Doctor Morozov – about vaccines: what vaccines do most Lithuanians need and who is not strictly vaccinated?

– Let’s start with the simplest question: what’s in that vaccine, what does it consist of?

– A vaccine is, in principle, one or another part of a microbe or virus, or the antigen itself, which elicits an immune response. Then there are the preservatives that help keep it intact. It can be said that there is a small canned virus or bacteria. Sometimes there is also an additive that strengthens the immune response. For example, new vaccines, such as meningococcus, cannot be extracted in any other way to gain immunity because the microbe is so well adapted to living in us that it needs to be strengthened a bit more. Everything is in a tiny pen, it is not at all what the antispaxes show us: a half-liter syringe with the needle that pierces the heart.

– How are live vaccines different from dead ones?

– It depends on what part of that antigen is added. It may be a tortured dwarf, but it is still a live virus that causes mild illness. We allow a tortured virus to enter our body that cannot do harm, but we learn to recognize it. Since the police are our cells, the lymphocytes are able to recognize them and the next time we have this disease, we will fight it quickly. If it is a dead vaccine, it is only a part of the bacteria or even the substances that it secretes, toxins, proteins. It’s like a barcode of a pathogen, which we inject and show the images to the police: “go, here it is.” They recognize illness in the same way. In the first case we can contract a very mild form of the disease, in the second case it appears to us and there is no talk of any infection.

– Apparently, what will happen after the vaccine?

– And yes, and no, it does not depend only on it. Side effects after vaccination depend more on the local response, the reaction of the immune system and the condition of the body. If our immune system is very activated and responds well, then when we show a picture or otherwise – after injecting the pathogen, we are happy, we say “oh hello!”. If the substance is fortified because otherwise you cannot get immunity, which is why now everyone is afraid of the temperature of those meningococcal vaccine side effects when swelling occurs, it is precisely because the added substance enhances the immune response. If we talk about a live vaccine, maybe 5 percent. common ailments that we may feel, as I mentioned, can be a very mild form of the disease that we are vaccinated with. Usually we get vaccinated against measles, rubella and mumps, it can cause inflammation of the salivary glands, rash. It is definitely not a disease, it is just a symptom. Vaccination against a yellow butterfly will definitely not erupt like a true yellow butterfly for a week with a temperature of 40 degrees. Yes, we may have a fever 2 to 4 days after vaccination.

– I’ve heard people say they won’t get a flu shot this year, because when they got vaccinated last year, they got sick. Why did this happened?

– There are even several studies conducted when people get vaccinated against the flu or other diseases and unconsciously expect something similar. And generally, in Lithuania, the flu is called a cold. And the flu, the real one, when we go to bed with a temperature of 40 degrees and we feel very bad, but our nose does not run, we mistake it for a cold. Then we say – oh, I’m sick, I won’t get vaccinated anymore. And in fact, that vaccine protected us from even higher temperatures and complications: lung complications, resuscitation, and death.

– What reactions are already abnormal after vaccination when you need to see a doctor?

– When we talk about live vaccines, we usually warn patients that they may experience certain symptoms when it is necessary to go to doctors to evaluate if it is dangerous. Everything is written. The first minor discomforts after vaccination can be low fever, swelling, redness, they can be all over the arm. Feeling of viral infection, headache. As with all other symptoms, if they don’t bother us much, if we can treat them with simple medications, paracetamol, ibuprofen, or just calm down, if the symptoms go away after taking the medication and resting, all is well. But if the symptoms persist for more than 3 days or are very bothersome, it is better to consult a doctor.

– And yet, vaccination is not available to everyone. I will list some groups of certain people and you will say possible or not. Let’s start with pregnant women.

– We vaccinate pregnant women at a time when the risk of getting sick is greater than after vaccination. Not only is it possible, but getting a flu shot is also recommended. All pregnant women are even voluntarily vaccinated against flu without flu. Getting sick can have very sad consequences, both miscarriage and fetal harm. There is a much lower chance of getting something worse than getting vaccinated than getting sick. Vaccination against tick-borne encephalitis is also recommended if a woman is at very high risk of developing it. And the absolute contraindications are live vaccines, precisely because they can cause a very mild form, but to protect the fetus, we really cannot vaccinate with this type of vaccine.

– The other group is lactating women.

– With women who breastfeed, things are much simpler, because even if we vaccinate, a child who ingests breast milk will not receive the direct effect of the vaccine, but will receive antibodies from the mother. Suppose we vaccinate a mother against tick-borne encephalitis and at the same time the child will be protected. Again, it’s possible to refrain from live vaccines for breastfeeding women because of all the anger, but it’s more of a coverage issue. I would not unnecessarily vaccinate nursing mothers with a live vaccine.

– Patients with oncological diseases.

– Vaccination with live vaccines is generally not recommended during active treatment, chemotherapy or bone marrow transplantation, radiotherapy, biological therapy. But since these are patients who are at very high risk of developing all possible complications from the flu or pneumococcus, these vaccines should always be considered. In the absence of active treatment, it is better to consult the attending physician. However, unequivocally, all patients with cancer disease are at increased risk of influenza and pneumococcal disease due to both the disease and the treatment applied. They must be vaccinated.

– People with colds, fevers, colds.

– This is an absolute contraindication for any vaccine because our immune system is already irritated and we do not know exactly how the body will react to the vaccine. While there is fever, treatment with antibiotics, antiviral drugs, vaccination is not recommended until the onset of post-acute symptoms.

– Is it not possible to vaccinate, even if it is a simple runny nose?

– Rhinitis is not a disease, it is often said. If it’s just a runny nose, but we don’t have that systemic inflammatory response, we don’t break our bones, we don’t feel bad, we just go out and come back with a runny nose and everything is fine, we can get vaccinated. The same goes for coughing. And a healthy person is exposed once or twice an hour to clear the airway. Also, when you wake up in the morning and hear your child barking when he runs and feeling fine all day, it is not a cough that should stop the vaccination. But if we see that the child or ourselves do not feel very well, we feel that the runny nose is a viral or cold consequence, the vaccine should not be administered.

– I have listed many groups, but maybe there are other diseases that cannot be vaccinated?

– There are not many contraindications to vaccination. One of these contraindications is immunosuppressive people, possibly the same ones who have received very serious treatment, eg. Eg People living with HIV. Or the same pregnant women. And live vaccines. At a time when we cannot guarantee that this tortured half-live virus will do nothing more in the presence of a weakened immune system. Another large group is pre-vaccine allergies. This is very extrange. The flu or measles vaccine is grown from chicken embryos or cells taken from a chicken egg. It’s not a chicken egg, it’s just a cell, usually the connective tissue where those viruses are grown, because the virus doesn’t grow in a bed like a broccoli anyway. In no way is an allergy to eggs a contraindication to vaccination. But if you have had an allergic reaction to the vaccine, it should be administered in a hospital with care.

– Currently, there is a wide variety of vaccines against various diseases. Perhaps we could break them down into which vaccines every Lithuanian should receive from infancy to old age?

– We currently have many vaccines just for babies. Rotavirus, meningococcal, and pneumococcal vaccine. I would recommend that everyone renew their diphtheria, tetanus and pertussis vaccines every 10 years by going to their family doctor for free. I would definitely recommend it, because we live in an area where there are active infected ticks almost all year round, vaccinated against tick-borne encephalitis. Also, everyone, especially those at risk, should get a flu shot every year. Pneumococcal vaccination from 65 years of age. All young women, whether they have had sex or not, should be vaccinated against the human papillomavirus. Older people who have not been vaccinated against hepatitis B and who frequently change partners or work with infected blood clearly need to be vaccinated against hepatitis B to prevent liver cancer. If you haven’t had chickenpox, get vaccinated against it. Those who are over 60 years old and have many chronic diseases, take a lot of medications, should consult a doctor about vaccination against shingles.