Against the Grain with Dr. Chad Edwards | Tulsa Sports Injury| Podcast 6 – Part 2

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Against the Grain with Dr. Chad Edwards | Tulsa Sports Injury| Podcast 6 – Part 2

Chad: The flu shot. Basically immunizations across the board, what we’re doing is we’re introducing some kind of antigen. An antigen is supposed to stimulate your immune system to develop specific antibodies so that you’re able to fight some kind of infection. Jonas Salk first came out with the first vaccine way back when. That made a very specific difference.

The idea of immunizations are that you prep the immune system, so when they do see an offender, they’re immediately able to ramp up the immune response. We can talk more about the geeky stuff on the immune system in some other podcast if there’s interest for that. You’re developing antibodies so that when you see this stuff, you’re ready to rock and roll. The flu shot is an immunization that is designed to stimulate your immune system in a very specific way against certain strains of the flu.

Bryan: Your own natural immune process to attach the flu virus.

Chad:  That’s correct. In concept, I’m a big advocate for that. I think that it makes a lot of sense in a lot of ways, in concept. There are definitely some things that it just doesn’t pan out quite that way when the rubber meets the road. What I’d like to do, with a lot of things I like to understand the why. Where do we come from? In order to understand the future, I think it’s best that we understand the past.

Bryan:  In other words, where did the vaccine originate?

Chad: Exactly. Basically, we had this big, massive flu pandemic in 1918-1919, influenza pandemic, and it killed, estimates are as high as 50 million people worldwide, so this was a big problem.

Bryan: Crazy to think about that.

Chad: Killed people. There’s a lot of fear associated with the flu and that’s understandable.

Bryan: Was it a stronger version of the flu or is it what we see today?

Chad: There’s what’s called virulence factors. If you remember from 2009, we had the swine flu which was predicted to cause a lot of deaths and we had a lot of people that got really sick from that. There’s different virulence factors and there’s hemagglutinin and there’s neuraminidase. It will be important to understand one of those, but basically you’ve got these proteins that are on the surface of the virus lipid envelope that make it more able to penetrate the respiratory epithelium in the cells and your respiratory tract so that it can get in and infect those cells and do what it does.

Some of them are more able to spread. They’re more transmissible. Some of them have higher virulence factors. Some of them are more able to make you really stinking sick. Some of them make you a little bit sick. When I say, “really stinking sick,” I’m talking ICU kind of sick, not like, “Holy crap, I feel bad.”

Bryan: Not like you and I get sick, which is for our wives, it’s almost like an ER clinic at home for guys.

Chad:  Exactly. Big flu pandemic in the late 19-teens and obviously that was occurring right about the same time as World War II. I’m an Army guy, so the U.S. military had a big, vested interest in making sure that their soldiers were healthy, so they definitely wanted to try and prevent something like this in the future. If your soldiers can’t go out and fight, then you’re national defense would definitely suffer. The military supported the development of a flu vaccine. They first studied this flu vaccine in 1944 and found that it did decrease episodes of febrile illness. In other words, illness with a temperature of greater than 99° Fahrenheit. That sounds good, but that’s not definitive.

There’s a concept that we need to understand and we’ll talk a little bit more about it as we go, but there’s absolute risk versus relative risk. These absolute risk reduction, relative risk reduction. We’ll talk about that. It will be a theme. As we go through scientific studies in the future, that will be a big theme. I don’t think we talked about that before in the first podcast.

Bryan: No, I don’t think we have, either. I agree.

Chad:  Basically absolute risk, I like to think about it in terms of winning the lottery. If you buy one lottery ticket, then your absolute chance, if you want to call that risk, your absolute chance or risk of winning the lottery would be like one in a million or one in a bazillion or whatever it is. If you buy two lottery tickets, your chances are two in a million, but that’s absolute risk or absolute chance.

Relative risk is if you buy two tickets, you’ve doubled your chances. You have a 100% increase in your chances of winning the lottery. Conversely, if you only buy one, you’ve got your chances by 50%. Those are true and accurate numbers, but it’s skewed. It makes you think, “Well, crap, I don’t want to cut my chances in half.” Or, “I do want to cut my risk in half,” but you’re talking about something that’s one in a million or two in a million, so really small chances. A lot of data is reported in this-

Bryan: Dumb and Dumber. You’re saying there’s a chance.

Chad: Exactly.

Bryan: You’re saying there’s a chance.

Chad: Okay, this relative risk stuff, it’s very common and we’ll be talking more about that. They found that it did decrease incidents of these febrile illnesses, but a subsequent evaluation that they looked at in 1947, found that the incidents of disease was no different in vaccinated and un-vaccinated individuals. Basically, if you get the vaccine or you don’t get the vaccine, it didn’t make any difference on whether or not you got the flu. That’s what they noted in 1947.

Bryan: Interesting. That’s very interesting. Is this the same, pretty much, clinical vaccination as what they had in the 1940’s that we take today, would you say?

Chad: Things definitely developed. We’ve learned more, we’ve refined techniques, those kinds of things, so I would argue without knowing exactly what they used, I would argue that we’re more effective today than we were back then.