|MadSci Network: Medicine|
Dear Mark: Thank you for your question! It raises an interesting point about the risks versus the benefits of immunization. When the government recommends immunization, it must weigh the possible risks of the immunization, such as causing the disease that is being immunized against or another unexpected complication, against the benefits of the vaccine, namely preventing widespread disease. The two vaccines you were given in 1976 are very different from one another. The first one, the swine flu vaccine, was only administered during 1976 (1,2). It was meant to prevent a pandemic of influenza after an outbreak of swine flu at Fort Dix, NJ. During a flu outbreak, many individuals become sick and may even die due to complications of the viral infection. People housed in crowded conditions and under stress, which would certainly include military trainees undergoing basic training, are especially at risk for becoming ill. The swine flu vaccine was discontinued in 1976, the same year it was started, due to associations with Guillain-Barre Syndrome (1,2). Guillain-Barre syndrome occurs about 1-3 weeks post viral infection or immunization. It is idiopathic, meaning we don't understand why it happens, and is characterized by symmetric pain and weakness of the extremities, which may in extreme cases lead to paralysis. This paralysis can extend up to involve the thoracic muscles, arms and face. The pain and paralysis follows a variable course, but usually resolves completely within a few weeks or months (3). The other vaccine you were given, against adenovirus types 4 and 7, is still in use today, although vaccine stocks are currently critically depleted. Adenovirus, which is a different virus from influenza viruses and thus needs its own vaccine, again is a threat to people housed in crowded conditions under stress. This virus is associated with ARDS, or adult/acute respiratory distress syndrome, which can be fatal. ARDS results in increased permeability of the capillaries in the lungs, leading to fluid accumulation in the lungs. Fluid in the lungs prevents effective oxygenation of the blood. There is also a huge influx of immune system cells, which are trying to kill off the virus, but end up contributing to the fluid in the lungs and poor oxygenation of the blood. The main treatment for ARDS is to help with blood oxygenation and help the body clear the inciting agent, in this case the virus. ARDS is a very serious condition, and death rates as high as 50% have been reported (4,5). The adenovirus 4+7 vaccine prevents this serious complication. There are no known complications to the adenovirus vaccine. The only drawback I can think of is that adenovirus is currently the vector of choice for people working on gene therapy treatments. For gene therapy, you need a method to get the gene inside the cells you care about. Viruses have been perfecting methods to get inside cells for millenia, so researchers borrow the virus' expertise by having it shuttle a desired gene into the cells, rather than the virus' own disease-causing genes. Having been vaccinated against the adenovirus vector, you would probably make a poor candidate for this method of gene therapy, should the need arise. Gene therapy, however, is likely still many years from being brought to the clinic, so your adenovirus vaccine was probably not a detriment. I hope I have answered your question, and if you have any more, please don't hesitate to contact us! Ingrid Dodge firstname.lastname@example.org References: 1. Dowdle, WR. "Pandemic influenza: confronting a re-emergent threat." Journal of Infectious Diseases, vol. 176, supplement 1: S69-72, 1997 Aug. 2. Hilleman, MR. "Cooperation Between Government and Industry in Combating a Perceived Emerging Pandemic: The 1976 Swine Influenza Vaccination Program." Journal of the American Medical Association, vol 275 (3):241-243, 17 Jan 1996. 3. Fauci et al, Ed. Harrison's Principles of Internal Medicine, 14th Edition. New York: McGraw-Hill, 1998. 4. Weinberger, SE. Principles of Pulmonary Medicine, 2nd Edition. Philadelphia: W.B. Saunders Co., 1992. 5. Barraza, EM; Ludwig, SL; Gaydos, JC; Brundage, JF. "Reemergence of Adenovirus Type 4 Acute Respiratory Disease in Military Trainees: Report of an Outbreak During a Lapse in Vaccination." Journal of Infectious Diseases, 179 (6): 1531-1533, 1999 Jun.
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