By Donald Cooley

W hat They A re

and How

They Can H elp You

4CCINES

e live in an age of great medi­cal advances in the treatment and cure of many diseases that not long ago were always dangerous and

& ^ ̂V U often fatal.But suPPose y ° u a choice:

to be stricken by a disease and have it cured — or not to have the disease at all?

You do have such a choice. You need never suffer the

misery, disablement, lost time, and expense of certain grave diseases if you choose to be immunized against

them. A general word for the protection your doctor can give you is “vaccination.” Another word is “immunization,” or, in popular language, “shots.”

For most of the diseases vaccination prevents — especially those that are caused by viruses — there are no curative wonder drugs. Once you get one of those diseases there are no particular medicines that attack the cause as directly, for instance, as anti­biotics attack pneumonia germs. The only specific weapon is vaccination.

But it does no good to be vaccinated after disease gains a foot­hold in the body. It takes time for a vaccine to build up your defenses. The time to be vaccinated is when you are perfectly healthy. Unfortunately, it may take an epidemic, an accident, or some scary emergency to make some of us realize how desperately important vaccination is to ourselves and our families. It’s easy to procrastinate about vaccination, for reasons which are all too human but which cost us a lot in suffering from diseases we needn’t have.

Myths about vaccination still exist. Some people feel that vac­cines are mysterious mixtures of unknown substances, that they make one seriously ill. Other misconceptions, such as the idea that vaccination is never again necessary if one has already had some “shots,” may discourage people from keeping their immunities up- to-date, thus jeopardizing not only their own protection but the continued good health of their families and of society. In this book we shall tell some heartening facts about the vaccines doctors can give us today, and about newer ones that are under development.

W h o needs vaccination?

Everybody needs some vaccina­tion, at some time, to live in health in a world where disease organisms are everywhere present. But nobody needs to be vaccinated against everything. Your doctor will tell you which immunities are impor­tant to you. It depends on your his­tory, occupation, exposures, work, play, travel, vacations, age, state of health, and many other factors. For instance, backwoods campers and travelers in regions of primi­tive sanitation will profit from typhoid vaccination seldom needed by urban dwellers who never venture outside the city.

Does your immunity need renewing? You have probably had your share of “shots.” But maybe your antibodies have lost a large part of their defensive punch. Vaccination protection does not last full strength for a lifetime. Immunities tend to “wear off,” some faster than others. Consult the vaccine chart on page 12 to see if some of your vaccinations are over-age.

Thousands of men and women in the armed services received immunizing shots during the war. Many of those vaccinations, which are also important in civilian life, have lost much of their effectiveness. Revaccination, or in many cases a “booster shot,” will restore waning immunities to full power.

H o w it ’s doneSmallpox vaccine is pressed lightly into

the skin with a needle point. Most other vaccines and toxoids are injected under the skin or in the muscle with a hypo­dermic needle. That’s all. From that mo­ment your own body chemistry takes over and does the rest of the work while you go about your daily affairs.

Yet, dread of a trifling needle prick makes some strong men quail at the thought of vaccination. Incredibly, some people choose to risk disease that could hospitalize them for weeks, and even kill them, rather than endure a split second of mild discomfort that thousands of babies in pediatricians’ offices survive every day with scarcely a yelp.

The sensation of a needle prick can hardly be dignified by calling it pain. If the needle is sharp and the doctor skillful, the discomfort is no worse — and certainly less gory — than the little skin nicks inflicted by everyday shaving.

Afterward, there may be a little pimple or swelling at the site of injection, and perhaps some redness. Your arm may be slightly sore for 24 hours or a little more. Sometimes there may be a low fever and a feeling that you don’t want to run a hundred-yard race for a day or so. Or, such signs may not occur and you may not be aware of any aftereffects at all. Different vaccines behave some­what differently, and people react differently too.

Initial smallpox vaccination causes a skin “bump” that grows and swells to about the size of a navy bean, is surrounded by an inflamed area, and slowly dries and withers away. Your doctor will inspect it to be sure of a “take” — that is, of effective activity.

Smallpox vaccination leaves a tiny faint scar. Virtually all other vaccinations leave no outward signs whatever.

W h y vaccines are safeNo other medicines your doctor gives you are prepared with

more meticulous, unremitting, repeated measures for safety than vaccines. Many steps in manufacture are performed by masked and gowned technicians in rooms more sterile than the average operating room.

All vaccine makers must obtain a special license from the

Secretary of Health, Education and Welfare. Regulations require repeated inspections of the product in the laboratories. Vaccines are made in “batch lots.” The manufacturer puts each lot through exacting tests of potency, purity, and effects on animals. Records describing the manufacturer’s tests on each lot in full detail must be sent to the National Institutes of Health in Washington before the lot is released for sale. This government agency often requires lot samples for testing. The number of a lot of vaccine that is finally approved for sale goes on the bottle label.

Vaccines against virus-caused diseases may be made either from live viruses (smallpox vaccine, for ex­ample) or killed viruses (such as Salk polio vaccine). In either type, the vi­ruses can no longer cause disease but can stimulate antibody production.

The painstaking procedures to as­sure quality and safety indicate the supreme importance that government, manufacturers, and physicians accord to vaccines as instruments of public health.

H o w vaccines work in your bodyJust what does a vaccine do when it gets into you?

It stimulates the same processes that you have been doing naturally all your life.Right now your blood contains chemical “memories”

of diseases you suffered and recovered from long ago. These “mem­ories” are physical particles, very special protein molecules, called antibodies. You acquired them by “catching,” let us say, measles.

The measles viruses penetrated your body cells and made you sick, but at the same time they stimulated your cells to manufacture measles antibodies on an emergency basis. These antibodies — specific antagonists, antidotes, neutralizers of measles viruses — sped your recovery. Years from now, if measles virus enters your body again, your measles antibodies will swing into immediate action and, in most cases, you won’t have measles again.

Your own wonderful immunity mechanism can’t get started without the right blueprint to work from. Having a disease furnishes the right antibody blueprint; vaccines do the same thing. They are spark plugs, igniters, which start the production of antibodies against the diseases they prevent. You do the work.

Vaccines contain viruses or bacteria. Polio, influenza, and

smallpox are virus diseases, and their respective vaccines are viral vaccines. Typhoid and whooping cough are examples of bacterial vaccines. The trick in making vaccines is to find ways of stimulating large-scale production of antibodies without causing the disease itself. Before men of medicine learned how to make safe and potent vaccines, the only way to gain immunity was to have a disease that, if it didn’t kill you, left you immune.

Smallpox, for instance.

One of every four persons died during the smallpox epidemics of Shakespeare’s England. At least 60,000,000 Europeans perished from smallpox in the eighteenth century. Centuries before, observant men noted that some attacks were deadly, others quite mild — and patients who recovered did not catch smallpox again. The paradoxi­cal idea that disease might be prevented by provoking it was born.

Ancient Chinese doctors gave dried smallpox crusts to patients by snuffing. In the Middle East, fluid from pocks of smallpox patients was collected on threads, dried, and applied to the skins of persons who soon came down with the disease. Those who recovered were immune. The practice, called “ingrafting” or “variolation,” was introduced to England by Lady Mary Wortley Montagu, wife of the British ambassador in Constantinople, who had seen it prac­ticed there in 1717 and had had it done to her children. Amidst outraged cries of “barbarism,” many people took a chance, and thousands of lives were undoubtedly saved although there were deaths, too, from the risky procedure.

Smallpox symptoms somewhat resemble an insignificant, quite undeadly disease called cowpox. Country legends that milkmaids who acquired cowpox were thereafter immune to smallpox led Edward Jenner, a rural doctor, to an important experiment in 1796. He injected fluids from skin lesions of a dairy maid who had cowpox into an eight-year-old boy named James Phipps who became mildly ill and recovered. Then Jenner inoculated James with deadly small- 6

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milkmaids had a

secret

pox fluid. Nothing happened.He did it again. And again nothing happened. The country doctor had invented vaccina­tion.

Except for smallpox, vac­cines were limited until the immortal Louis Pasteur estab­lished the “germ theory” of disease beyond dispute. In 1857 he announced that fermentation was caused by the life processes of living cells (yeasts), and he suspected that “contagious diseases owe their existence to similar causes.”

Pasteur prepared vaccines from weakened chicken cholera and anthrax microbes. The vaccines produced only mild illness but con­ferred strong immunity against these diseases. From nerve tissue of rabbits killed by rabies Pasteur made a vaccine that was lifesaving to persons bitten by “mad” or rabid animals.

These trailblazing vaccines were forerunners of today’s immu­nizing agents which are triumphs of preventive medicine.

W hich vaccinations do you need?Let us take a look at a list of major modern vaccines. Perhaps

you will see some “holes” in the protection of your family or your­self, or some risk you didn’t know about that’s related to your plans or work. Or perhaps you’ll be alerted to take steps you planned to get around to sometime.

SMALLPOX The vaccine is a live-virus type that gives long- lasting protection. But smallpox vaccination every three years is recommended for complete safety. In fact, it is required in certifi-cates of vaccination for international travel and re-entry into the United States. Almost everyone in the country has been vacci­nated against smallpox at least once. But if your smallpox vaccination was done a half-dozen or so years ago, you probably need it again for safety’s sake.

POLIO This vaccine is strongly recom­mended for everyone up to forty years of age—or older, for that matter. There is no specific treatment for polio. Vaccine is the only effective way to prevent paralytic dis-

ease — and vaccination should be begun well before the polio “sea­son,” since the killed-virus type vaccine needs some time to build up maximum protection.

Salk-type vaccine is given in two injections, a month to six weeks apart, followed by a third seven to nine months later. Killed-virus vaccines ordinarily do not give quite such long-lasting protection as live-virus types. Since the length of immunity is not positively known, a fourth booster shot, perhaps an annual booster, is con­sidered desirable by many doctors. There is no question of the safety of polio vaccine in current use. Not a single case of polio attributable to the vaccine has appeared in the tens of millions of vaccinations given since present standards of safety and manufacture were established.

INFLUENZA Vaccination against flu is important for certain groups of people who should seek medical advice about their need for it. These include pregnant women; older people with any chronic illness; persons of any age for whom flu would be an added health threat; persons in the home or in occupations where it’s essential to keep going during epidemics; persons who refuse to be weakened and laid up by flu at a considerable cost in lost time and money. Polyvalent influenza vaccine contains killed viruses of several dis­ease-causing strains, including the Asian type. Two doses, spaced

two to four weeks apart, give protection for one season. Vaccination should be repeated (one shot may suffice) each season. The vac­cine is made from viruses grown in fertilized eggs. Tell your doctor if you are sensitive to eggs or feathers.

Russian scientists have reported large- scale use of a live-virus influenza vaccine. The chief advantage is that the vaccine is simply squirted into the nose and does not require injection. Results are yet to be determined.

TETANUS OR LOCKJAW is it possiblethat you will ever step on a nail, suffer a com­pound fracture, a bad burn, a puncture wound, any wound contaminated by soil particles? Everybody has to answer “yes, it’s possible” — which means that everybody should have tetanus toxoid vaccination. In­numerable accidents and injuries, even ap­parently superficial ones, bring on the dread possibility of infection by the widespread tetanus organisms that cause lockjaw — a very

serious disease with a high fatality rate. After such an injury, you can get an immediate injection of tetanus antitoxin to prevent lock­jaw, but it contains horse serum, to which sensitized people react. However, if you have been immunized by tetanus toxoid — a harm­less vaccine devoid of horse serum — antitoxin is ordinarily not needed after an infectious wound. A booster shot of toxoid gen­erally suffices.

Tetanus immunization is given in two or three spaced injections under the skin. Immunity is quite long-lasting; a booster shot upon injury keeps immunity high.

While tetanus immunization is a primary safety measure for everybody, it is particularly important for persons who drive cars, do garden and lawn chores, work with machinery, handle shipping cases, change tires, do carpentry or thousands of other jobs where a pos­sible injury could be con­taminated. Since the vic­tim of an accident may be unconscious, it’s a wise idea to carry a card in your billfold or purse with this information.

I have had a course of tetanus toxoid inoculations given byDr.....................................................................Address ........................................................Vaccination completed onBooster shot received on

BASIC IMMUNIZATION OF CHILDREN Most mothers andfathers are more conscientious about immunization of their children than of themselves. Basic immunization of babies begins when they are two months old. Smallpox vaccination is given separately, but injections for diphtheria, tetanus, and whooping cough (the latter a serious disease in infants) are now given simultaneously in a com­bined triple vaccine. This means fewer injections to get the same results. Commonly, the product is given in three spaced injections. Polio has recently been added to the combined vaccine to give a four-way immunizing agent that is now available to doctors.

THE COMMON COLD “Personalized” vaccines, prepared from the patient’s own secretions and injected in a series of doses, may give a useful degree of protection against repeated colds. Such “custom-made” vaccines are not widely used, partly because of ex­pense, partly because duration of protection — like the brief im­munity given by having a cold — is not long-lasting. As yet there are no stock or standard vaccines that are effective against the common cold.

A number of important vaccines are not intended for general inoculation of the public at large, but can save lives or prevent very serious trouble in conditions of special need. Some of these are:

TYPHOID The disease is usually con­tracted from food contaminated with typhoid fever germs. Occasionally water or milk serves as the vehicle of transmission. Typhoid vaccination is desirable for persons who live or travel in rural areas where water may not be pure; for campers, outdoorsmen, travelers in foreign countries, anyone likely to en­counter unsanitary conditions. Vaccination consists of three injections a week to a month apart; thereafter, a booster dose every two or three years.

ROCKY MOINTAIN SPOTTED FEVER(TICK FEVER) Acquired from infected ticks which pierce the skin for a meal of blood and transmit the causative organisms by contami­nating the skin with their feces. Antibiotics generally cure the disease, but consider im­munization if you live in or visit tick-infested areas where the disease is prevalent. Vaccine is injected in two or three doses about a week apart, renewed by an annual booster dose.

YELLOW FEVER A lethal virus diseasetransmitted via mosquitoes. Yellow fever exists in parts of Africa and in the Americas from Guatemala into southern Brazil. Vacci­nation is essential if you travel in those areas. Long-lasting im­munity (at least six years) is conferred by a single vaccination.

RABIES (HYDROPHOBIA) Not people, but household pets should be vaccinated against rabies. This protects you, your family, and society. Once symptoms appear in a person bitten by a rabid or “mad” animal, death is inevitable. But the rabies virus works slowly in the victim; a daily injection of rabies vaccine for 14 to 21 days (Pasteur treatment) will prevent the disease. In most cases, there is time to observe the biting animal to see if it actually develops rabies. If it does not, the in­jections will not be necessary. Do not kill the biting animal unless absolutely necessary; then, preserve the head for laboratory exami­nation. Capture the animal if possible for health department observation.

TYPHUS Literally, a lousy disease, transmitted by infected lice or fleas (not the same as typhoid fever). Inoculations are recom­mended for persons going to infected areas where living conditions are poor. Immunity is induced by three vaccine injections a week apart, with a booster every two or three years.

MUMPS A commercial vaccine which gives immunity lasting eight months to one year is available, but not widely used. The disease is rarely serious in children, but in adult males it may affect the reproductive organs and in some cases even cause sterility, though this is a relatively rare consequence.

TUBERCULOSIS BCG vaccination against tuberculosis is quite common in some European countries but has not won wide accept­ance in the United States, although it is available. The vaccine is harmless, and some respected medical advocates as well as some equally respected authorities doubt its practicality, at least on any large-scale basis. Tuberculosis protection is most important for persons who are occupationally (nurses, sanatorium employees, and the like) or otherwise intimately exposed to infection, and medical advice should be sought.

TULAREMIA The disease is usually acquired from skinning and preparing wild rabbits. The preventive vaccine is a special one for rabbit hunters. Or, one may stop hunting rabbits.

Vaccines induce active immunity (you make the protective sub­stances yourself), which is relatively long-lasting though of variable duration. There are other kinds of “shots” that give passive im­munity, quite brief but often important when it’s necessary to get some protection in a hurry. These shots contain antibodies or other protective substances created in someone else’s body or in the body of an animal. These protective gifts don’t last long in your body, but they may do a very important job while they last. Shots may be given with immediate hope of preventing a disease in a person who has been exposed to it, or of making the disease milder if it does break through. Substances most commonly used for such shots are convalescent serum, the gamma globulin portion of blood, or anti­toxins. They are frequently used to modify such diseases as measles, mumps, infectious hepatitis, German measles, and some other infections.

Shots for temporary protection

VACCINES OF UNIVERSAL IMPORTANCEVaccination for: Who needs it? How given? How long does

protection last?SMALLPOX E veryb o d y 1 d o s e , l i g h t l y

p re s s e d in to sk in3 to 7 y e a rs , s o m e ­t im e s lo n g e r . V a c c i­n a tio n e v e ry 3 y e a rs re c o m m e n d e d

POLIO E ve ryb o d y up to 4 0 y e a rs o f a g e . D e s ir ­a b le ab o ve th a t ag e

3 i n je c t i o n s , t h e se co n d 4 to 6 w e e k s a f te r th e f i r s t , th e th ird 7 to 12 m o n th s a f te r th e s e co n d

N o t kn o w n . F o u rth b o o s te r dose re c o m ­m e n d e d o n e y e a r a f te r th e p r im a ry s e ­r ie s o f th re e d o ses

INFLUENZA T h e yo u n g , th e o ld , a il in g p erso n s , and p re g n a n t w o m e n to w h o m flu is a s p e ­c i a l r i s k . A l s o , h e a l t h y m e n a n d w o m e n w h o n e e d to be on th e jo b a t h o m e o r a t w o rk d u r in g e p id e m ic s

1 o r 2 in je c tio n s , as d o c to r d e e m s b e s t

U n c e rta in ; p ro b a b ly 8 m o n th s to 1 y e a r . R e p e a t v a c c in a t io n e v e ry y e a r

TETANUS( L o c k j a w )

E ve ryb o d y . In ca se o f in ju ry , i t m ay m a k e e m e rg e n c y in ­je c t io n o f te ta n u s a n t ito x in (m a d e fro m h o rse s e ru m ) u n n e c ­e s s a ry

2 o r 3 in je c tio n s in ­tra m u s c u la r ly , a t in ­te rv a ls d e c id e d by d o c to r . B o o s te r s h o t a t t im e o f in ju ry

L o n g - la s t in g . A fte r p r im a r y im m u n iz a ­tio n , b o o s te r s h o t on in ju ry

DIPHTHERIA ] WHOOPING

COUGH TETANUS( c a n i n c l u d e p o l i o )

A ll b a b ie s

3 s p a c e d in je c tio n s B o o s te r fo r d ip h th e ­ria and te ta n u s e v e ry 3 y e a rs up to a g e 15

And more are comingGreat advances in scientific knowledge and techniques in the

past few years have opened the doors to other vaccines of the future.One great advance, which won a Nobel prize for Dr. John

Enders and his associates of Children’s Hospital, Boston, is the “tissue culture” technique by which viruses are grown easily and in great quantities. Tissue culture made Salk polio vaccine possible.

Now an oral polio vaccine may not be very far away. (Not close enough, however, to risk waiting for it.) Three research groups have developed pleasant-tasting polio vaccines which millions of children in foreign countries have swallowed. Antibodies against polio have developed in their bodies. Could these weakened viruses from immunized children possibly turn vicious again and cause paralytic disease among unvaccinated people? Apparently not, but

VACCINES IMPORTANT IN SPECIAL CIRCUMSTANCESVaccination for: Who needs it? Dosage and duration

TYPHOID D e s ira b le fo r c a m p e rs , t r a v e l ­e rs , w o o d s m e n , p ers o n s lik e ly to e n c o u n te r q u e s tio n a b le s a n i­t a r y c o n d i t io n s a n d im p u r e w a te r s u p p lie s

3 in je c tio n s , a w e e k a p a rt . B o o s te r dose a f te r 2 o r 3 y e a rs

ROCKY MOUNTAIN SPOTTED FEVER

P e rso n s in t ic k - in fe s te d a re a s w h e re th e d is e a s e is e n d e m ic ; la b o ra to ry w o rk e rs ex p o s e d to th e o rg a n is m s

2 o r 3 d o ses in je c te d a t 7 - to 1 0 -d a y in te rv a ls . A n n u a l b o o s te r dose

YELLOW FEVER T r a v e l e r s to c e r t a in f o r e i g n c o u n tr ie s

1 in o c u la t io n (liv e -v iru s v a c ­c in e ).C e r t i f ic a te g ood fo r 6 y e a rs

RABIES( H y d r o p h o b i a )

P e rso n s b it te n by a “ m a d " a n i­m al s u s p e c te d o f h a v in g ra b ie s . W a s h w o u n d c o p io u s ly w i t h soap u n d e r ru n n in g w a te r . C o n ­s u lt d o c to r . Do n o t k ill a n im a l; c a p tu re if p o s s ib le ; k e e p u n d e r o b s e rv a tio n as d o c to r o r h e a lth d e p a r tm e n t d ire c ts . S h o ts w ill n o t be n e c e s s a ry i f a n im a l does n o t d e v e lo p ra b ie s

O ne dose o f v a c c in e in je c te d e v e ry day fo r 2 w e e k s . Vac­cination of pets against rabies is the most important preven­tive of human rabies

TYPHUS T r a v e l e r s to c e r t a in f o r e i g n c o u n tr ie s

3 v a c c in e in je c tio n s a b o u t a w e e k a p a rt .B o o s te r e v e ry 2 o r 3 y e a rs

MUMPS A d u l t s w h o h a v e n o t h a d m u m p s in c h ild h o o d an d w ho m ay h ave in t im a te e x p o s u re to th e d is e a s e — fo r e x a m p le , p a r ­e n t s ( e s p e c ia l l y f a t h e r s ) o f yo u n g fa m il ie s

I n je c t i o n g iv e s im m u n i t y 8 m o n th s to 1 y e a r

authorities will have to be absolutely certain of safety before oral vaccines are released for general use.

Other promising vaccines are less further advanced. A measles vaccine, tested on a dozen children, produced all the signs of im­munity to measles. But it also produced a little rash, a trifling fever, so scientists are working to “tame” the vaccine a little more. A chickenpox vaccine is also in a fairly advanced stage of develop­ment. And, at the University of Michigan, an experimental and still crude vaccine to prevent syphilis proved to be about 50 per cent effective in animal tests.

The concept that many cancers are caused by viruses is an excit­ing and controversial one in medicine today. If viruses do cause cancer, as many authorities suspect, and if the viruses can be isolated and identified — tremendous ifs! — then the possibility of vaccines to prevent cancer is not at all visionary. The search is going on in a hundred quiet laboratories.

Do you know when you were last vaccinated against smallpox? Are you still protected? Do you know what vaccinations other mem­bers of the family have had, and when, and when booster shots may be due? Your doctor keeps a record, but families do move around, or change doctors, or forget. It’s simple enough to keep a permanent

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Family Immunization Record, a valuable reminder, which your doctor or his nurse will help you to fill out. Some day it may be very valuable when you plan to leave the country, or the children are entering or changing schools, or in case of some unexpected emer­gency. A simple permanent record can be kept as follows:

IZATION RECORD(N am e) (N am e) ------------ (N am e)------------

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PUBLISHED FOR GM MEN AND WOMENI n f o r m a t i o n R a c k S e r v i c e General Motors Personnel Staff