August 20, 2020

Myths and Misconceptions About Immunization

Show Notes

On this episode, Chuck Gaidica is joined by Kelly DeJager, clinical pharmacist for Blue Cross Blue Shield of Michigan. Together, they uncover myths and misconceptions about immunization.

In this episode of A Healthier Michigan Podcast, we explore:

  • How our bodies build up immunity from vaccines.
  • Side effects from vaccines and how they’re manufactured.
  • Building our immunity naturally and how vaccines could further help.
  • Getting input from our doctor or pharmacist about getting vaccinated.
  • The impact the pandemic has had on routine doctor visits and vaccinations.

Transcript

Chuck Gaidica: This is A Healthier Michigan Podcast, episode 61. Coming up, we uncover myths and misconceptions of immunization.

Chuck Gaidica: Welcome to A Healthier Michigan Podcast, the podcast dedicated to navigating how we can all improve our health and well-being through small, healthy habits we can start right now. I’m your host, Chuck Gaidica, and every other week, we’ll sit down with a certified health expert from Blue Cross Blue Shield of Michigan. We dive into topics that cover nutrition, fitness, and a whole lot more. And on this episode, we’re talking about vaccinations. This is going to be a huge topic. As we head, hopefully, toward the end of this calendar year and into next year as well, we’ll explore how they work, what impact they have on our immune system, and even uncover some myths. With me today as a clinical pharmacist at Blue Cross Blue Shield of Michigan, Kelly DeJager. Kelly, how are you?

Kelly DeJager: I’m doing great, Chuck. Thank you.

Chuck Gaidica: So you’re a Michigan native, you got your bachelor’s in material science and engineering from U of M and then got your Doctor of Pharmacy from Wayne State. You’ve got a couple of kids, a husband who allows you to be a runner. Does he run with you?

Kelly DeJager: He does sometimes.

Chuck Gaidica: Do you allow him to run without you?

Kelly DeJager: Yes.

Chuck Gaidica: Okay. And I see a picture of you. I have to ask about this because I know you have a dog named Pepper, but this is not pepper who you’re holding. I see a picture of you holding, is that a baby alligator?

Kelly DeJager: Yes. No, that is not Pepper. That is from a family trip to Florida, not this year, last year. And we got to hold an alligator, it was actually at a mini golf course.

Chuck Gaidica: That’s wild. Was that Fort Myers down to Naples, somewhere down there. Because I may know the area.

Kelly DeJager: It was near Daytona Beach.

Chuck Gaidica: Oh, okay. Different. Well, we were in January, we were down there as well. And my wife in a million years, I never thought she would do such a thing. I have pictures of her holding, I mean, this is a three to four-foot alligator. It’s not tiny. Yeah. Very cool. Well, listen, we want to get into this topic of immunizations because there’s so much to talk about and we are hearing news, it seems like every day, right? We’ve got major pharmaceutical companies racing to the finish line to try to create something for COVID-19. We’ve got talk of 20 other companies, smaller, that are doing the same thing, that this could take literally the military to help immunize us. And I want to double back to that, but I want to start with some of the basics. How do they work? How does a vaccine work once I get it in my arm? What happened?

Kelly DeJager: So, great question, Chuck. They work by imitating an infection. So vaccines stimulate your immune system to recognize and fight a pathogen. And what a pathogen is, it’s anything that can produce disease. So in the case of vaccines, it’s usually a virus or a bacteria. And to do this, the molecules from the pathogen must be introduced into your body to trigger that immune response, which is what the vaccine does, is introduce it into your body. And the molecules called antigens, they present themselves as virus or bacteria, and giving the vaccine allows the person to build up immunity to a disease.

Chuck Gaidica: So when we build-up this immunity, why, for instance, do we hear comments about building up immunity to COVID, but with the flu, there’s still a vaccine for the flu, but if I’ve had it before, wouldn’t I have built-up an immunity or does it just go away over time?

Kelly DeJager: With the flu virus, it mutates, so it changes every year. So that’s why we have the flu vaccine and a new flu vaccine comes out every year. So they start manufacturing that well before the flu season comes out. And based on studies around different like Southern and Northern Hemisphere, they predict what the strain is going to be. But that’s why you need the flu vaccine every year because it mutates.

Chuck Gaidica: So is it better to have a natural immunity? I mean, if you had some kind of immune system booster that helped you, is that better than getting a vaccine, or is that really not the proper way to ask it?

Kelly DeJager: Natural immunity is, of course, important; however, obtaining natural immunity for these diseases that we now have vaccines for such as measles or polio, to name just a few, is always far more dangerous than acquiring that immunity from the disease itself. If you were to get the measles, for example, before we had this vaccine available, it would infect three to four million people a year in the United States, and of those, several hundred would die from the disease. So you have that risk with the natural immunity that you don’t with the vaccine-acquired immunity.

Chuck Gaidica: And, of course, if I walk into my local drug store chain, I’ll see the clinics that have popped up now and seems to be a pretty big part of their business model. But I’m also seeing on a sign even at Walmart or somewhere, I can get a vaccine now for pneumonia for shingles. Is it okay to get multiple vaccines as long as you’re doing it in the proper order? Is that okay? Because I guess some of that’s targeted towards seniors.

Kelly DeJager: Yes. It’s okay to get multiple vaccines. There are certain ones, as you mentioned that you want to get in a certain order. And the CDC publishes guidelines for people from birth all the way into adulthood with a schedule of how it’s best to receive the vaccines. But it is perfectly fine to get more than one at a time if that is required.

Chuck Gaidica: So for some people, they could have a reaction, and I’m not sure everybody knows that that reaction is coming. I had a bad reaction years and years ago to a flu vaccination. And I don’t know if it has to do with an egg allergy or what it could be. But anyway, there are people who don’t know it’s coming, but generally is most everybody okay getting a vaccination? And for those who aren’t okay, like who are they? Because we all should really know that somehow.

Kelly DeJager: Right. Yes. Most people are fine getting a vaccination. You mentioned maybe having a reaction to the vaccine in the past. Most of the reactions that people are going to see are a side effect to the vaccine. That would be like a sore arm, maybe a mild fever, some redness at the site of injection. Very serious reactions are extremely rare to vaccines and it is much more risky to actually get the disease itself. And to answer your question about who should maybe not get a vaccine, so for every vaccine that is out there, the CDC has guidelines on contraindication, so people who shouldn’t get the vaccine or a maybe precaution. So just to give one example would be someone who is immunocompromised. For example, a patient who has cancer, who was receiving chemotherapy would be considered immunocompromised, so there are certain vaccines that they would not be able to get until they were through treatment and well again. But there’s very few people who would not be able to get a vaccine.

Kelly DeJager: As I mentioned before, too, age plays into that factor, so there’s vaccines that are to be given at a certain age. And it’s interesting too, you bring up the egg allergy and the flu vaccine, the traditional way for over 70 years was to actually grow it in an egg so there was always that theoretical risk that someone who has an egg allergy could have a bad reaction to it. However, they have found that it’s more of a theoretical risk that people that do have an egg allergy can actually receive that vaccine. Just to let you know, there are two, within the last decade, they’ve developed other ways of growing these vaccines. So there actually are two available that don’t have any egg in them. So if you’re still unsure, I would recommend that you check with your doctor or pharmacist about how it was manufactured, even look at the CDC website.

Chuck Gaidica: Yeah. Well, it’s interesting because I think we all tend to think, or a lot of us do that we’re getting vaccinated for our own health. And just, gosh, it’s got to be five years ago, we were having a new baby granddaughter introduced into our family. I was doing a bit of caregiving for my two senior parents. And I was advised by my doc that I should be vaccinated for certain things so that I wouldn’t pass on something to them, like I could do okay with it, maybe be sick for a day or two, but, boy, if you give it to your parents, it could be a whole different thing. So some of these things we need to think about the others around us, much like we have been with wearing a mask. It’s not just about us.

Kelly DeJager: Yes, exactly. So that probably I’m thinking was maybe if you were having a new grandbaby come, the Tdap vaccine.

Chuck Gaidica: Yes. That’s what it was.

Kelly DeJager: So that is recommended for women who are in their third trimester of pregnancy and then anyone who is going to be in close contact with the baby when they’re firstborn. There’s a couple of different terms, you form like a cocoon around the baby to help protect it, or kind of in a broader sense with even more of the different vaccines we have, like herd immunity. So those patients that maybe, we talked about immunocompromised, can’t get the vaccine, it’s really important that everyone else who is able to be vaccinated, get the vaccine to protect those people.

Chuck Gaidica: And what, outside of the obvious that we’ve just spent a few minutes talking about, what other benefits could I be missing for getting a vaccination? What else can we be thinking about?

Kelly DeJager: The benefits of vaccines, so they protect people by producing immunity. They’re going to reduce the risk of not just infection, but also many of these different diseases have complications from an infection, some of them could be lifelong. Those are the main benefits of the vaccine, is just by protecting you from getting the actual infection, protecting those around you, and then also just reducing the risk of complications. We talked a little bit about the flu vaccine, sometimes people may feel that it’s not that effective or hear through the news that it maybe isn’t that effective, it will still, generally people who have the flu vaccine will have a milder case of it. So it’s still recommended to get it with that being a consideration.

Chuck Gaidica: So let me ask you a question because here you are a doctor of pharmacy, so you’ve forgotten more about this than I know, but I’m just so curious, why did it take so long for us to see a clinic in a pharmacy where I could get a shot? It used to be you had to make an appointment with your doctor, you had to go pay an office visit, et cetera. So I’m assuming there’s a profit center to some of this, right? It just makes sense for CVS and Walmart and Walgreens to have this. But beyond that, it’s a convenience factor. It’s like bada bing bada boom, I’m in, I’m out and I got to go. And so why did it take so long?

Kelly DeJager: The exact answer of why it takes a long, I don’t know that I can answer that. But as far as advocating for pharmacists coming into this role of immunization, I think that it is great especially like you mentioned, the convenience factor of getting to just go into the pharmacy to get vaccinated. And I will say that the role has been expanding as well. So for instance, the age that you can get vaccinated in a pharmacy has gone down. It used to maybe be teenagers or adults, but some pharmacies are even vaccinating at the age of four, which is great. Some of those vaccines that you get when you’re an infant, of course, they combine them with well visits so it makes sense to go to your doctor. But to just get your whole family a flu vaccine, I think that being in the pharmacy is very convenient and great to see that happening.

Chuck Gaidica: Is it actually pharmacists who are dispensing a vaccination, the person giving me the shot, or is it a med tech? Literally, who is it that’s doing it?

Kelly DeJager: Depending on how the practice is set up in the pharmacy it could be the pharmacist. And I think traditionally when it first started, that was who was doing the vaccinating. You see like the minute clinics or other things that are in some of the pharmacies, those ones, it might be not the pharmacist in those. I’m actually not a hundred percent how those are set up, but it could be a med tech, or nurse, or someone other than the pharmacist.

Chuck Gaidica: Since the vaccine is helping fight off the potential for whatever strain of the flu is coming, this still doesn’t mean that if you have a regimen that seems to work for you, we’ve heard a lot about zinc and vitamin C and there are a lot of people that have their own little system of boosting their immune system, that doesn’t mean you should automatically pull back on that either, right? It seems like you’ve got double barrel power then going off against the flu.

Kelly DeJager: No. And especially with what is happening right now with COVID-19, you kind of touched on that a little bit, it’s more important than ever to make sure that you’re getting that flu vaccine this season because we don’t have that kind of protection for COVID-19 right now. So to have the potential to have both infections is there for a person and just the strain on the healthcare system, we really want to encourage people to get their flu vaccine and to even get it earlier than they may have gotten it in the past, just to make sure that everyone’s protected.

Chuck Gaidica: And you say everyone, so the flu vaccine is really for the entire family, from young kids all the way up to mom and dad. This isn’t just for middle-age and older.

Kelly DeJager: Right. It’s recommended for six months and up, so babies under six months can’t get it. That’s why, again, it’s important for those that are around infants that young to be protected. But yes, it is recommended for people who are six months and older.

Chuck Gaidica: This is going to be a weird question because it’s like saying what if antibiotics weren’t here because there was a time, not that long ago where if you cut your leg open on a wire fence, you didn’t have any ointment to put on there. And now we know why people died younger maybe. But if vaccines went away, if we didn’t have vaccines, what would be happening?

Kelly DeJager: I think one of the best ways to describe that is to just look at history. Nowadays, we don’t see diseases like measles, polio, whooping cough that were around more. I know my parents had measles. And prior to vaccines, you would have thousands of people who would die or have permanent complications from these disease. And as we’ve seen them develop, we don’t really see these diseases anymore. And as we mentioned, they kind of protect the whole community. So if we stop vaccinating, you would see increased cases of these diseases out there. And we have even seen pockets of this. I don’t know if you remember last year in 2019, there was an outbreak of measles in Oakland County, the Michigan Department of Health and Human Services actually confirmed there were 46 cases. So, things like that would be more widespread if we didn’t have them.

Chuck Gaidica: Now, I’m going to date myself, but I know, I remember distinctly growing up, and I don’t know from what age that I even was aware of it, to the point that I still knew it was going on, there used to be measles parties. Can you imagine your mom and dad would say, “Take little Chuckie over to that party over there because his two cousins have measles.” They wanted you to catch it. Would that be considered herd immunity in a rough sense back in the day? That’s crazy to think about.

Kelly DeJager: In a sort of sense, but that’s definitely not something we recommend now.

Chuck Gaidica: I know.

Kelly DeJager: When I was young, the chickenpox was still out there and I know that that parents had done that. But again, the dangers from getting the disease are far more serious than the vaccines.

Chuck Gaidica: Right. Yeah. I mean, I know it was there and I don’t remember exactly if I was thrown into the huddle or not. I mean, I don’t remember if I got it naturally or otherwise. So let’s double back on something that I think is important because there are a lot of parents, and parents are the ones that should be in charge of their children’s health and their own health, who are kind of lumped into a group of anti-vaxxers. They really are concerned about kids getting vaccines because it could lead to autism, or it could be that there’s something in the actual vial, or the needle isn’t sterilized, there’s something. And I’m not going to say that it’s crazy thinking, I’m just saying that this thought exists. Give us your take on this. And if you were advising young families with children about vaccinations, you’ve kind of said it already, but why is it that with all the information we have at our fingertips, we would still have people thinking that vaccines are bad when it seems to me that the evidence is overwhelming the other way?

Kelly DeJager: I think it’s really important that parents or anyone who’s going to get a vaccine, make sure that they seek information from credible sources like the CDC, because as you mentioned, there is a lot of information out there from anti-vaxxers that kind of stirs up fear that maybe these vaccines are causing more harm than good. And that is completely not the case. So to address the potential link that has been posed with autism, the widespread fear from that came back from a study that was done in the late 1990s. And the author of that study has since lost his medical license because that study was proven to be not founded. There is no link between vaccines and autism. But unfortunately, some damage was already done with that. And since then, there have been numerous studies done, and again, I would urge people to talk with their doctor or look at what the CDC has because they have some really awesome info that links the studies, even the names of the studies that have been done in these vaccines and none of them have linked the vaccines to autism.

Kelly DeJager: And then, Chuck, I think you mentioned too, the contents of the vaccines, so what’s in the vaccine. And some parents are kind of afraid about that, which, of course, I’m a parent too, so you have a lot of concerns to keep your child safe for sure. And just assuring parents that each ingredient in the vaccine serves a purpose, whether it’s providing the immunity so the antigen that’s in there, keeping it safe and long-lasting, and then other things that are used in the production of the vaccine. So vaccines do contain trace amounts of formaldehyde, which I know sounds, but you actually produce that naturally in your body. So what we metabolize is actually more than what’s found in the vaccine. All these different editors actually make the vaccine safer. So it’s just trying to assure parents that these have been studied and have gone through lots of safety testing before they’re actually given to their children.

Chuck Gaidica: And I think in this fast-moving world of ours, especially now with social distancing, we, maybe over time, have lost sight of the fact that our pediatricians, our doctors, our pharmacists, the experts that we’ve always had in our life, we sort of think it’s just the person behind the glass and they filled my script, and again, got to go and swipe my card and let’s do it. But I think that we need to rely on those people as well, because those are the people, pediatrician they’re going to be in your child’s life, in your life, you’re going to see them a lot over the course of time. And I think it’s good to defer to their knowledge and to some extent their authority in this matter too. Take their advice to heart.

Kelly DeJager: Yeah, of course, I think that’s really important. And as I mentioned that my children, I have vaccinated them all on schedule up-to-date and even just making it a little bit more personal when you’re talking with maybe your doctor and your pharmacist about what their take on it, what they’ve done maybe with their family. Because I think that really, even more than some of the facts and the science out there, it has that connection if you can make that with like your patients or have that with your doctor or pharmacist.

Chuck Gaidica: As a mom, how often does this conversation, especially when your kids were much younger, but how often does that come up in a parents’ circle of your friends, neighbors, churchgoers, et cetera? It seems to me when we were raising our kids, we were talking to other parents a lot. Well, what are you doing? What do you think? Do you think it’s safe? That happens holistically.

Kelly DeJager: Oh, yeah. And I think that, yeah, definitely. And especially things are different now with social media and it’s really easy. There’s just information everywhere. So, who do you trust? What do you do? So that definitely comes up when you’re a mom talking with your friends. I think that a lot of times maybe we, most of my friends, we’re kind of on the same page as me as regarding vaccination, so I didn’t really get any kind of arguments that way. But, yeah.

Chuck Gaidica: That’s good. And we’re in a world where it seems like, again, daily, this idea of vaccines for COVID-19, the big players that we’re hearing about some names we never even knew, Moderna, but we know Johnson and Johnson, and some others, but there are all these other small companies, some that are international, and they’re racing to the finish line. Our government and other governments are throwing billions of dollars at them to say, “Come on, let’s get it done fast.” And it seems like they’re moving at breakneck speed. And I don’t know, as a pharmacist, what’s your view of the speed at which we’re trying to do this because it seems like we should be racing to the finish line for a really good reason quickly?

Kelly DeJager: Right. And I would agree that kind of what you said with they’re sort of pulling out all the stops with this vaccine and trying to get it to market with a good reason. But I would still let the people know that this is still being tested. It’s still got to go through … There’s a federal advisory committee for vaccines called the Advisory Committee on Immunization Practices. And they are made up of public health experts and they review the data, the science behind vaccines, and make recommendations to the CDC. So I’m thinking that what’s happening now, even though it’s happening fast, that there’s some level of trust with your medical community and what this committee does and just how it develops its recommendations to the CDC. And I don’t know that it’s … Obviously, we’re trying to get it out there. But it might not be in phases. They might recommend it for people who are going to be high-risk. So yeah, it’s interesting to hear everything that’s going on.

Chuck Gaidica: Well, it’s been referred to as a war effort. And I think when you just … Even if a third of our population wanted to get a vaccine, and I’m just assuming it’s one shot, maybe you have to go back in a month or something and get a second shot, but one shot for a third of Americans would be over a hundred million doses. I mean, that’s a lot to expect companies to ramp up. So in a funny way, I’ll just speak for me, I’m kind of a type-A guy. I like to get things done fast. If the government’s lumbering along on something, or it takes too long for a package, or I can’t get my book from Amazon tomorrow, I’m sort of like, oh. I’m used to getting things now in a day.

Chuck Gaidica: So it’s funny that I hear people complaining about how fast things could be moving because maybe the federal government did what it was supposed to do and just kind of cleared the deck of a lot of different regulations and smoothed the system out so we can get this stuff we need as quickly as it’s feasible and safe.

Chuck Gaidica: So what will be the true test for a new vaccine for you, your husband, and your two kids? What are you going to be looking for, which then will be my new advice in my brain of what I’m looking for? Is it this national panel you’re talking about that reports to the CDC?

Kelly DeJager: Yes. Follow what the CDC is recommending as far as schedules for how the COVID-19 vaccine would be distributed and which population is going to get it first and follow along with that.

Chuck Gaidica: Yeah. Well, that’s good advice. And I think we’re all going to have to do that because it sounds like there’s hope even if you just kind of read between the lines, there’s hope something’s coming here toward the end of the calendar year, which would be interesting to hear about. So as we wrap things up, give us some takeaways from all that we’ve discussed, and I know we’ve gone down some trails, but you’ve got so much information and you’re so nice to give it to us. But what are some takeaways we should all think about when it comes to vaccinations in general for us and our families?

Kelly DeJager: So I think first I’d like to start with just what’s happening with the pandemic and the situation that we were in with people just not being able to leave their house, not being able to maybe go see their doctor to get those routine vaccinations, and the importance of making sure that parents or even adults, contact their doctor and make sure that if they are either miss vaccines, behind, please reach out to your doctor and make sure that you get caught up. And if you’re still afraid of maybe to bring your child into the office, I know that our pediatrician’s office has been doing a great job with allowing parents to wait in their car until they come in and just do everything that you can to get your child caught up with their vaccines. I think another tip would be to make sure you get your flu vaccine this season because that is one that you need to get every year. And as I mentioned again, with the COVID-19 pandemic, you want to make sure that you’re protected from the flu because we don’t have that available right now.

Chuck Gaidica: And pneumonia, anything else that we should be thinking about, especially as we head into the fall and winter, vaccines for anything else beyond flu?

Kelly DeJager: Yeah. So that is one that is given to both children and adults. So if you are not sure if you’ve had it or not the pneumonia vaccine before that would be something to contact your doctor about or pharmacist and see where you are in the schedule and if it would be part of that. And then, there’s some data that has come out too just as how far behind Michigan was itself in vaccines and we’ve seen a huge drop in vaccines in children under two, just with the outcome of COVID-19. I think as much as 15% decrease from April of 2020 compared to ’19.

Kelly DeJager: And there’s just a few statistics that I wanted to give off that I hold from a website called I Vaccinate, which was created to educate new moms, the importance of vaccines. So it stated that before vaccines were around, parents in the United States could expect that polio would paralyze 10,000 children, the pertussis or whooping cough would kill 8,000 infants. Measles would infect 4 million children, killing about 500. So these are kind of the reality of what we kind of already talked about, what would happen if we didn’t vaccinate, some things that we could see.

Chuck Gaidica: And what you’re saying, I’m listening to you say this, because of the COVID, a lot of people just weren’t taking their youngsters to the doctor to get the vaccine. Is that what it is, they pulled back?

Kelly DeJager: Yeah. Unfortunately, rightfully so, some offices had to close for a period of time in order to figure out what are we going to do with COVID-19. So we’ve been encouraging at Blue Cross, our members to reach out to their doctor to find out what they have in place. As I mentioned, they’ve done creative things with having your waiting room be in your car so that they don’t have a waiting room anymore. You come into the office and they take a temperature. To try and also limit the number of people that are coming into the visit, so maybe if you’re able to just have one parent take the child instead of both parents so that you’re limiting the people that have to come in contact. But yeah, definitely, I think it was part out of necessity of what was happening and then part out of some fear of parents.

Kelly DeJager: And even another tidbit or point, we’ve heard a lot about schools, what schools are doing as far as if they’re going virtual or going back, and I would encourage parents, even if you’re falling the strictness of social distancing and not leaving the house once, things will get back to normal. And when they do, you want to make sure that your child is protected. So that’s so important to make sure that they’re caught up on those.

Chuck Gaidica: Yeah. Staying up-to-date, and pack your patients even if you have to make a doc appointment a little farther down than you thought you had to in terms of your calendar, just make sure you’re up-to-date.

Kelly DeJager: Yeah. Like I said, I would contact your child’s pediatrician because I know that they do want to vaccinate.

Chuck Gaidica: Well, Kelly DeJager, thank you so much for being with us. Kelly’s a clinical pharmacist at Blue Cross Blue Shield of Michigan. I suspect we’ll talk again as we start to hear about vaccinations, which I can’t imagine we won’t by the end of this year, into next year, hopefully. So thanks so much for all your input and your knowledge, Kelly.

Kelly DeJager: Thank you, Chuck.

Chuck Gaidica: Take good care of yourself and be well. We want to thank everybody for listening. This has been A Healthier Michigan Podcast. It’s brought to you by Blue Cross Blue Shield of Michigan. And if you like our show, you want to know more, you can check it out online, ahealthiermichigan.org/podcast. You can leave reviews and ratings on Apple Podcast or Stitcher, and you can get all the new episodes and all the old episodes. I mean, today was episode 61 so there’s a lot of good stuff available. You can take this with you on your smartphone, your tablet. So be sure to subscribe to us on Apple Podcast, Spotify, or your favorite podcast app. I’ll say it again, be well. I’m Chuck Gaidica.