Tag Archives: vaccination

Carvings July 1, 2026

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In the news

The exercise-cancer connection

            Physicians have recognized for decades that persons who engage in regular, moderately intense exercise have lower rates of cancer than non-exercisers. There are two reasons for this. First, exercise strengthens the immune system that can snuff out abnormal cells before they can multiply and produce cancer.

            Another reason is that exercisers do not become overweight or obese, whereas fat deposits produce two cancer-promoting factors, estrogen and inflammatory chemicals. Obesity, in fact, is associated with at least fourteen different types of cancer.

            In recent years, cancer specialists have become aware that exercise keeps cancer from returning in those who have received treatment. In 2024 the International Society of Exercise Oncology was formed to help organize the more than 2100 cancer exercise programs in the United States and to further their expansion.

            As I have noted numerous times in these posts, regular, moderately intense exercise is a fundamental requirement for good health. Yet, only about twenty percent of Americans exercise at least four or five times a week. The majority do not exercise at all. If those 80-20 numbers could be reversed cancer would no longer be the second leading cause of death, and deaths from heart disease and stroke would plummet as well.

Lifestyle

            In the early decades of my pediatric career I treated children for diseases that are virtually absent today. They ranged from common ear infections to infrequent but devastating meningitis, from uncomfortable mumps to sometimes fatal measles. Vaccines deservedly get the credit for the near elimination of those heartbreaking illnesses. Unfortunately the anti-vaccination movement is tragically undoing some of these advances, as shown by the surge in measles and whooping cough in recent years.

            One group of vaccines that is available for adults as well as children is the pneumococcal vaccine. A major cause of ear infections (otitis media) in children and pneumonia in adults and children is a bacterium called Streptococcus pneumoniae, commonly called the pneumococcus.

            The first attempts at creating a pneumococcal vaccine began over a hundred years ago but it wasn’t until the 1980s that a truly effective vaccine became available. Methodological advances and the vagaries of the bacterium itself have led to numerous formulations, each one capable of thwarting more and more strains.

            Use of the vaccine in children has led to a significant decline in the incidence of ear infections and a marked reduction in pneumonia, meningitis and blood stream infections. The adult vaccine has sharply reduced the incidence of pneumonia in adults. Widespread use of the pneumococcal disease in children has led to the emergence of herd immunity among adults. 

            The effectiveness of the pneumococcal vaccine and the absence of significant side effects should encourage every adult over the age of 65 to receive it but only about seventy percent of seniors have done so. Universal acceptance would almost completely eliminate pneumonia in the elderly population, a condition once described by Sir William Osler as “the old man’s friend”. Before the availability of antibiotics, pneumonia, often caused by the pneumococcus, quickly and relatively gently ended the lives of older persons who would otherwise have suffered through weeks or months from diseases such as cancer, stroke or heart failure.

            Because the vaccine has undergone so many changes since 2000, persons who received the vaccine several years ago should consult with their physician regarding the need for another dose. We no longer need the old man’s friend

Carvings February 1, 2025

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Why vaccines fail

            One of the major factors in the steep rise in life expectancy that occurred between 1900 and 2000 was the development of childhood vaccines. Today’s young physicians may never see a child with measles, polio, some forms of bacterial meningitis or chickenpox. Even the oldest physicians among us have likely never seen a child dying agonizingly from whooping cough or tetanus or diphtheria, those diseases having been vanquished before World War Two. If these diseases occur in the United States – and they do sometimes – it is usually because the patient came from a country where medical care is poor and immunization rates are much lower than they are here, or because parents have been caught up in the anti-vaxx hysteria that has been increasingly common in the twenty-first century.

            But sometimes a vaccine does fail to provide infection from the disease that almost always prevents the disease against which it is targeted. One reason is that some vaccines must be kept at specified refrigerator temperatures. When the measles vaccine was released in 1963 pediatricians noted occasionally that vaccinated children developed measles. Investigation showed that some pediatricians’ staff had placed the vaccine on a door shelf of the refrigerator instead of deep inside, which had been recommended. The slight increase in the temperature of vials kept on the door shelf was high enough to weaken the live vaccine, rendering it ineffective. The oral polio vaccine, a live form developed by Albert Sabin, has the advantage of not requiring needles and syringes that are prohibitively costly in developing countries, but it requires a “cold chain” that is also expensive in order to prevent degradation of the vaccine.

            Children who are born with a severe immune deficiency or those whose immune system is weakened by chemotherapy will not respond to the stimulus of a vaccine agent. Obesity may be a factor in the adult population, not only because obesity or its accompaniment, type 2 diabetes, degrades the immune system but because ordinary-length needles fail to reach the muscle tissue deep within a layer of fat. The result is that the patient cannot develop adequate antibodies or immune cells.

            Vaccines vary tremendously in their duration of protection. Diphtheria and tetanus vaccines provide nearly lifelong immunity but the mumps virus fails to protect after just a few years. The disturbing occurrence of numerous mumps outbreaks among young adults has prompted a reevaluation of that vaccine. Yet more evidence that mother nature keeps throwing curveballs!