Transcription:
The Importance of Vaccines

Prakash Chandran (Host): In the time of a pandemic, the word vaccine seems to be on everyone's mind, but outside of the COVID vaccine, did you know that vaccines in general are considered to be one of the most important life saving medical innovations of the 20th century? They prevent the spread of contagious and dangerous and potentially even deadly diseases. We're going to talk about it today with Dr. Scott Bartkoski, a Primary Care Physician at WakeMed Health and Hospitals. This is WakeMed Voices, the podcast from WakeMed, Health and Hospitals. My name is Prakash Chandran. So, first of all, Dr. Bartkoski, it's great to have you here today. Let's just start with the basics here. Can you tell us a little bit about how vaccines work to prevent the spread of disease?

Scott Bartkoski, MD (Guest): Yeah, sure. Thanks so much for having me on, I appreciate this opportunity. You know, as doctors we've done a lot of talking about vaccines and the importance of them and how they are so beneficial for all of our patients. So, the basics idea of a vaccine is that we're trying to give somebody some kind of an agent that basically just resembles some kind of infectious disease basically. And so by giving somebody this agent that resembles that, it kind of tricks the body into thinking, oh my gosh, this is not a normal thing I'm dealing with. Let's mount this immune response. Let's make proteins and antibodies. So, that the next time that we see the real infection, our body's already prepared to fight whatever infection we're facing.

Of course the big hope is that we'll never even have any kind of symptoms or illness because our body is so prepared and ready from the vaccine to fend off that infection. And the thought is the more people that get vaccinated for all these different diseases that exist, you just look at the epidemiology of disease and how common these things are, the more people get vaccinated of course, you're going to really ramp down and kind of decrease how common these infections are. And these are very effective in general, these vaccines, and we've really, one of the great discoveries are medicine, as you mentioned, and so, vaccine is huge important part of medicine and it's a great topic to go over and it's just a great tool for primary care and all of medicine to be honest.

Host: Yeah, absolutely. And so just breaking it down, you're saying that when someone gets a vaccine, that vaccine is really just a way to teach the body that when they come into contact with whatever they're getting vaccinated for, they basically teach it to have that immune response, so, when they come up to the real battle or the real thing, their body is ready for it. Is that correct?

Dr. Bartkoski: Yeah, exactly. You know, it's all about prevention. And so that's why, for example, we really like to go over vaccines during a yearly preventative visit because vaccines, it's a very important tool. You get the vaccine, you're prepping your body for down the road, you face this infection, you're going to overcome it much easier than you would have without the vaccine. Exactly.

Host: Got it. So, can you talk about some of the main diseases that are prevented by vaccines?

Dr. Bartkoski: Yeah, there's a whole handful, obviously. A very common one we hear about every year is influenza, the flu. There's the vaccine that we can get every year to help fight that off. There are different vaccines for different types of bacterial pneumonia. A very common one that people hear about before going to college is a meningitis vaccine.

Shingles is very common. Shingles as the reactivation of chicken pox when you were younger. And so there's a vaccine to help prevent shingles, the very painful, red, blistery rash and now of course there are these new COVID vaccines that have been proven very effective among a slew of other very possibly dangerous infections and diseases.

Host: So, can you talk to us a little bit about when people start getting vaccinated in their lives and how often they should be vaccinated?

Dr. Bartkoski: Yeah, sure. So, it really starts, during a woman's pregnancy. So, typically around 28 to 30 weeks of gestation, when the woman is pregnant, she's gets the TDAP vaccine, which is tetanus, diptheria and pertussis. And then that kind of protects, number one, the mom throughout the rest of the pregnancy, but even, you know, early in the baby's life. But even within the first couple of days, we start with the hepatitis B vaccine and there's a very set kind of regimented schedule that we have found to be very effective. But it starts a couple of days of life and every couple of months afterwards for a while, then every few years. And even going into adulthood, there are set schedules for these different vaccines.

And for example, after the age of 65, there are a couple of different pneumonia vaccines that we should be getting. Age 50, the shingles vaccine comes into play. So different points in time, vaccines. We've done a lot of research, so we know at what point in time would be the most beneficial for the patient, but definitely kind of spans throughout the whole life cycle.

Host: Yeah. And I think that it's important to understand that a lot of these diseases that we're talking about, they exist in the world and the vaccines are administered over the course of your life to protect yourself from them. Is that correct?

Dr. Bartkoski: Absolutely. So, a lot of vaccines, you do have to get, maybe what we call it a booster where you get a vaccine, maybe, you know, this year. And then maybe in a couple of years you have to get another vaccine. But the hope is you get to the vaccine according to the schedule and that will protect you, for many years to come. Exactly.

Host: Got it. Understood. So, let me ask, is there anyone that can't or should not receive vaccination?

Dr. Bartkoski: Yes, definitely. Very good question. Like any medication or vaccine that we have to offer patients, there are certain groups of people that we would suggest not get the vaccine, for example, pregnant women, there are a couple of different live vaccines that they should not get. Other folks that maybe have had an adverse or a bad reaction, let's say to the flu vaccine, for example, probably should not get that exact same type of vaccine in the future. Always best to talk with your specific primary care provider or doctor or pediatrician, whoever you want to ask about that, that can give you some really good advice and support.

Host: Yeah, that makes sense. You know, one of the things that I've heard is that when you get vaccinated, depending on what vaccine you get, there's a chance that you'll experience side effects. Can you speak to these a little bit?

Dr. Bartkoski: So, any medication, any vaccine does have a potential risk, and there's no way to avoid that, but we know through years of research and studying these vaccines in general, they are very, very safe. There are potentially some local reactions like arm pain, swelling, maybe some redness at the injection site, more rarely than even that, would be some of the more serious complications. But if you look at that and compare it to the dramatic benefit that these vaccines provide, we all think it's a very good idea and it's, it's really a pretty easy decision in our minds that vaccines, if you compare the benefit to the risk, the benefit is so great. The risk is really pretty minimal, that we think vaccines are definitely a good idea given the disease and the infections that could happen if you don't vaccinate people.

Host: Yeah. So, speaking of not vaccinating people, I know that there are those out there that may not believe that vaccines are as important as we're trying to emphasize here. So, what would a world without vaccination look like?

Dr. Bartkoski: So, if we kind of just projected what would life look like without vaccines, for example, smallpox. That was essentially declared eradicated, I think around 1980, I want to say. And before that, the mortality rate was about 30%, meaning three out of every 10 people who got smallpox, died. And so that's just one infection, just one disease. And you can imagine if there were no vaccines or somebody chose not to get any kind of vaccines for any of the other currently potential infections to get, the death rate would be very much higher in general. And some people can't get vaccines because they have some of these underlying health issues. So, it's important for the rest of us to get vaccinated, to protect those people. The so-called herd immunity. But I think the life span now is a lot longer than it was previously years and years ago. I think in large part because of vaccines. No doubt.

Host: That totally makes sense to me. It seems like it's helped in eradicating many different diseases. Why do you think that there's pushback to the vaccine sometimes?

Dr. Bartkoski: You know, I think a lot of people might not get information from the most well-respected literature and research. There's always going to be a concern whenever you inject something into somebody, for example the patient doesn't know specifically, maybe what's in the vaccine. Because there's only going to be some kind of concern or hesitancy about that. Ideas that are spread mostly incorrectly. For example, autism is the big talking point that some people don’t want to get vaccinated because they worry their child might get autism.

We know that's not true. If you look at all that data and the literature and the trials, there's really no evidence of that. Whenever you're talking about a scary thing like autism, as far as what could that represent, people, they really get kind of scared about the unknown. And so that's why it's really important to talk with a trusted medical professional who can kind of sit down and kind of just hopefully ease the minds of people. But it's a big issue and obviously we try our best, as clinicians to teach people about what does the evidence really say? And that really says that they're very safe and in general.

Host: Yeah. And one final clarification was around booster shots. So, do people need boosters or to get vaccines yearly because the strain of virus mutates? Can you maybe speak to why people need boosters?

Dr. Bartkoski: Yeah. So, I think you kind of hit it right on the head, you know as far as mutation. So, viruses, they replicate quite a bit, obviously, it's how they cause infection and then disease. But whenever they do replicate, they typically are very common. They will have the errors in kind of how they spread basically. And so in their genetics, they make these errors and that's kind of how we get these mutations. And so we have to stay ahead of those mutations by basically making a new vaccine every year for the flu to account for that. Otherwise, they wouldn't work nearly as well as they do. If you only got it once every five years compared to every year, it's going to be much more effective if you get the booster for the flu, for example.

Host: Understood. So, just before we close here today, is there anything else you'd like to share with our audience regarding the importance of vaccines?

Dr. Bartkoski: Yeah, I think I would always stress, if you have any question or any kind of doubt about a vaccine, feel free to talk with a medical professional, especially in the your primary care team. We'd much rather spend time with somebody answer questions, if that means you're going to be more open to the idea or kind of help resolve any kind of questions or concerns.

As we talked about kind of earlier, these vaccines are very effective. Again, they're typically considered very, very safe compared to the risk of getting these infections if we didn't have vaccine. So, I always encourage people to follow the guidelines as far as what we think works to best listen to your medical team, do your research and make sure you just look in the right place for sure.

Host: All right, Dr. Bartkoski. Well, that is great advice and a perfect place to end. Thank you so much for your time today. That's Dr. Scott Bartkoski, a Primary Care Physician at WakeMed Health and Hospitals located in Raleigh, North Carolina. For more information, head to wakemed.org. And if you found this podcast helpful, please share it on your social channels and be sure to check out the entire podcast library for topics of interest to you.

I'm Prakash Chandran with WakeMed Voices brought to you by WakeMed Health and Hospitals in Raleigh, North Carolina. Thanks for listening. And we'll talk next time.