The Future of Vaccines: Part Two

how they work. And this time we're gonna do what we do on the show and look at the future of the future of vaccines where we can go with this technology. But if you haven't listened to that original episode, the one we did last time, you should probably go back listen to that one first to get the foundation that the science basis, yeah, the foundation for the discussion we're about to have, and then come back and rejoin

us here for a journey into the great unknown. In fact, we're gonna start with some fud, fear, uncertainty, and doubt. It's true. We mentioned right back at the beginning of the last episode that I have a theory that news about developments in vaccine technology kind of gets undersold in the in the media a little bit because the media space for vaccine related stories is mostly taken up by

anti vaccine activism controversy. In fact, if you if you were to do internet searches on things about vaccines, and you know, just you're you're using good search techniques, a lot of your results are going to come up with some very non scientifically minded material that has no real relationship to any proven foundation. Yeah, if I can be if I could be straight with all of you guys

out there in podcast world. I suggested this topic specifically because over over on a show called What the Stuff, which is a video show that we run through how stuff works, we published a video about about misconceptions about the flu. Caroline Irvin hosted it. I wrote the script. It was a really terrific episode, and the comment thread on YouTube is interesting. I gotta I gotta ask, was

there a sizeable anti vax incredibly sizeable? Interesting? And and actually even even the pro vaccination faction was being really quite impolite, which which I don't think was helping the matter. And this is part of why the debate gets so hot. Yes, yeah, exactly, this this was well, for one, we're literally talking about life and death. Yeah, this is not. This is not some minor issue. This is something that you know, we as we mentioned in part one, vaccines have saved countless lives,

not just the people they directly saved, but their descendants. Right. So, yeah, and also heard immunity, and we'll we'll get into this a little bit a little bit later on. But protecting other people who can't catch a disease from you if you don't have that disease, it's a really huge part of why vaccination is rad Well, we should address this topic, I think by starting with the sort of historical facts

about where the current strain of this controversy came from. Now, one of the things I think we should say at the outset is that vaccines are medications, and pretty much every medication that exists can, in some number some subset of cases have side effects. And this is true. This

is true of vaccines as well. But the problem is the side effects that have been claimed most of the time by the anti vaccination movement are not the real side effects, or they've been claimed to happen at a much higher frequency than is actually observed in the medical medical literature. And I think the most commonly cited side effect has been this perceived association between vaccines and autism.

That's the leavy big one, easily the most the most covered of all of the controversies, right in the basket. So uh, as we often do on forward thinking, uh,

the the vaccine autism connection or lack thereof. As I wrote in our notes, Uh yeah, the the general thought was that that because of the publication of a particular paper, and I'll get to that in a second, that that childhood vaccination schedules were somehow not just correlated, but had a cause effect relationship with the rise in the diagnosis

of autism in children. Uh. This all really got started back in n seven when Andrew Wakefield, who was a British surgeon, published a paper in The Lancet allegedly establishing this link between MMR vaccine. Uh that's mumps, measles and rubella I believe, uh, and arise in the number of

children being diagnosed with autism. Now the lens it is a highly respected journal like it's This isn't a blog that someone has put up and given a vaguely scientific or medical sounding name and then treats it as if it were a pure reviewed journal. This is top notch stuff in the field of medicine. Yes, but even a respected journal can make mistakes, absolutely yes, And and in this case, since the publication of this article, the research has been really gone over and through and and it does.

It does not hold up. The scientific method was not being used properly. Some people have gone so far as to accuse Wakefield of knowingly misrepresenting data, not just cherry picking, but misrepresenting. There were procedural errors. There were undisclosed financial conflicts of interests. Essentially, Wakefield was getting money from parties that had a vested interest in alternatives to vaccination. So this was a big deal and eventually took longer than

many of us would have liked. The scandal cost Wakefield his medical license in the UK, and the Lancet retracted the paper and said, uh, this it was a mistake to ever publish it in the first place. We don't stand by the results as anymore and they don't seem to be true. However, when a cat is let out of a bag, the bag is no longer filled with cat, and it's even worse if that cat goes on to

have many, many litters of kittens. Yes, including people who have a visible place in the public consciousness, like people who have a platform upon which to continuously promote this idea of a connection between vaccines and autism. Yeah. This, this has been a factor in the history of this debate because even though the medical establishment considers this link between vaccines and autism completely debunked, uh, it has had some very popular celebrity endorsements. And you guys know him,

you've heard him. I mean, we're not going to name yeah, mostly because I won't be able to complete the rest of this podcast. I will just be drooling at and foaming and yelling. Yeah. But but the but the absolute fact of the matter is I'm and I'm sure you've heard it before, but here it again from us. There have been studies, peer reviewed, well researched, like good science studies that have shown that there is no link between

vaccines and autism exactly. It just does not exist, as far as a scientific method can tell, right, Like, as as certain as we can be about anything, at this point, we can be certain vaccines do not lead to autism. There there are other theories about why the diagnosis for autism has been on the rise, largely due to things like redefining what the autism spectrum is autistic spectrum, I should say. And by redefining it, suddenly, if you have a wider net, what do you know, more people fall

into that definition. If you're paying attention to these to these poor people who otherwise would have slipped through the cracks, that of course you're going to find more of them. Uh So. And furthermore, okay, adding to this, adding to this problem of celebrities, uh, misinforming the public about this issue, you have a few misguided people in the government who have accused the CDC of destroying or covering up evidence that vactsines cause autism. And if you've heard about that,

these accusations have been proven to be completely unfounded. Uh. Data from the studies that these governmental people were talking about was neither destroyed nor covered up. It's there, you can you can go look at it for yourself. Um. And furthermore, every study that has been conducted that potentially indicated a link between vaccines and autism has been shown to have used really shoddy statistics to bend the data

to their to their wishes. You again largely cherry picking information, ignoring anything that does not back up your claim and only picking the stuff that does seem to back up your claim. That's a that's bad science for anything, right, not just with vaccines, but any kind of science where you are you feel motivated to only present the information that supports your hypothesis, that's bad science. It's not the

way science is supposed to work. And that's why we have the pure review process so that others can come in and really scrutinize the work that you've done to make sure that that hasn't happened. Sometimes it even happens unconsciously. I'm not necessarily saying that people do it on purpose

all the time. And sometimes you can look at numbers and think that they're leading in one way, and you know if perhaps your sample size is too small, or or you've you've assumed a variable is in play that is not, or there there are variables that you did not take into account. Sure, sure, absolutely, like lots lots of completely honest mistakes can happen in this kind of situation. Now, at the end of the day, not vaccinating people leads

to disease outbreaks and potentially to fatalities. As an example, UH in California back in there was an outbreak of pertussis also known as whooping cough. Whooping cough had not been seen in any large numbers for sixty years in California, and then there's an outbreak of more than nine thousand cases.

So that also included ten infant deaths. Right, And when we talk about herd immunity, part of that is our responsibility to be vaccinated against diseases, so we don't pass them onto people who are too young to have been vaccinated already, yeah, or who have compromised immune systems vaccines. Yeah. So I'm getting a little head up about this. I apologize for that, but this is one of those those

those topics that are really get very passionate about. So at any rate um vaccines and autism, there is no credible scientific link between the two. This is not the only thing that vaccines have been um allegedly connected to. Another one is type one diabetes. This was popularized by Dr J. Bartholow Klassen, who who had claimed that the rise and diabetes diagnoses in the US were tied to childhood vaccination schedule. So very similar to the autism story

and also very similar to the autism story. Other scientific studies do not seem to bear this out at all. One of the ones I looked at was a study that followed twenty one thousand four children over the course of ten years after they had received the hip conjugate vaccine the hib conjugate vaccine, and found that there was no greater incidents in diabetes than a control group of twenty two thousand, five d fifty seven children who did

not receive the vaccination. In other words, there's no rise in diabetes in the test group compared to the control group. That's a pretty decent sample size. I was about to say, yeah, that that's what you like to call a good sample size. And of course that's not the only study that has been conducted in terms of vaccines and diabetes. That was just the one that I had looked at too choose as an example. But uh, again, there does not seem

to be any credible scientific link between the two. Uh. There's also the fear about vaccines containing toxins, heavy metals, for example, or formaldehyde. Yeah, yeah, because there are now some vaccines like we we've outlawed some of these chemicals to be used in vaccines, even though at the levels that they were in in vaccines, they were well below toxic, right, because because there's certain chemicals that you can you can come into contact with and not have any toxicity. There's

no toxicity involved. You have to have more than that. Yeah, if you eat enough nutmet it can kill you. Guys, don't eat too much nutmeg. Yeah, the don't like, drink, don't like, don't don't like, just chew on nutmeg all days. It's for you. Or like, if you eight five pounds of apple seeds, then you might have enough cyanide to actually do some damage to you, but otherwise the levels are so low that they aren't toxic. That was the very case of the materials that are in vaccines. Um,

this is just a misunderstanding of what toxic means. Yeah, because of course formaldehyde is toxic. Of course, mercury is a bad thing to drink, right, but there are certain levels that you can encounter that aren't going to harm you. In fact, when it comes to things like formaldehyde, our own metabolic processes create formaldehyde right in your body. Yeah, and more so than you would find in any vaccine.

So the thing that drives me nuts in this is when people are will say, like, oh, the same chemicals that are in formaldehyde are in this, uh, this material that's inside of vaccines. Have you look to see what other stuff these chemicals are in. I mean, they're in like lots of things. You don't understand chemistry is what what this is telling me? Yeah, but at any rate,

that's another, you know, another fear that is largely unfounded. Clearly, any substance that we're introducing to our body, Uh, there needs to be a great deal of testing to make certain that it's not toxic. But these are materials that at these levels we know aren't toxic. Um another fear that vaccines caused the very disease they're meant to prevent. In other words, you go in, you get a vaccination, and then two days later you've come down with whatever

it is you got vaccinated against. Clearly the vaccine did it right. If you don't know what you're talking about, this makes sense. Yeah, sure, well, and we talked a little bit about this one in the previous episode. But yeah, there's um. The way the vaccines work is that it takes a while for your body to take the information in the vaccine and to extrapolate it out and build up a resistance to that disease, right, And in that time between when it gets the information and when it's ready,

you could still catch that disease. You could still encounter it and end up becoming sick because your body isn't in the ready state yet, right, right. And we should say that that it's not that this has never in the history of vaccines happened. No, it did happen once. It happened one time, literally one time, really one patient the oral polio vaccine, which is no longer used in the United States. But yeah, that's the one time there

was a recorded case where this actually happened. In all the other cases, the reactions that a person had to vaccines, they were something else. It wasn't that they were caught the disease they got in the vaccine. Sometimes there's a complication because the immune system reacts in a way that is far too uh too strong, and as a result, someone can suffer something like seizures or or brain damage even in some cases. But it's super rare for that to happen. But it's not the disease that did it.

It's the body's own immune system went haywire, uh well, And in the case of the flu, we should say there are there's okay, there's a lot of different strains of the flu going around at any given times. So if you catch the flu after you've received a vaccine, uh,

it could just be a different strain. Because the vaccine for the flu that's sent out every year is made up of is made to target two to four strains that global researchers have guessed is going to be are are going to be the most active in the coming year, And they're making real educated guesses, you guys. So it's

like they're looking at pipe. Yeah it's not like a dice roll, but yeah, they might be looking at a big pie chart, right and saying like this, this particular strain of the virus has this percentage chance of being one of the really prevalent ones this year. Yeah, they're looking yeah, they're they're looking at Yeah, they're looking at patient data from from people around the world, and uh, but but you know, it's it's completely possible to catch

a different strain what was in the vaccine. We've seen outbreaks of flu where it would end up being a strain of flu that everyone was fairly certain was going to be more or less inert and turn out that they were wrong. It does happen. Um, So anyway, that's that's a list of things that people often fear are bad or can go wrong with vaccines. Now, there are some things that can go wrong, you want to address them. Sure, we've mentioned a couple of times already that, like all medications,

vaccines can have side effects. They typically the approved vaccines that are given out are going to have an extremely low incidence of of catastrophic side effects, though maybe you know one in a million type things can go very wrong. The standard side effects you might get are like soreness at the injection site, something maybe a low grade fever depending upon the vaccination that you received, And that's your

body's immune system kick. But yeah, and obviously if you are someone who has a compromised une system, it could be much more serious than that, which is why you know most vaccines you would never administer to someone who has that kind of condition. Sure, you can't have allergies to certain ingredients in vaccines, Yeah, and that can that can be pretty scary. I mean, as someone who has I have a couple of pretty severe allergies not to anything that's in vaccines. As far as I know anyway.

But uh, you know, it's one of those things where the reaction is pretty quick after you're introduced to the thing, and it can be pretty terrifying. But again that's that's your body misidentifying something as being super duper dangerous, so it goes into hyper attack mode. You stay away from the shellfish vaccine. Yeah, for me, it's a lobster and alcohol. Those are the two things I can't have because I

will go into anaphlyctic shock. It's exciting, it's a fun trick to do it parties, but I can only do it once. Um. One other problem that we sometimes encounter with vaccines is access right and then absolutely you know this. This is sometimes in the case of shortages where we literally do not have enough vaccines for the populations that

are most in need of them. Sometimes it has to do with the vaccines are not in the part of the world where we need them to be right, like the the outbreak may be in one part of the world, and all the vaccine production centers could be in a different part of the world. Um. Part of that issue is that it's it's difficult to ship vaccines. A lot of vaccines have to be kept at a very low temperature in order for them to remain viable. And we'll talk about this a little bit later when we're talking

about the future of vaccines. Not all places in the world have temperature controlled storage. So while you could argue, hey, why is this even an issue. We have vaccines for that disease, Well, if we can't get the vaccine to the people who need it, then there's still very much a problem. So in that case, the problem isn't so much with the vaccine itself and what it is, but rather how much of it do we have and do we have it in the right place at the right time.

But there's a serious issue with vaccines, has nothing to do with autism or diabetes or anything along those lines. Now, let's go on and talk about some of the future of vaccines because there's some really exciting stuff. Oh yeah, yeah. And and to to start us out, I just wanted to give a shout out to genome sequencing because being able to take a look at the entire genetic code of a bacterium or virus has let researchers start to make again those very educated guesses about sequences of code

that could work as antigens in the future. Um. It's sometimes called reverse vaccinology, like trying to create a vaccine out of something that that you're you're not sure will work, but this might be the right puzzle piece to plug in there. Um uh. There's also been study into the genes that turn on in microbes when those microbes switch from being passive to being active when they become virulent.

That is, and um we talked a little bit about that one in our episode about antibiotics and back to communication. That one was called forget going viral Bacterial communication is awesome. Who came up with that title? It's Jonathan? Was it me? I can only assume that probably was me. It wasn't me. I was the one who called the operation plowshare. That's the bomb. Oh my goodness. I'm not proud of that. But uh that that episode about bacterial communication came out

in September. If you would like to go check that one out. Um so, so, yeah, genome sequencing good good technology. It's not like a new technique the way that a lot of these others are going to be. But I just wanted to say, hey, thanks Jeans. Yeah. So some other stuff that's being that's under research and development right now and various companies around the world. And vaccines are big business, right We're talking you know, as part of

the pharmaceutical business. It's it is and well, and I did want to say that, like that's part of the reason that some people distrust vaccines because it's big pharma, and you know, and I get it. I get that it it's a scary industry. And and there are some downsides to write, like there's some some diseases that big Pharma might not be that motivated to go out and develop vaccines for because there's not a lot of money

back there. If you're talking about diseases that largely affect the developing world versus the developed world, there might be this it's pretty grim to talk about this, but there might be this you know, investment versus reward discussion. Yeah. Yeah, Well, and and actually that was that was an issue with Big Pharma and the flu vaccine for a number of years. It was definitely like a like a loss item for them,

for for most companies for a very long time. There's a couple of newer vaccines that are they're they're able to incorporate more strains of the flu in a single vaccine, and so those are actually like capable of making money because you can sell them to richer populations as like an upgrade sort of thing. But but for the for the most part, certainly the flu vaccine and some other vaccines as well are are not big money makers. These are not the things that big farm is going out

and looking at to to make all of their Boku bucks. Fortunately, there's still quite a few uh labs out there that are actively looking into improving our processes with vaccines. Yeah, yeah, it is right, right, it's it's it's a complicated price issue, is basically what I wanted to say. That's a good point, it's an excellent point. So one of those one of

those technologies we're talking about a live orcombinant vaccines. This is the practice of using a vaccine of one attenuated virus or bacterial strain to prompt an immune response to a different illness. Well, wait a minute, isn't this kind of what happened when Edward Jenner put smaller cow pox into one person to protect them from a small box very much? So, yeah, that's a great example of an early use of this. So really it's a it's an

idea that's been around since we had the word vaccination. Well, this is a little bit more of a direct application though, because in that case he was using one disease to prevent another, and and in this one, uh, you're you're directly putting some of some of the dangerous disease into

a less dangerous disease. Yeah, it gets a little yeah, exactly, it does get a little more comfortable, right, right, So infection, let's see, let's see if my my example that I wrote when I was getting into nap mode makes sense.

Here's how I wrote it out. I said, so you want to vaccinate somebody for disease A. All right, so you take you take a vaccine that's meant for disease B, totally different disease, but you incorporate some of the protein from disease A into the vaccine for disease B. So now the disease B contains a little bit of protein from disease disease A, and you administer that to an

uninfected person, their immune system kicks in the gear. Their immune system recognizes the protein that belongs to disease A. Even though disease A is not really represented otherwise in this vaccine, and as a result, you develop a resistance or immunity to disease A. This is a great way of UH using a method to protect someone from a disease that otherwise would be far too dangerous to introduce, even in a vaccine form. Now, what would make a

disease too dangerous to introduce? Would it be if if you can't make it safe enough, Like you can't knock it out the way you would these others. HIV is a great example of this. Right, So HIV is is so potentially dangerous that you cannot attenuate it enough for it to fall below the threshold of danger, you would constantly be endangering any uninfected person with its Yeah, you could contract HIV and then that could develop into AIDS.

So this is an example of a way to get around that where you incorporate some of that protein so it's not the actual HIV virus, it's just some of the protein that marks it as such and help your immune system defend against it. Now, HIV in particular, there might be a totally different vector that we discover to to vaccinate against that. We'll talk about that a little bit a little bit later, but this one holds a lot of promise. I'm excited about it. Yeah, it's pretty cool.

Another one that I think is really neat is, uh the DNA vaccine approached. Um, So, these vaccines consist of DNA coding for a specific antigen. You take that DNA coding and you inject the vaccine directly into muscle tissue, which sounds so comfortable. That's that's what you do with most vaccines. Yeah, I just whenever it's worded that way, I can't help. But I can't help but feel that tetan is shot right, Like that's the one that always that I always also seen he prefers them injected into

his eyeballs. I have had things. Why would you say that show I had? I've had my eyes messed with before. Thank you. We haven't done an episode about lasik. I could talk about it. Uh so strange enough, it doesn't bother me at this point. But so the DNA from the antigen integrates itself into the patient's cells, which begin to produce the antigen. And because the antigen is a molecular marker that indicates a foreign microbe, you can go

back and listen to our first episode. If you don't know what that means, this triggers the body's immune response. Now one big advantage, so back up, hold on. So you are you were essentially programming cells within your body to make the antigens that you would need to recognize for the vaccine. Yes, exactly, yeah ye, so so they don't have to pick it up from any from any microbes, right. So,

So these antigens, remember, are just molecular markers. They're not they're not the actual disease carrying microbe, but rather kind of like their name badge. So your cells are printing out these name badges, your immune system recognizes that and then can build that into its antibody response. One, yeah, it can. It can take those antigens and build it into its DNA code, so that that's that's a name badge that knows to look for and kick right out

of its par Right. So, even though it's never never encountered that particular disease, if you ever encountered it in the future, at least in theory, you would be able to produce the correct antibodies to fight it off. So why would this be better than a regular vaccine, Well, a DNA is is relatively easy to manufacture, so it could be very efficient. It could be very relatively inexpensive

compared to other methods of producing vaccines. But there are some drawbacks as well, because you'd say, well, if it's easy to do, then why why isn't that the standard. The big reason is that, um they've yet to be proven to induce an immune response strong enough to create

immunity to prevent future infection of diseases. So, in other words, they can be used to help create antibodies for a particular disease, but so far we have not demonstrated this approach as being effective enough to truly create immunity, so you could still be vulnerable to some of these diseases. Your body would be fighting it off, but it might not win. So that's a big reason why DNA vaccines

haven't been completely adopted as the new approach. But there's a lot of work going into improving it, and it is possible that this will be useful in creating vaccines for diseases against which we have no current preventative measure. But we've got some other stuff we can talk about. Uh, there's the use of adjuvants or adjuvants. Have you heard about these? I read about. Yeah, this is like this is like special sauce that you put in with your vaccine to make it a little give it a little

more oomph. Essentially, these are additives that stimulate the immune system in one way or another. So it's not directly related to the disease necessarily, but it's meant to ramp up your immune system's response to make it more effective. Right Yeah, yeah, because as as we were discussing in the first episode, there's a few different signals that go on among the cells in your immune system that that get everyone rear and to go. It's the big big

coach speech before the before halftime is over. Come on, guys, we know what we're up against. Now, let's not give up another yard. So uh, that's literally everything I know about football is just I just exhausted it in that one analogy. Um So anyway, yeah, this is that's exactly right like that. These are additives that are meant to boost that ability for your immune system to respond very

quickly and uh and build up those those antibodies. Um. There are a lot that are under various clinical trials right now that could end up um increasing the efficacy of a lot of promising vaccines as well as just increasing the efficacy of existing vaccines. So one frontier in vaccines that has seemed like an interesting possibility to me

is the delivery mechanism itself. Because I know it sounds kind of sad to say this, but I do think a fairly serious obstacle to everybody getting their flu shot and stuff like that is the whole shot part is the needle. Yeah, yeah, I mean people don't like getting shots. In fact, I've even wondered sometimes if this contributes to parental fears about vaccines for their infants, because you don't want to see your baby stabbed with the needle. Oh,

absolutely not. And I I accompanied one of my friends when her one year old boy was getting one of his rounds of vaccines and and the baby was fine, like like I mean, I mean, like like literally literally the moment that that the immediate pain of the actual prick was over, the baby was fine. Uh, the mother and I were traumatized because the baby was so upset for that one moment that it was who I'm like,

I'm like cool just thinking about it. So, So when I was a kid, get it, man, When I was a kid and me and my sister went in to get our jabs as the Brits called them. Um, this was before we actually got the the shot they need

to take a quick blood sample. And why when I was a kid, why was the place of choice to remove blood the tip of a finger where most of your nerve endings are, right, But they would, you know, prick the tip of your finger and put a little tube down so that blood would go up the tube and you all know how it works. Still, I'm still I think it's ridiculous that all the places to take blood. Yeah, blood comes out of everywhere. It's not at the place

where every nerve ending ever is. But at any rate, so my sister should take it from right inside your nose or your nipple. Okay, just pass that along your lip or your eyeball. You're just getting the fluid out of an eyeball despite despite the fact that you at the back of your knee. Maybe let's think of all the different places you can take blood. How about the lobe of an ear at any rate? Um, So they they did this too, exactly, So they did this to my sister. So it's not not directly a shot that

shows the whole traumatizing effects of the needle. So my sister, the stoic young lady, she was, she was just all enough to talk, and she stared at the nurse, one solitary tear running down her face, and she said thank you, and the nurse burst into sobbing, a sobbing wreck. And I'm thinking, here's a practitioner who's she's working in a pediatrician's option, hundreds of kids, sensitized to the pain of children, and yet my sister broke her Good on you, sis.

At any rate, Yes, there was a long way of getting dinggentially around the people needles. People don't like needles. My wife is one of those people. See I've gotten to a point where it doesn't phase me anymore. Um, but for my wife it's a big deal. She it takes a lot to work herself up to going to get a shot. Uh So, one of the things that people have been looking into our alternatives to that, and we've seen some of that already, right, Like there's some

vaccines that are orally administered. There's some like the influenza virus. There's there's the nasal spray that's that's a vaccine for some strains of of influenza year over gear. And there are also some developments going on into creating patches that would administer a vaccine. The patches actually have little needles in them, but they're very very very tiny, so you don't really feel it, and the medication releases over time. It goes through the needles into your blood stream and

then you end up producing the antibodies that way. So that that must be the micro needle thing that that I that I read about and didn't have time to follow up on. Micro needles. Oh yeah, yeah, micro needles that thing. Yeah. Now, I you guys have seen the Star Treks, right, the Star Treks, Star Trek Collective, Star Treks. I've seen some tracks around stars, so you know the one with the lightsabers, No, that would be the would be the Wars and the Stars. Now the Star Treks.

So you know, Bones has this thing that he would always put up against someone's neck and you would hear a sound and then they'd be magically okay. You know, they actually developed one of those. Once upon a time there was a device that was meant to administer shots in this kind of way. My dad actually had it done when he was younger, and uh he reports that it hurts like all hades. Yeah, so not less an advantage to getting the old needle. Well, keep working on

that one bounds. It might be for people who who maybe like me or bothered not so much by the pain of the injection but the creepiness of the needle and its thinness and some sometimes I feel like I'd almost rather just get stabbed with a knife than a tiny little like like like a knife is honest. Have you been stabbed with a knife? Oh yeah, I know all about it. Okay. I was just about to say, like, I've never been stabbed with a knife, but I've been

cut by a knife before. I've stabbed myself with a knife. It's a little different when you're doing yourself, So you're you're right, I'm much less creeped out by by like knives, and like i'd like paper, Like I slice myself open with paper all the time. I think I've just had enough really close calls with severe allergic reactions to just not even register anymore. That's true. Yeah, yeah, like you're

a weary desert warrior, just dscape. Okay, hit me all right, but but but bring bringing it back, bring it back. Researchers are also working on other ways to to get more vaccines, like orally nasily or through other mucus membranes in order to yep in your butt or regina. That is, that is what's going on. So um yeah, so oh man, I just said but on a science podcast, you guys, I feel real, I feel real scientific. Um hey, hey, these are all very scientific words, according to the Ninja Turtles.

Um alright, so so why why would we want to use mucus membranes Because lots of infections start at the mucus membranes. Lots of lots of stuff gets into us via our mucus membranes. It's basically the primary way that stuff gets into us, unless you happen to have an open wound. Because your skin, you guys, is so good, so good at preventing microbes from getting into you. It's essentially it's it's it's it's one job and it does. It's so good. And I keep saying weird stuff on purpose.

I want you guys to know that I that I'm very articulate. That well, okay, so um, so if you if you put vaccines into the places where infections start. Giving those cells in that area direct access to that vaccine can actually help Nasal flu vaccines, for example, create not only the systemic response throughout your immune system, but also a local response to the flu. Straight up your nose, straight up your nose. Yeah. So, so your body will be better prepared to fight other strains of the flu

in the future. And it's only the ones that it's perceiving the vaccine for. It's like, it's like the army itself knows what to look for, but the special forces that are in the hottest point of contention are really ready. Yeah, totally, and so so some people are are some some researchers are working on some plant based delivery materials. Some some like transgenic plant cells that could carry these antigens into

your mucous membranes really effectively. Interesting. Wow, all right, Well, anything else about interesting ways of delivering before we move on to oh yeah, yeah yeah. Also falling vaguely into this category are practices being studied in which vaccines can be given to pregnant women so that their babies can receive those antigens while they're developing and and while they have that the mother's immune system to to bolster its own.

It's awesome because part of the spread out nature of child immunization schedules is that their their immune systems are so ADI BiDi and so and so working up to two bigger and better things that that you've got to you've got to give some time to just but if but if we could give that to to the mother while the baby's in the womb, then that could speak the whole process up a great deal and also help in those instances that I mentioned before with herd immunity,

where you're worried about passing on an illness to a child who's not yet old enough to have received their scheduled immunization from a particular disease. Uh. We also are looking at new ways to keep vaccines viable in a wider spectrum of conditions. Earlier, I mentioned how in the shortages section we're talking about that problem about the idea of cold storage, and not everywhere in the world has access to good, reliable cold storage. One of the ways

we're trying to address that, uh. You know, obviously one way would be to make sure that cold storage was something that was easily attainable in more parts of the world. But that's that's a long term Yeah, that's a big energy resource. There's a whole infrastructure that has to exist for that to work, right. So another approach is, well, what if we design vaccines that are more hardy and can remain viable in a greater list of UH or

a greater range of temperatures, for example. And that's a big one like trying to find ways of creating a vaccine that is able to survive at higher temperatures. The smallpox vaccine, the reason why it was so effective, or one of the reasons it was so effective, is that relatively it could remain viable at a greater range of temperatures than a lot of other vaccines can. So we could get that two different parts of the world and

treat people um. But there's a lot of work going into finding new ways of designing vaccines so that they stay viable. And one of them I thought was really interesting. It involves suspending viral particles in a layer of sugar glass that's applied to a very thin membrane, so it's a solid storage mechanism for vaccine material. They found that if they used this particular approach, and they stored the

vaccines in a relatively high temperature environment. We're talking a hundred thirteen degrees fare kneit or I'm assuming Lauren that you jumped in and helped me out with this fourth five degree celsius. Uh. Lauren's always looking out for you. Guys. Me, I'm like, hundred thirteen fahrenheit. Let them figure it out. Uh. Anyway, they stored it in a hundred thirteen degree fahrenheit forty five degrees celsius container for six months and it remained

viable and all that time. Um, they actually did this to two different viruses. They did a different group where they stored it in liquid format, and in one of those two viruses, after just a couple of weeks in the degree fahrehkneight storage unit. Uh, it was completely destroyed. Like there was no real useful material left in that sample. So this is a possible solution, at least to some types of vaccines. UH. That could mean that you could

get this material to the right destination. Of course, then you have the trick of how do you turn this solid stuff back into a usable vaccine? Uh. And there's a lot of development on that front as well, but very interesting work. And then we have something that doesn't really fit into those categories. But Joe, you wanted to talk about and it sounded really fascinating. Yeah, I wanted to take a look at a different way of thinking

about vaccination. This is a little bit more metaphorical, but it follows the same kind of idea of establishing immunity to a disease or debilitating condition, though in this case

it would be a cognitive vaccine. And this is related to something that I talked about on an episode of the other podcast I'm on Stuff to Blow Your Mind, where we did a couple of episodes about the science behind Tetris, the video game Tetris, And one of the things that's interesting about Tetris is it has been used in all kinds of laboratory research with people studying what Tetris does to the brains of people who play it, especially playing it under certain conditions and in conjunction with

certain tasks. And one of the most interesting things that has been found is uh the work of a scientist Emily A. Holmes out of Oxford and in her team on using Tetris as a cognitive vaccine to prevent the consolidation of traumatic memories. So y'all are familiar with PTSD.

You know, sometimes somebody has a traumatic experience. They might it might be a battlefield experience, or they're the victim of a crime, something violent happens to them, Uh whatever, it's some kind of traumatic experience that's very unpleasant and very difficult to get past, and it can cause recurrent flashbacks. So you can be doing other stuff in your life and suddenly you're you're presented with these these cascading unpleasant

memories that can really mess up your life. And traditional and current treatments to it or things like cognitive therapy, exposure therapy, certain different drugs, uh E M d R, which is an interesting thing I talked about on that podcast and we got a bunch of interesting listener mail about. But anyway, what if there was a way to instead of treating PTSD after you got it, to inoculate yourself before the symptoms set in. Uh. And so there there

have been a few studies on this. One was in January of two thousand nine and it was the study was titled complaying the computer game Tetris reduced the build up of flashbacks for trauma a proposal from cognitive science, and they were sort of they were working with a couple of assumptions. One of them is that cognitive science suggests that the brain has selective resources with limited capacity, and the other one was that the neurobiology of memory

suggests a six hour window to disrupt memory consolidation. And they came up with an interesting hypothesis based on these two facts that we know from neuroscience. If you make the brain do a visuospatial task during the period of memory consolidation, you basically deny the brain the resources it needs to consolidate a memory of a physical visual series of events. You can stop bad memories from consolidating with with this great emphasis in your brain. So so they

had this essentially. The way their research went was they showed a bunch of people traumatic videos. Yeah, a lot of fun. I'm already glad I was not part of this. Yeah. So they sat people down and they made them watch these film clips that were real scenes of human surgery, fatal road traffic at accidents, and drowning. Welcome to our snuff film experiment. Yeah, a lot of fun. I joked in the other podcast that they made them watch Faces of Death. But that doesn't see it seems like something

along those lines. Yeah, But so anyway, they'd have them do this, And then they split the participants into different groups. That had a control group who just watched the horrible movie and then and then they had took a break and sat in silence. Then they had the other group

played Tetris for ten minutes and the researchers. They sent the volunteers away with instructions to keep a diary on how many times they experienced flashbacks over the next week, and they checked back to see how many flashbacks the different groups had had, and they found that the ones who played Tetris had fewer flashbacks than the control group who didn't and so uh and interestingly, they found that both groups had the same level of voluntary recall of

the film, so they could both remember just as well what had happened in the movie they watched. It's not like it blocked the actual formation of memory. But the only the group with that did not play Tetris experience the significant number of unintentional flashbacks to to this nasty thing they saw. Uh, and so that's a really interesting effect. Why did that work. And so there are a couple

of things to note. Number one is that there are limitations to the study that the researchers themselves acknowledged, Like, you know, showing somebody a movie is not the same as having a real traumatic experience in their life. But it's the best you could approximate in the lab ethically, right, you could not you could not actually create a true traumatic experience for someone, right. But these but these findings

were replicated and expanded on in subsequent studies. So they did another study where they found the same thing, and then they tested different kinds of games. They said, okay, well let's take Tetris and then also like a trivia quiz game, And it found that Tetris works, but the trivia quiz game didn't. So it's something specifically about Tetris, probably not just tetrisk, but games like it's some kind

of visual spatial candy crash orientation. I was thinking it was just the soundtrack that Do Do Do Do Do Man. I love that soundtrack. Yeah, that's really cool. I mean it's obviously it's a little different from the other concepts of vaccination because you already have to be exposed to the event that would have created the the post traumatic

kind of a response. It is. It's kind of like how you know, you get bitten by a dog and they take you to the hospital and you get a rabies vaccine immediately administered, and if you follow the course of the vaccine, I think they have to give you multiple ones. But it's a little different now that it used to be used to be that it was multiple shots and they were all delivered to the abdomen. It's it's changed since I was a kid. Well in the

In both cases, you're you're talking about exposure. You're potentially exposed to to the flu, to measles, to whatever it is, uh and and what the vaccine is doing is preventing you from getting sick from it, right, So it's not a therapy. It's a preventative measure. That's why they call

it a cognitive vaccine. So instead of you already having PTSD and experiencing flashbacks and then going through therapy to try to stop them from happening, this is supposed to they're obviously developing techniques for preventing flashbacks from every beginning in the first place. It's really really a cool h idea well, I guess we can conclude this by talking about some of the diseases that we don't yet have vaccines for, but people are working on them. The first

is a universal flu vaccine. Wouldn't that be nice? Yeah, we've already kind of covered this a bit. Lauren mentioned that, you know, when we get a flu vaccine, If you get a flu shot, it typically has between two and four strains of flu represented within that flu shot, and if you come into contact with one of those strains, you're all right, But then the next year you have to get a whole new flu shot. Part of that is because the influenzas one of those viruses that mutates readily.

It's constantly mutating, and if it mutates enough, then it no longer resembles its old self, and your body won't recognize it and can't effectively fight it off. So, like I mentioned before, there's some parts of the flu virus that remain consistent from one mutation to the next, and researchers are hoping that that's going to be an in road to creating a multi year vaccine, something that will protect you several years of flu season in a row

before you have to get another shot. I mean eventually you probably will anyway, just because again the mutations will be enough where it will necessitate that. Uh. There's also the hope that perhaps they will be able to develop a universal flu vaccine, something where you find that route that is common to all strains of the flu, and because you have you have targeted that route, if it works against any kind of flu you would come in contact with, not just the ones that they are reasonably

sure will be the most relevant for that year. And that would be fantastic. Another one, obviously, this would be a big deal's ebola. It's a viral infection. So just a few days before we recorded this episode, we're recording this on January two thousand and sixteen. Just a few days ago, there was an uh AN announcement from GAVY, the Vaccine Alliance, which released a statement to support a vaccine developed by Mark and Sharp and Domi Dome Dome the O h M e UH Corporation for the Ebola virus.

Now that vaccine has yet to be approved for use as a preventative for ebola. It's still in clinical trials. However, so far they've been very promising, having an overwhelmingly positive response efficacy according to the papers um, which is fantastic obviously, uh So, the next will be a wider range of clinical tests. They're they're part of the money that's being poured into this development is to allow for a broader array of tests which could potentially save hundreds of thousands

of lives just as a result of the tests. And obviously the hope is that further down the line, the vaccine will be approved for for official use. But there are a lot of other companies that are also looking into ebola vaccines. That's not the only one. That was just one that was recently in the news as we record this. Also HIV we talked about that earlier. It's

another viral infection. Computer models have shown that even a modestly successful HIV vaccine would make a massive impact on a sustainable response to the HIV AIDS epidemic across the world. So there are a lot of companies that are currently researching potential approaches to developing an HIV vaccine. Yeah, and

I meant to say earlier. And an interesting thing about HIV, and one of the reasons why it in particular is so difficult for your body to fight is that HIV carries antigens that are really similar to those of common bacteria,

like like equal I uh. And so when your immune system sends attackers, they're trying to attack the wrong thing and they have identified it as something it is not, and so they show up and nothing happens to the virus because that antibody doesn't fit with that particular anti and and furthermore, the virus can then attack your your

your immune system cells, which is bad times for everybody, right. Uh. There's also a lot of work in developing a vaccine for malaria, which is a parasitic infection that's been a target for a working vaccine for more than a decade, but it's really challenging, and that's largely because the parasite is responsible for malaria have a very complex life cycle, so protecting against each phase of that life cycles really challenging.

Um Also, malaria is really good at avoiding the immune system, so it's hard to create a working vaccine to target malaria, but there is some hope that DNA vaccines in particular could lead to a working preventative for malaria. Then there's also pulmonary tuberculosis. So if you're an infant, you get the BCG vaccine that's an effective in protecting newborns against tuberculosis, but that vaccine does not appear to be effective in UH adults. So as an adult you can't get this

to be a preventative or catching tuberculosis. It does not appear to be effective at all. So there's no booster shot that you can get that can extend that protection later in life. UH. And in addition, tuberculosis is one of those disease that in the Western world is not such a big deal. Yeah. Yeah, and in in largely

developed countries it's not a big deal anymore. You tend to only encounter it like watching movies about Victorian age occasionally, if you're watching a Tombstone and you're watching a doc holiday slowly succumb to consumption. And by succumb to consumption, I mean we're more red Eyeliner. Yes, but um but but now over here huckleberry though. But it's still but it's still a very serious problem in many parts of the world. It is, and and there have been some

outbreaks in Europe. But the issue is that one of the issues that this is going back to what we were saying before, um, there's not as big a return on investment on investing in a vaccine for tuberculosis, So the World Health Organization has been hard at work trying to come up with UH financial incentives to actually encourage tuberculosis vaccine development. There's some other ones that are pretty interesting. There's a lot of work looking into potentially creating a

vaccine that could prevent Alzheimer's disease. So these are really more about therapeutic vaccines rather than a direct preventative of Alzheimer's itself. So the main target would be the sticky protein that can develop UH it's an aloid beta peptides. They form this plaque like substance in the brain that can lead to neuronal cell death. And there's also the HOW protein, which is correlated with dementia. So the idea here is creating therapeutic vaccines that target diseases that produce

these proteins. So it's it's it's like, let's let's find the early steps that we believe leading and if we can stop those from happening, then maybe we can head off any development of Alzheimer's. Yeah, yeah, that's that's sort of in the way that that that vaccines against cancer currently are working. That's a great and that's a great lead into the final one. Yeah, there are a lot of talk, there's a lot of talk about developing vaccines

to prevent cancer. HPV vaccines are are being used right now. From that Cervical cancer is caused by cellular changes that are created by infection by the human papaluma virus or HPT. Yeah, there are two types of the virus that cost of all cervical cancer. So clearly that sort of vaccination could be a really powerful tool in preventing that type of

cancer for lots of people. Yeah. Even even just the development of tests to look for that virus, uh and to look for those kind of cellular changes have saved it. I think that I think the cervical cancer used to be certainly in the top three of causes of death of of American women up until like the nineteen forties, like crazy amounts of death. So it's it's so so coming up with a vaccine for that is really big.

So similar to what we were talking about with Alzheimer's, this is looking at viral infections or bacterial infections that could lead to conditions that further develop into cancer, and if we can vaccinate against those initial conditions, then it's possible that someone who would have developed cancer won't. It's heading that cancer off at that that tipping point, that moment that causes it to all start off in the first place. So there's a lot of research in that

area as well. Not clearly, not all cancers are alike. There are a lot of different types of cancer out there, a lot of different things to take into considerations. Some of them are caused by environmental factors. There are many carcinogens out there. If you've ever gotten kind of sick of news reports being like does this cause cancer? And you're like, well, doesn't just everything cause cancerner So, vaccinations

are even at their peak. Once we like get to a point where we're reasonably sure we have covered as many bases as there are covered, likely there are going to be some things that we just can't address because it's beyond the ability to vaccinate against it. However, it's really encouraging to see the work that's going in and I really hope that we continue to see people advocating for good science, people advocating to make sure you know what you're talking about when you're looking at the risks

versus reward of vaccines. Uh, that it's it's pretty clear from the science that the reward is enormous compared to the risk that we can't ever say there is no risk. Oh yeah, yeah, And and there there's misinformation coming from from both camps. Honestly, you know, it's it's it's important to to take into consideration that like the flu vaccine

is not effective. Honestly, it prevents the flu in about and in about half of people who receive it um and so it's it's it's understandable with that and with other side effects and with general misunderstandings about how vaccines work that people have doubts. Uh, but you know science, guys, and I never think it's a bad thing to ask questions. It's certainly, yeah, it's certainly not good to just assume you know the answer, or or to or to cling

to something that has been disproven or debunked. I mean, uh, lockness monster a side because she's real at any rate, guys. That wraps up this discussion about the future of vaccines. I think we had a really interesting talk here about what they are, what they do, where they're going and why they're so important. Guys, if you have any suggestions for future episodes of forward Thinking, maybe there's something else you've always wanted to know. What's that going to be

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