the immunizations program, managing several of our public health center clinics throughout the valley. I transplanted to the health department from the jail about 10 years ago where I had became a nurse, having worked with them and seeing the good that they did, and now I'm here on the health department side working to be part of a solution and prevention.
Speaker 1:I'm so grateful you were willing to come on to our podcast today. We live in a world that can be very divided about immunizations, and so today that's what I want to chat with you about. I want to kind of bust some of those myths that are out there regarding vaccines and immunization, and I'm grateful that you're lending your expertise to us. Are you okay if we just jump right into these questions?
Speaker 2:Yes, thank you.
Speaker 1:Okay, so the first one that I have for you is how do vaccines help prevent the spread of infectious diseases in our community?
Speaker 2:Kirsten. Vaccines teach our body how to fight a disease before contracting the disease. Prevention is the key. Covid taught us that. You know. Vaccines help protect us from severe illnesses and hospitalizations and death by teaching the body to recognize and respond to the virus before it has a chance to overwhelm a person's immune response. Recognize and respond to the virus before it has a chance to overwhelm a person's immune response. So it helps prevent the spread of infectious diseases in a community. If I can't get the disease and pass it on to someone else, then it can't spread.
Speaker 1:Perfect. I know that there's a lot of fear about kind of how vaccines are made. Can you help walk us through how vaccines are made and what goes into the development process?
Speaker 2:The process normally takes about 10 to 15 years. First there is the discovery, as in the need for the vaccine is identified we have this disease, it's causing these problems. We need to figure out a way to help everybody fight the disease. And so researchers then develop the vaccine and start testing it and studying it in small animals. And when they've developed it, figured it out, got some basic data, then they go to the FDA, food and Drug Administration, and apply for licensure to begin developing and doing human studies. And those are clinical trials. And those trials go through three full phases. The first phase is of just a small group, you know about 10 to 30 people, and they evaluate the top level safety of it. Safety is the priority throughout the whole process, but the very first part is establishing that it's safe in a small population. Then they move into the second phase where they look at the effectiveness and they use a slightly larger population for that a group of people to test, where they are trying to match both a diversity across the globe as well as bring in people that the vaccine is meant for. If the vaccine is to be used with children, they're going to use more children in their testing than they will adults. I mean they'll still have adults to see how it works there too. But if they're focusing on the elderly or the young, then they'll be sure to have a good representation of that population. When those tests and research comes back good, then they move into phase three, which is where they really expand the clinical trials populations we're talking several thousand people across diversities, across ethnicities and global locations and at that point they are really truly studying the safety and effectiveness of the vaccine.
Speaker 2:There's a lot of testing going on. If we do it at this dose, at this spacing, what kind of response do we get from everybody? Do we need to shorten the spacing? Do we need to do more doses, type of thing? And once they have all of that data, then they take it back to the FDA and submit for biological license application, where they bring all of that data to the table. The FDA evaluates their manufacturing processes and facilities. The FDA determines you know all of the reports and all of the data and all of the research you've done has shown us that this is safe. The prescribing information that you have developed, based on all of your testing, is this dose, this time frames between doses, all of that. And then they approve. If they don't approve it then it goes back to the drawing board. They keep working on it. But once they approve it, then that vaccination moves on to the Advisory Committee on Immunization Practices wing of the CDC and they again review all of the data, all of the research. They review all of the documentation and develop their recommendations.
Speaker 2:And the ACIP Advisory Committee on Immunization Practices is a group of both medical and public health experts. The FDA looks mostly at the safety and effectiveness. They're not quite as far in the medical side. The ACIP is the truly medical side of things. Where they're looking at it. They have meetings that they discuss. Those are available for the public to listen to. Our Immunizations Bureau Manager, liz Vervong, listens to every one of them. She tries to stay on top of the latest and know what's coming and so that we can be ready if any changes or updates come. But once the ACIP meets and they consider the safety and efficacy at specific ages, they also evaluate the disease severity how, without the vaccine, if the disease is serious enough to potentially cause long-term health problems or death, even in children and adults. And then they also look at the disease spread probability, which is will this vaccine benefit the entire population significantly, or would this vaccine be better for college-age students, who are more susceptible, and that is the time when they get this particular disease that the vaccine is meant to treat? So once they have determined all of that and voted on it and reached their conclusions, then the CDC director approves the recommendation of that research and all of that discussion and all of that evaluation. The vaccine is then implemented and may even become part of the official United States adult and childhood immunization schedules. Then we continue monitoring for safety after approval. Again, safety is priority throughout the entire development and approval process and it remains the biggest priority and consideration afterwards.
Speaker 2:There are multiple systems to continually monitor the safety of vaccines, even after they're in production and use. The Vaccine Adverse Event Reporting System is a CDC government reporting system that anyone can go to. It's publicly available and, again, anyone can report suspected vaccine reactions and issues. There's also programs like the Vaccine Safety Data Link, which is a collaboration between the CDC and multiple health organizations, as well as Clinical Immunization Safety Assessment Project, which is a partnership between the CDC and clinical research medical facilities, and they receive all of these reports and they evaluate them. They look for trends. Did this person getting this vaccine? Did a lot of people with this vaccine have this type of reaction, and do we need to look at it? Another thing that the FDA does is they do continually evaluations on the produced vaccine. Manufacturers produce vaccines in batches or lots, and each of those lots is tested for correctness and that it's viable and not a big deviation from the previous lots that are supposed to be the same thing.
Speaker 1:So what I'm hearing is that they go through extensive, extensive research and trials and processes and even once they're technically on the market, even then they're still going through testing to make sure that they're safe.
Speaker 2:Absolutely. A good example of that is that after vaccines have been in the market and in use, sometimes testing and research shows that a little shift in the schedule or the dosage might be indicated. A good example of this is with the human papillomavirus vaccine. They have found through testing and through documented lab results and stuff that children who received the vaccine before they turned 15 years of age their body responds better to the vaccine and has a stronger response to where those children between 9 and 14 get a strong response with only two doses separated by six months. Then the recommendation and testing and lab results have shown that if a person starts at 15 or older they get the best response if they have three doses across that six months One now, one in two months, one in four months after that. This shows that even after the recommendations are made they continue evaluating the data, they continue evaluating the safety and they can make adjustments as the data shows is best.
Speaker 1:And I think that leads perfectly into our next question is that you know if you're a parent or a guardian oftentimes right, there's this recommended schedule that you're given. Why is it important that we vaccinate according to a specific schedule, especially for children?
Speaker 2:The schedules are based off of, again, those years and years of research. The research shows that we give a child a dose of this vaccine, their body maps a response. We wait six months, we give them another dose and their body makes a much stronger response. And on the back end, on the testing process, they've looked at well, if we give a child at four months, what kind of response do they get? If we give the child another dose at six months, what kind of response do we get? And they look at all of those lab results and those values and they find the trends. And that's where they determine if we should do three doses or if we should do two doses and how far between.
Speaker 2:And one thing to note is that in all cases we can always go a little longer than the recommended schedule. If you don't come back in exactly six months, coming back in seven months is fine. It's when we try and go shorter than those responses or than those intervals that the response is diminished. Our body needs that time to make the response build, the antibodies chill out for a second and then when we dose again, then the body's like okay, I know how to deal with this, but apparently we need to do more. If not, then the body hasn't quite recovered from the first one and it's like, oh, this is still going and the response isn't quite as good.
Speaker 1:I also know that there's like different types of vaccines that we have, right, we have I've heard you know mRNA. We have a viral one and an activated one. Can you go into a little bit more depth about what those different types are and how they work in our body?
Speaker 2:I'm going to try and not get too far technical and into the weeds on this, but when scientists create vaccines they consider several things how our immune system responds to the germ or the virus or the bacteria itself, evaluates who needs to be vaccinated against the germ and the best technology or approach to create the vaccine. Based on these factors, scientists decide which type of vaccine they will make and, like you said, there's inactivated live virus, mrna and several others. They all work by different mechanisms. Some of them are live, some of them are not, some of them are only parts of the germ. Inactivated vaccines are where the virus or bacteria has been chemically killed and can't reproduce and make a person sick, but it's still there and teaches the body to recognize and fight the germ. Live attenuated virus vaccines are where scientists have found a way to weaken a virus so it can't reproduce enough to cause sickness, but the body can make a very strong response because it is a still a live virus. Natural viruses reproduce thousands of times during an infection, but vaccine viruses that have been weakened usually produce fewer than 20 times. Because of this, live virus vaccines do have some limitations. They cannot be given to people with weakened immune systems, with long-term health problems or who've had organ transplants. Those individuals should talk with their healthcare providers before receiving the vaccines as well, as they are not recommended for pregnant women, who may pass the live virus onto their baby.
Speaker 2:Then we have messenger RNA vaccines, or mRNA vaccines. They have really gotten a lot of spotlight recently with the COVID pandemic, and mRNA vaccines are like a genetic protein blueprint. The vaccine is delivered into our cells and instructs them how to replicate proteins that are found on the surface of the germ that we're trying to treat. Our cells produce those proteins and our bodies then recognize them as foreign. Even though our cells produced them, they're not supposed to be there. So our bodies mount a response to those foreign substances and learn how to fight the actual disease containing that same protein. At the same time, one thing to note is that researchers have been studying mRNA vaccines for decades, all the way back to 1987. The technology was most notably used to make some of the COVID-19 vaccines. As we all know, they have several benefits, including faster manufacturing times, and do not contain a live virus, so there's no risk of causing the disease. As we saw with the pandemic, the faster manufacturing times were a key factor in being able to get those vaccines out as soon as trials had shown that they were effective and safe populations. So in the scheme of things it seemed like they really came out fast, but they still went through all of the processes and whatnot. It was not just nothing to giving to people in two weeks type of situation. Another fun fact is the first mRNA vaccines were used against the deadly rabies and Ebola viruses and they are currently researching their use against Zika, hiv and CMV cytomegaloviruses, which are just diseases that we don't currently have good treatments for.
Speaker 2:Then we have the subunit or recombinant polysaccharide conjugate vaccines, which use only a portion of a vaccine. Polysaccharide vaccines contain chains of polysaccharides or sugar molecules that are found on a pathogen's cell wall of the bacteria. They do help you make protective responses against the surface of that bacteria, allowing your body to kill the bacteria. They don't typically work well in children under two, so that method of vaccinating is not used in those kits. Conjugate vaccines are when a weak antigen is combined with a strong antigen carrier. The weaker guy gets piggybacked on somebody that the body responds better to and in doing that the body mounts a better response to the little weak. Weak guy that helps our body remember the germ better in the future. We also have protein-based vaccines that teach us to respond against a specific protein.
Speaker 1:On the surface of a virus or bacteria.
Speaker 2:So the proteins on the surface of those viruses and bacteria help the germ cause disease. So inducing an immune response against them helps the body fight against the infection or the effects of a toxin. Subunit vaccines like these can be made one of two ways. They can be made from the original germ, or what they call recombinantly, and recombinant vaccines are laboratory made and they bring together genetic material from multiple sources, creating sequences that teach us how to fight the disease but aren't found otherwise in nature. Because these vaccines only use specific pieces of germs, they do give us a strong immune response that's targeted to those key parts of the germ, but they don't make us sick. With the germ we can't get the disease because they're only delivering parts of it. They can be used on almost everyone who needs them, including people with weakened immune systems and long-term health problems. So that is a consideration that scientists take when determining what kind to use booster shots to keep ongoing protection against the diseases, especially in diseases that mutate rapidly, like the flu and the COVID viruses that we had experienced.
Speaker 1:That leads great into my question of why do some vaccines need boosters? Or why do like the flu shot right we get every year? What makes those vaccines different than like our measles, mumps and rubella vaccines?
Speaker 2:So With vaccines that need boosters and whatnot, a big part of that could be the disease's mutation factor, requiring seasonal adjustments. Fast replicating diseases have more opportunity for mutation, as we saw with COVID. There was the original, and then there was the XB11, and then there was the LMNOP3.2, and it just kept mutating all over the place. And it just kept mutating all over the place, and so the vaccines needed to try and keep up with those mutations to continue to help us fight the disease before coming into contact with it. Another thing that can affect efficacy of a vaccine is a natural waning of antibodies. Antibodies inside us have natural lifetimes as time passes they get old and are removed from the body. And while vaccines also teach our immune systems to produce the long-term B cells and T cells which are reinforcements for antibodies, production of the antibodies does take time, and while the time is being used to create those, the virus or bacteria is replicating in our body. So when we get boosted, we've got more antibodies at the ready and the rate of infection drops by a huge amount.
Speaker 1:Perfect. That was a great explanation. I feel like I've learned so much. I have a couple more questions, especially when it comes to this herd immunity. I've heard it on the media. You know as someone who's in public health we talk a lot about herd immunity. I've heard it on the media. You know as someone who's in public health we talk a lot about herd immunity. But can you explain why herd immunity is so critical to vaccine efforts and what would happen if people just stopped vaccinating their kids or skipped certain vaccines?
Speaker 2:Yeah. So herd immunity or, as some people like to term it, community immunity less of a farm-like connotation in the mind. Community immunity and herd immunity happens when enough people have become immune to an infection that the disease cannot reproduce fast enough to spread from one person to another in that population, and that reduces the likelihood of infection reaching individuals who lack immunity to that disease or can't get it. Once the herd immunity has been reached, disease gradually disappears from a population and may result in eradication or the permanent reduction of infections to zero, if achieved worldwide. I have a good example of this.
Speaker 2:I have a personal friend who is allergic to and cannot receive the pertussis portion of the Tdap vaccine. They had a bad allergic response, very bad situation, and so they rely on me and everyone else around them to be able to not get sick with pertussis and not pass it on to them and therefore all of us become a protective barrier around them because they are susceptible, they're not immune to it, they can't get the vaccine and become immune to it, so we protect them by not getting it and giving it to them. So if people stop vaccinating or skip certain vaccines, there is both a personal risk of contracting the sickness or having worse outcomes from getting the disease, as well as an increased likelihood of passing it to others, including those who can't protect themselves from or fight the disease themselves if they're immunosuppressed and they're immunocompromised, or are taking medications to make them immunocompromised to treat other diseases, like organ transplant or other complications.
Speaker 1:So I know that a lot of people have once again they have some fears around vaccines. So what are some of those common misconceptions about as a nurse and a healthcare professional? How do you address those misconceptions and what are some of those misconceptions you hear the most?
Speaker 2:Addressing misconceptions about vaccines is all about education and referencing credible sources. One myth surrounding vaccines is that because diseases like polio have disappeared from the United States, it's no longer necessary to vaccinate children against them. Education on this is that illnesses such as polio and measles are still widespread in other parts of the world and could easily be brought back to the United States when people travel to those locations and return home infected. Many of our recent measles outbreaks here in the United States have occurred this way. Any disease is just a short plane trip away. Another myth is that more vaccinated than unvaccinated people get sick. With this, we would educate that no vaccine is this way. Any disease is just a short plane trip away. Another myth is that more vaccinated than unvaccinated people get sick. With this, we would educate that no vaccine is absolutely 100% effective. Everybody's body is different and occasionally vaccinated individuals don't respond as well to some vaccines, and that leaves them a little bit susceptible. There's also percentage factors versus simple quantities with this misconception. Any listeners who get lost in figures feel free to let your attention wander for a moment. For all the number buffs out there, I've got a great example. Okay, let's say that a thousand people are exposed to a rare disease, 10 of which are unvaccinated, leaving 990 who are vaccinated. If that vaccine is 98% effective, which is really great, that still unfortunately leaves 20 people of that 990 who are still susceptible and can get the disease, whereas all 10 of the unvaccinated will get the disease. On the surface, 20 people vaccinated and 10 people unvaccinated got the disease. So it looks like a lot more of the vaccine, a lot more people who were vaccinated got the disease, and that's true that with those raw numbers that's what happened. But the percentages is the key. 2% of the vaccinated individuals became ill. Oh, 100% of the unvaccinated got sick. So, simply put, being vaccinated significantly decreases someone's possibility of getting sick. I'd rather have a 2% chance than 100% chance of getting a disease.
Speaker 2:The last myth I'd like to touch on is that natural immunity is better than vaccine-acquired immunity. While it's true that in some cases natural immunity lasts longer than vaccine-induced immunity, the risks of natural infection outweigh the risks of immunization for every recommended vaccine. Here's an example Wild measles infection causes encephalitis, which is inflammation of the brain. Very bad. Brain needs to not be inflamed. Two people out of every 1,000 reported measles cases die. The combination of MMR, measles, mumps and rubella vaccine, however, results in encephalitis or a severe allergic reaction only once in every million vaccinated individuals, while still preventing measles infection and transmission to others.
Speaker 2:Additionally, some vaccines, such as tetanus, actually provide more effective immunity than natural infection, but without the nasty side effects of the disease. Again, the example here is the tetanus. It's a serious disease caused by a toxin producing bacterium that affects the nerves. It causes painful muscle contractions, particularly in the neck and jaw, and it can interfere with your ability to breathe and eventually causes death. There is no cure and treatment just focuses on managing complications. I'd much rather get a vaccine than you know my body learning to fight it by getting it and there is no cure. So again, back to education and reputable sources.
Speaker 1:It's so important for everyone right to understand how vaccines work, why they are safe and being able to make themselves right have an educated decision on how they're going to proceed with those vaccinations. So I appreciate your time here with us today. Is there anything else like one last thing that you want to leave our listeners with? That, if there's one thing they take away from our conversation today that they can go home with, A last comment I'd like to make is that safety and research are the keys to vaccination.
Speaker 2:They have been proven safe, they've been proven effective, they are currently and continually monitored, and if anyone needs or wants more information, reach out to your public health officials, get on the CDC website, phone a friend. So there are some very exciting things coming up in the world of vaccines. Better technologies around manufacturing and delivering and storing vaccines are increasing accessibility, which helps people in third world countries and whatnot have access to these life-saving devices. And it's about prevention and keeping ourselves and our friends and our families as healthy as we can be.
Speaker 1:Thank you so much for your time today, troy. I really appreciate it. I know our listeners do, and so we are going to close our Wellcast for the day, but remember that we are here every single month and we are your Salt Lake County Employee Wellness Wellcast, the podcast that breaks down complex health topics and interviews experts in the wellness field to help participants live healthier lives. I hope everyone has a great day. Thank you.