Conway McLean, DPM, Journal columnist

Polio was once a devastating disease, crippling millions, both here and abroad. Less than one percent of those infected with the polio virus developed paralysis, yet those individuals were often permanently affected.

And this paralysis sometimes resulted in death. Once infected with the virus, there was no cure. As is the case with many viral infections, no antibiotic exists that kills off the infection. Yet here we are in 2020 and polio has nearly been eradicated from the world. How was this possible? Through the widespread vaccination of the world’s children.

The first vaccines were developed just prior to the 1800s, but the science has improved tremendously since those early efforts. Like pretty much everything in medicine, our understanding of the mechanisms of viral infections has deepened tremendously.

This has led to many diseases being, for the most part, wiped out. Deadly but all-too-common conditions like whooping cough, tetanus, rubella, in addition to polio, are now things of the past, forgotten by many of those now living. But it would be a mistake to let down our guard, thinking these infectious viral organisms are no longer present on this planet, and no longer a threat.

One of the most critical parts of our immune system are white blood cells whose job it is to recognize invading organisms, and create proteins called antibodies that lock onto the invader, leading to its destruction. A vaccine works by training our immune system to create the specific antibodies needed to fight some disease. Vaccines provide a “test” exposure to our body, specifically, to an antigen.

This refers to some molecule on the surface of a viral particle, which is recognized by the antibodies generated by our immune system. This preparation of the immune system means there is always a defense in place should there be exposure to the actual virus (rather than some small fragment).

Through experience, our immune system can be trained to recognize various invading organism as foreign, resulting in its destruction. This is what happens when we are exposed to a disease. But vaccination works by priming the immune system.

It is critically important to understand vaccines use only a small part of a virus and thus are incapable of transmitting the disease. They work to educate our immunity, without making us sick.

Immunizations can do more than just save your child’s life. It helps prevent the spread of these diseases to your friends and loved ones, and the families on your block. They can prevent years of disability, as well as the financial toll of a prolonged illness. Vaccines have the potential to protect future generations by eradicating a disease. It has already occurred with smallpox. Children no longer have to get smallpox shots since the disease no longer exists.

Given the clear scientific evidence, why do many parents question the need for vaccination, a relatively new phenomenon termed “vaccine hesitancy”. A frequent reason cited is religious in nature. Others see some benefit in having their children contract certain diseases, that exposure to a disease makes them stronger. Some parents believe that the diseases for which we vaccinate are not very prevalent so their children are at little risk. Perhaps the most significant reason parents refuse vaccinations for their children are concerns about safety. Most of their fears are based on information they have discovered in the media or received from acquaintances. The popular media, including social media and large-scale news outlets, seeks to sensationalize any incident possibly related to any vaccinations, all to elicit higher ratings

Vaccination is a safe and effective approach to reducing disease, especially in the young. Vaccines are administered only after rigorous review and testing by numerous scientists and doctors. The flu vaccine is known to occasionally cause some transient ache or fatigue, but does not lead to the flu. Serious side effects following vaccination, such as severe allergic reaction, are very rare. For most children, the risk-to-benefit ratio is clear.

What about the COVID19 vaccine? The FDA gave approval in November for the vaccine developed by Pfizer. The company announced theirs is 90% effective in preventing the illness, although infectious disease experts say such grand claims are overblown. A week after its release, the Moderna company proclaimed their vaccine was 94.5% effective and was expecting to ship 20 million doses to the US by the end of the year. As with all vaccines, these are intended to provide immunity to some viral particle, in this case the corona virus. Vaccinations are expected to begin right away, although questions abound concerning manufacture and distribution.

There appear to be many ways to induce the production of large numbers of virus-fighting antibodies for this corona virus, so many different vaccines are being developed. By the middle of 2021, there may be over half a dozen promising COVID-19 vaccines. A bigger issue is likely to be distribution: who gets the vaccine first, next and last. Dr. Fauci, director of the National Institute of Allergy and Infectious Diseases, believes a person will be able to walk into their local healthcare provider and get vaccinated for the COVID-19 virus.

Until we have the ability to inoculate many, a specific plan is needed to guide allocation of a vaccine. The strategy developed by the government prioritizes those at greatest risk, especially front-line health care staff, those with high-risk medical conditions, and seniors in nursing homes. The second phase will include essential workers such as teachers, and all seniors. The next phase will consist of kids, young adults and remaining essential workers.

Because of advances in medicine and science, our children can be protected against more diseases than ever before. Diseases that once crippled or killed young people world-wide, have been eliminated completely or nearly so, all due to the safety and effectiveness of vaccines. If you don’t believe in vaccinating, then why use a car seat? Both protect an infant from harm. The data is clear; the modern vaccines are reliable and effective. How else have many of these crippling diseases been nearly eliminated?

As to the COVID vaccine, the news is promising, vaccines are coming. How well they work, how many have allergic reactions, many questions remain unanswered. Another concern is how well will a vaccine work on someone who has a compromised immune system, such as those with an organ transplant, or a person taking long term steroid drugs.

Considering the death toll and the number of cases, many experts agree, this may be the time for distribution of a vaccine which hasn’t gone through years of trials. Our need is that great. But the bottom line seems good, vaccines are coming. Let us hope all the parties and people involved can agree on a humanitarian effort to manufacture and deliver such an inoculum. Perhaps we can buy some time with smart practices (masking, distancing, etc) keeping everyone alive for a few more months. I see the following scenario: you walk into the local pharmacy, down the aisle, and next to the cold medicines is the COVID-19 vaccine!

Editor’s note: Dr. Conway McLean is a physician practicing foot and ankle medicine in the Upper Peninsula, with a move of his Marquette office to the downtown area. McLean has lectured internationally on wound care and surgery, being double board certified in surgery, and also in wound care. He has a sub-specialty in foot-ankle orthotics. Dr. McLean welcomes questions or comments at drcmclean@outlook.com.