Test your antibodies: how immunity is developed after vaccination

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— Vaccinations: I want to know everything — How does vaccination help build immunity?
Every second a person encounters hundreds of bacteria and viruses that can lead to one or another disease. In addition, atypical cells constantly appear in the body, the further proliferation of which becomes the cause of malignant formations. Immunity is a defense mechanism. It protects against bacteria, viruses, and recognizes foreign tumor cells.

The immune system is represented by organs such as: lymph nodes, spleen, thymus and special blood cells. It performs the following tasks:

1. recognizes bacteria or viruses that have entered the body;
2. begins the synthesis of antibody proteins;
3. remembers the pathogen in order to “fight it back” in the future.

Blood elements play an important role in protection: phagocytes, T- and B-lymphocytes. Each group of cells does its own job.

Phagocytes are the first cells to appear at the site of infection. They capture, absorb and digest foreign agents. They cope only with fairly “weak” aggressors, whose visit takes place for a person without any symptoms.

Digesting “foreigners,” phagocytes release substances called cytokines, which attract more serious artillery to the focus—lymphocyte cells. There are 2 main groups of lymphocytes.

B lymphocytes synthesize 5 groups of immunoglobulin proteins. For protection against a specific infection, types M and G are important. Immunoglobulins are stored in the body and protect a person from repeated cases of the disease for a long time. Vaccination uses immune memory: a person is injected with antigens or weakened pathogens. If there is a second attack, the defense mechanism is activated immediately.

T-lymphocytes perform different tasks: one group helps B-lymphocytes synthesize antibodies, the second destroys diseased or atypical cells of the body itself, and the third strengthens or weakens the immune response.

What is active and passive immunity

A person can obtain antibodies in various ways. Antibodies enter the body passively through the placenta during pregnancy, with mother's milk after birth, or during emergency immunization with ready-made immunoglobulins. Such immunity is unstable and needs to be “renewed” quickly: antibodies protect only while they circulate in the bloodstream. They do not reproduce on their own.

Active immunity occurs after an infectious disease or vaccination, since entry into the body of the pathogen itself or its fragments triggers the formation of new colonies of B-lymphocytes. These cells quickly synthesize antibodies and protect the body. So a person either does not get sick or suffers the infection easily.

The duration of active protection depends on the type of pathogen, so a person can suffer some diseases only once, while others occur repeatedly. The same statement is true for vaccinations: some vaccines are administered 1-2 times throughout life (for example, measles, rubella vaccination), while others require revaccination after a certain period of time (for example, diphtheria, tetanus - every 10 years).

Vaccines and vaccine-preventable diseases

There are a huge number of viruses and bacteria dangerous to humans in the world. Thanks to vaccination, some diseases (for example, smallpox) were defeated. Other infections are under control - pathogens circulate in the environment, but outbreaks and epidemics rarely occur.

Unfortunately, infections cannot be prevented with proper nutrition, hardening, etc. Vaccination is the only way to protect children and adults from the disease.

The following are common vaccine-preventable diseases:

• Tuberculosis. It affects the lungs and bronchi, less commonly the joints and the genitourinary system. Dangerous due to the development of generalized forms, meningitis. Mycobacterium tuberculosis is extremely resistant to most drugs.
• Whooping cough is a disease that affects the respiratory tract. The toxins of the pathogen irritate the cough center, provoking attacks of painful coughing with respiratory arrest and vomiting. May be complicated by brain damage or episyndrome.
• Diphtheria is a disease in which toxins from the pathogen circulate in the blood, having a detrimental effect on the cardiovascular and nervous system. More often, patients develop croup - a dense film on the tonsils that blocks the lumen of the respiratory tract. Complications include shock, paralysis of the soft palate, damage to the heart and kidneys.
• Poliomyelitis is an acute intestinal infection that affects the central nervous system. Breathing is impaired, paresis and paralysis develop. The changes are permanent; more than 80% of those who have recovered from the disease remain disabled. It is almost impossible to cure this disease.
• Measles is an extremely contagious viral disease. It affects the respiratory tract with the development of bronchitis, false croup, and pneumonia. The central nervous system often suffers - meningitis, encephalitis. Deafness may develop. There is no specific treatment for measles, and the mortality rate among unvaccinated children is high.
• Rubella is a viral infection characterized by skin rash, swollen lymph nodes, and fever. It is most dangerous for expectant mothers - infection leads to severe developmental defects (heart defects, deafness).
• Tetanus is an infectious disease in which bacterial toxins have a toxic effect on the nervous system. Death occurs from respiratory paralysis, sepsis, myocardial infarction. Mortality is high. The entry gate is damaged skin (wounds, abrasions, etc.) - this means that anyone can accidentally become infected.
• Mumps (“mumps”) is an inflammation of the parotid salivary glands. Children get sick more often; can be severe - every tenth person develops meningitis, and hearing loss is possible. Boys who have had mumps often experience inflammation of the testicle, which leads to impaired fertility.
• Viral hepatitis B spreads through sexual contact, household contact, medical procedures, and the placenta. The disease in 60-90% is chronic and leads to cirrhosis or primary liver cancer.

The effect of the vaccine on the body and the virus

If an agent enters the body, a protective barrier is formed along its path. These are numerous cells of the mucous membranes of the oral cavity, nasopharynx, and eyes. The mucous membranes contain antibodies and interferons that resist infection. As soon as the infection has overcome the first barrier, the body’s innate ability to resist the virus comes into play.

At the next stage, adaptive defense comes into play - the work of individual cells to destroy the virus. At this moment, immune memory is formed, which allows for further relapses to fight the disease faster and more effectively. The formation of adaptive immunity allows you to increase the production of antibodies that destroy infectious agents before they pass through the membranes of healthy cells.

Vaccination against non-cellular influenza agent has a beneficial effect on immunity.

When immunized, a program for creating adaptive immunity is launched, which exactly repeats all of the above natural actions of the immune system:

1. Formation of primary immunity.
2. Antigen synthesis.
3. Blocking infection by lymphocytes.
4. Production of interferon (antiviral agent).
5. Development of specific immunity.

Active production of antibodies begins, which helps strengthen the body's defenses.

The course of the infectious process without vaccination

Flu is a dangerous disease that can lead to death. After passing through the active phase of the incubation period, the virus penetrates the cells of the respiratory system, synthesizes and injects proteins and ribonucleic acids into them for further spread of the virus.

Irritation of the mucous membranes of the mouth, nasopharynx and upper parts of the lungs occurs, and a cough develops. All this is accompanied by severe headache, muscle pain, fever and disruption of the nervous system. The disease weakens the body, which leads to further complications and the development of secondary infection.

Features of influenza in vaccinated patients

Vaccination allows you to strengthen the body's defenses, synthesize more antibodies, interferons and other cytokines. This will prevent further flu infections.

Scientists have proven that if a healthy and vaccinated person becomes infected with a pathogen, then the active phase of the disease will be mild.

Important information about vaccination

When thinking about whether to vaccinate themselves or their children, adults worry about the safety of the drugs, are interested in possible contraindications, and believe that the national calendar is “overloaded.”

How safe are vaccines? Vaccines usually contain the following components:

1. Antigen. This can be a live, killed form of a virus, bacteria or fragments of a pathogen. This component “teaches” the immune system to recognize the enemy and produce antibodies against it.
2. Preservatives and stabilizers to protect antigens during transportation or storage. There are vaccines without preservatives; they are used in pediatric practice.
3. Some drugs contain adjuvant substances that enhance the immune response.

Each vaccine goes through several stages of clinical research: safety, metabolism, methods of elimination, frequency and severity of undesirable effects are studied. Next, immunogenicity is assessed - the ability to stimulate the synthesis of antibodies in response to administration. This parameter indicates the effectiveness of the drug and is estimated as a percentage. For example, when a flu vaccine is administered, antibodies are produced in 95% of those vaccinated. The higher the immunogenicity, the greater the likelihood that the population will be protected from an epidemic of the disease.

A safe and effective vaccine can be allowed into mass production and recommended for use. After drug approval, clinicians continue to monitor for adverse effects.

Popular hypotheses about the connection between vaccinations and diseases such as autism, cerebral palsy, and epilepsy have no scientific confirmation. Often, severe mental and neurological disorders first manifest themselves after 1 year of age, regardless of whether the baby has been vaccinated or not.

“Immunity to COVID-19 was developed six years ago from other “colds”

This assumption was made by American scientists after studying blood samples from 2015-2018.

American researchers from the Institute of Immunology in La Jolla have published sensational data. A study of donated blood samples collected in 2015-2018 revealed signs of specific cellular immunity, similar to those that appear with the new coronavirus. From this we can draw a cautious conclusion that the body of those who were once sick with other types of coronavirus may be resistant to COVID-19.

Today, many are concerned about the question: does the fact of having antibodies to the new coronavirus guarantee immunity? However, the situation with immunity is much more complicated. Its presence depends not only on the presence of antibodies (immunoglobulins) in the blood, but also on the presence of important cells - T lymphocytes, T killer cells (CD8 cells) and T helper cells (CD4 cells). T-killers are able to recognize cells in the body infected with viruses by various signs, and, if they are detected, kill them themselves or call on other cells to help. And T-helpers increase the number and “killing” potential of T-killers that are specific to a particular virus.

A new American study (currently a preprint) aimed to identify specific coronavirus antigens that cause the most powerful cellular immune response - this information is very important for creating a future vaccine.

However, another important discovery happened at the same time. In every second sample of human donor blood taken in 2015-2018, specific CD4+ T-lymphocytes were found, which are now found in absolutely all patients who have recovered from the new coronavirus infection. That is, it can be assumed that 50% of the population who have not yet encountered a new infection may already have immunity to it. In addition, today specific CD8+ T lymphocytes are also found in the blood of 70% of those who have recovered from COVID-19. They were found in 20% of donor blood samples.

The results of the study suggest that a significant part of the population may have cross-immunity to the SARS-CoV-2 virus due to previous “seasonal colds”, i.e. "ordinary" coronaviruses. Those who once suffered from other “coronas” could receive antibodies that could cope with the new virus. Perhaps this is why most suffer from a mild form of the disease or without any clinical picture of the disease at all.

“Donors whose blood samples were analyzed definitely could not have had COVID-19 in 2015-2018. However, in about half of the cases they showed a specific T-cell response to the virus antigens.

The authors of the study believe that the issue is cross-reactive immunity. They tested the donated blood samples used in the experiment for antibodies to two of the four previously known coronaviruses that infect humans, HcoV-OC43 and HcoV-NL63, and received a positive test result. That is, these people had previously suffered from other coronavirus infections other than COVID-19,” notes Sergei Katsalap, senior researcher at the Central Clinical Hospital of the Russian Academy of Sciences.

“This study is extremely important for understanding the mechanisms of adaptive immunity,” the head of the department of clinical immunology and allergology of the First Moscow State Medical University named after. THEM. Sechenov, Academician of the Russian Academy of Sciences, Honored Scientist of the Russian Federation Alexander Karaulov. – If we have studied the etiology of the COVID-19 disease, this is the new coronavirus SARS-CoV-2, then there are constant discussions regarding the formation of immunity to it.

Sometimes this immunity is pathogenic (people die from a cytokine storm or from an excessive immune response), sometimes it is protective (which is important for creating vaccines).

Antiviral immunity is based not only and not so much on the antibody response, but on T-cell immunity, the reaction of T-cells: CD-4 helper cells and CD-8 killer cells, as well as memory cells. These cells are involved in the body's defense in response to viral infection, incl. and SARS-CoV-2, and, thanks to them, during acute infection, elimination of the virus occurs, that is, “cleaning” of the virus and the formation of immunity to subsequent infection. And in this sense, everything goes according to the classics.

But the question is also what determines the severity of the infection? We see that viral clearance does not occur in some older people or in people with severe illnesses such as diabetes or cancer. In them, the connection between innate and adaptive immunity is disrupted; They don't have enough adaptive stuff.

Today, the main hypothesis for answering the question of why some people get mildly ill and others severely is that those who are mildly ill apparently have cross-immunity to other coronaviruses. Cross-reactivity occurs with some infections, such as influenza.

It has been established that those who had cross-immunity to other strains of influenza were more easily affected by the H1N1 flu, that is, they have killer T cells that actively work against the virus, which allows them to recover faster. Of course, the Americans’ work is preliminary; additional research needs to be conducted among seriously ill patients in hospitals. Still, these data prove that the existence of cross-immunity in healthy people in response to SARS-CoV-2 is possible. And this must be taken into account when creating vaccines.

— It turns out that those who have T-lymphocytes for old coronaviruses, when meeting a new one, will most likely get sick more easily?

— Yes, due to the same cross-reactivity between circulating coronaviruses that cause the common cold. This is approximately 40-60% of healthy individuals without exposure to COVID, for whom memory T cells will potentially provide an immune response, that is, they will launch an active and sufficient T-cell cytotoxic (killer) response, in addition to the antibody response. But these killers are very difficult to determine diagnostically; special studies in the laboratory are needed...

Meanwhile, another study by biologists from the University of Washington was published in the journal Nature. A patient who suffered severe acute respiratory syndrome (SARS, caused by SARS-CoV) in 2003 was found to have antibodies that can block the work of SARS-CoV-2.

The causative agent of SARS-CoV is most similar in its structure and properties to the new SARS-CoV-2. Scientists were able to produce eight different antibodies using the patient's memory B cells, which blocked the virus to varying degrees. And one of them demonstrated the ability to bind to the S protein of the new coronavirus SARS-CoV-2, which is responsible for the penetration of the virus into the human cell, and therefore is protective, that is, protective.

And this is very important, since understanding which fragments of the virus are protective is necessary for the development of an effective vaccine against coronavirus infection, as well as for new methods of treating COVID-19, scientists suggest. “This is also a way to use a cocktail of antibodies for the prevention and treatment of severe disease,” says Academician Karaulov.

Link to publication: www.mk.ru

Can multiple vaccines be administered at the same time?

Mothers of infants worry that vaccinations “kill” their own immunity and can cause harm if administered simultaneously. In reality, every person encounters tens and hundreds of bacteria and viruses every day, and his immune system successfully copes with them.

Two-, three-, four-, and five-component vaccines are well tolerated by children and help develop immunity by the time the kids attend preschool institutions, clubs or sections. You can get complete information about the procedure for administering drugs from your pediatrician.

When should you refrain from vaccination?

Some people should delay vaccination or avoid it entirely. Temporary contraindications include:

• treatment of cancer (course of chemotherapy);
• decompensation of severe chronic diseases;
• acute infectious diseases;
• pregnancy and breastfeeding (but not all vaccines, for example against influenza, can be vaccinated in the 2-3 trimester of pregnancy);
• period less than 1 month from the last vaccination.

But there are also conditions in which vaccination can cause harm to health. This:

• autoimmune diseases;
• epilepsy, convulsive syndrome;
• allergy to vaccine components;
• poor tolerability of the previous dose of the vaccine.

Before administering the drug, the doctor examines the patient, measures body temperature, and collects an epidemiological history.

Is it possible to get vaccinated during pregnancy?

Pregnancy in itself is not a contraindication for vaccination. A distinction should be made between routine and emergency vaccinations.

Seasonal influenza vaccination is routinely recommended. So the flu vaccine is not only allowed, but also recommended. It reduces the likelihood of a baby getting sick in the first six months of life by 60-65%.

In an emergency, therapeutic and prophylactic vaccination against rabies is possible in case of animal bites. The doctor weighs the dangers of vaccination against the risk of developing a deadly disease.

Vaccination is the most effective and safe way to protect adults and children from dangerous infections. The list of recommended vaccines is indicated in the National Vaccination Calendar. You can find out more information about the procedure for administration, rules for preparing for vaccination and possible undesirable effects from your doctor.

What should you know about the flu shot in 2021?

Despite the fact that today doctors know how to treat the flu, it is impossible to treat it irresponsibly. Like any disease, it is dangerous due to its complications. One of the most effective ways to protect yourself from the disease is to get vaccinated on time. Flu vaccination is included in the National Calendar of Preventive Vaccinations in Russia, Komsomolskaya Pravda reports. Every year everyone is vaccinated, but there are certain categories for whom an injection with medicine is required. These are workers of medical and educational institutions, transport, children, and elderly people over 60 years of age. Pregnant women also need the vaccine; it can be done starting in the second trimester (after the 14th week). Those at risk include smokers, as well as those suffering from chronic lung and heart diseases. Doctors are developing the vaccine taking into account the age of the patients, so there are options for adults, the elderly and for children from 6 months, reports RBC.

When to vaccinate?

It is recommended to get vaccinated before the start of the disease season, since it takes about two weeks for the body to start producing antibodies. If you do it in July-August, then by the infection season the effect will significantly decrease. Plan vaccination for September - early October. This does not mean that it is pointless to do it in November or December; the risk of infection lasts throughout the entire period of activity of the virus. Keep in mind that children should start vaccination earlier, because for them the vaccination is divided into two doses, the interval between which is four weeks.

Where to get the vaccine?

Vaccination takes place in clinics and private medical institutions. In the form of injections, the medicine is injected intramuscularly into the shoulder. Some vaccines are instilled or sprayed into the nose. The only condition is the absence of signs of other diseases, even a cold.

Is it worth getting vaccinated outside of a clinic?

The Department of Health has set up mobile vaccination sites. Before the injection, the patient undergoes a medical examination, and after vaccination the doctor issues him a certificate. This is a government program created to speed up vaccination of the population - the procedure takes no more than 10-15 minutes.

Children and adolescents under 18 years of age, as well as people with allergies and chronic diseases, should be vaccinated in a hospital, under the supervision of a doctor. The preventive vaccine can be given in vaccination rooms at the place of attachment, in mobile vaccination points, as well as in the MFC.

How long does the vaccine last?

Immunity after a flu shot is short-lived. Usually it is only enough for one season - the next season the vaccine will no longer protect against the flu. The previous vaccination will help only in 20 - 40% of cases. This is due to the constant mutation of the virus. In this regard, annual vaccination is carried out using new strains of the current season. But the flu shot will not protect against other diseases. To do this, it is necessary to take other preventive measures, not forgetting about a healthy lifestyle.

There are more than 30 varieties of influenza, but there is no need to get vaccinated against each. A modern vaccine contains 3-4 types of virus. As a rule, this is enough to protect against the main types of disease. But there are situations when re-vaccination is required.

On average, the vaccine prevents about 60% of infections in healthy adults aged 18 to 64 years. It is important to protect yourself not only before, but also immediately after vaccination. Immunity is not formed immediately after the vaccine is administered, but after about two weeks. Therefore, you can get sick even with vaccination.

What flu vaccinations are available in Russia?

Almost all modern flu vaccinations are vaccines made from viruses “killed” by formaldehyde or UV irradiation. Influenza viruses are grown on chicken embryos, and this is the main cause of possible allergies - due to traces of chicken protein in the composition. In Russia, the drugs mainly used are Grippovac, Vaxigrip, Begrivak, Agrippal S1, Grippol, Grippol Plus, Influvac, Fluarix, Inflexal V. In total, about two dozen such vaccinations have been registered.

What if it doesn't work?

There is an opinion that the vaccine is useless: a person was vaccinated, then fell ill, and doctors diagnosed the flu. The fact is that many viral diseases give the same symptoms. If you have not taken blood tests to detect a specific disease, then it may not be it.

About contraindications

These may include: age, health status, allergic reactions and chronic diseases. Before getting vaccinated, you should discuss the possible consequences with your doctor. Children under six months of age are not vaccinated against influenza. A clear contraindication is a patient's history of Guillain-Barré syndrome (a paralyzing disease, also called GBS).

Flu and coronavirus

One of the major changes to this year's shot is that the high-dose flu vaccine for people over 65 will cover four strains of the virus instead of three. Experts advise getting a flu shot to reduce your risk of contracting COVID-19.

One study confirmed that a person can become infected with influenza and coronavirus at the same time, which complicates treatment and is fraught with complications. Vaccination will protect the body from excessive burden of a dangerous seasonal disease and will help identify COVID-19, because its symptoms are similar to other respiratory diseases. But if you want to protect yourself from both the flu and COVID-19, it is better to get both vaccinations. Doctors advise keeping a month interval between them so that the body has time to adapt to the first vaccine and develop antibodies.

What to do after vaccination?

Immediately after vaccination, do not rush to leave the clinic. Even if the doctor did not offer to remain under observation, you can sit in the waiting room and observe the sensations. 10-15 minutes will be enough to eliminate rare allergic reactions that require immediate help.

During the day after vaccination, try not to get the injection site wet. It should not be scratched, otherwise there will be a risk of infection. Stick to a healthy diet, avoiding fatty and spicy foods at least for the first day. It is better if you spend the evening after vaccination at home, avoiding crowded places and physical activity.

Question answer

Doctor of Medical Sciences, Professor Alexander Sergeev spoke about all the intricacies of vaccine production and their safety.

— What complications can there be after getting a flu shot?

— Thanks to new technologies, there are fewer and fewer adverse reactions to the flu vaccine. For example, in the late 70s, during the production of a vaccine, the virus was killed, “cleaned” a little, and on its basis a so-called whole-virion vaccine was created. Today, scientists understand that the whole virus is no longer needed; a few proteins are enough, to which an immune response is formed in the body. Therefore, first the virus is destroyed and everything unnecessary is removed, leaving only the necessary proteins that cause immunity from influenza. The body perceives them as a real virus. This vaccine can be used even in those who are allergic, including to chicken protein. The technology has been advanced to such a level that its contents are almost impossible to detect. There may be a slight reaction to the vaccine: redness, sometimes the temperature rises slightly, and a headache appears. But even such a reaction occurs infrequently - about 3% of all vaccinated people.

— How do you know that a vaccine is safe?

— As with any drug, individual reactions may occur to the vaccine. At the same time, modern drugs are high-tech products that undergo long-term tests (from 2 to 10 years) for effectiveness and safety of use, so there are no unsafe vaccines entering the market. Even after a vaccine is approved for use in human immunization, health regulators continue to monitor its quality and safety. The specialized institutes of the Russian Ministry of Health regularly monitor the performance of produced vaccines.

— Can I come to the vaccination with my own vaccine?

— Precisely because you can be sure of the safety of the vaccine only if all transportation rules, etc., are followed, you should not buy and bring your own vaccine. Its quality may suffer. It is much more reliable if it is properly stored in a medical facility. Most doctors refuse to administer the brought vaccine precisely for this reason. Candidate of Medical Sciences, allergist-immunologist, pediatrician Oleg Togoev answered other questions.

— Is there a difference between imported and domestic vaccines, which are better?

- There is no fundamental difference.

— Is it possible to pick up a vaccine at the clinic or is there only one?

— Most often, the clinic has one vaccine, usually domestic.

— Is it possible to combine a flu shot with other vaccinations (primarily for young children, there are many other scheduled vaccines for them). What is priority?

— All vaccinations (with the exception of BCG) are combined with each other and can be done at the same time. The only rule recommended by WHO is to do no more than 4 injections at a time. However, one vaccine can contain up to 7 antigens, and this is normal and convenient.