Herd immunity | Romina Libster | TEDxRíodelaPlata
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0:23 - 0:27One of the first patients
I had to see as a pediatrician was Sol, -
0:27 - 0:30a beautiful month-old baby
-
0:30 - 0:34who was admitted with signs
of a severe respiratory infection. -
0:34 - 0:38So far, I had never seen
a patient worsen so fast. -
0:39 - 0:42In just two days
she was connected to a respirator -
0:42 - 0:45and on the third day she died.
-
0:45 - 0:47Sol had whooping cough.
-
0:47 - 0:52After discussing the case in the room
and after a quite distressing catharsis, -
0:52 - 0:55I remember my chief resident said to me,
-
0:55 - 0:58"OK, take a deep breath, wash your face,
-
0:58 - 1:01and now comes the hardest part,
-
1:01 - 1:03we have to go talk to her parents."
-
1:04 - 1:08At that time,
a thousand questions came to mind. -
1:08 - 1:12From: "How a month-old baby
could be so unfortunate? -
1:13 - 1:16To: "Could we have done
something about it?" -
1:17 - 1:20Before vaccines existed,
-
1:20 - 1:25many infectious diseases
killed millions of people per year. -
1:25 - 1:29During the 1918 flu pandemic
-
1:29 - 1:3250 million people died.
-
1:32 - 1:35That's greater
than Argentina's current population. -
1:35 - 1:39Perhaps, the older ones among you
remember the polio epidemic -
1:39 - 1:42that occurred in Argentina in 1956.
-
1:42 - 1:46At that time, there was no vaccine
available against polio. -
1:46 - 1:48People didn't know what to do.
They were going crazy. -
1:48 - 1:50They would go painting trees with lime.
-
1:50 - 1:53They would put camphor bags
inside their children's clothes -
1:53 - 1:56as if that could do something.
-
1:56 - 2:01During the polio epidemic
thousands of people died. -
2:01 - 2:05And thousands of people were left with
very important neurological damages. -
2:07 - 2:09I know this because I read about it,
-
2:09 - 2:13because thanks to vaccines
my generation was lucky -
2:13 - 2:16to not live through an epidemic
as terrible as this. -
2:16 - 2:21Vaccines are one of the great successes
of the twentieth century's public health. -
2:21 - 2:23After drinking water,
-
2:23 - 2:27they are the interventions
that have most reduced mortality, -
2:27 - 2:29even more than antibiotics.
-
2:30 - 2:35Vaccines eradicated from the planet
terrible diseases such as smallpox -
2:35 - 2:38and succeeded
in reducing mortality significantaly -
2:38 - 2:40due to other diseases such as measles,
-
2:40 - 2:44whooping cough, polio and many more.
-
2:45 - 2:48All these diseases are considered
-
2:48 - 2:52Vaccine-preventable diseases.
-
2:52 - 2:54What does this mean?
-
2:54 - 2:57That they are potentially preventable,
-
2:57 - 3:00but in order to be so,
something must be done. -
3:00 - 3:02You need to get vaccinated.
-
3:02 - 3:06I imagine that most,
if not all of us here today, -
3:06 - 3:09received a vaccine
at some point in our life. -
3:11 - 3:15Now, I'm not so sure that many of us know
-
3:15 - 3:19which vaccines or reinforcements
we should receive after adolescence. -
3:21 - 3:25Have you ever wondered
who we are protecting -
3:25 - 3:27when we vaccinate?
-
3:27 - 3:29What do I mean by that?
-
3:29 - 3:34Is there any other effect
beyond protecting ourselves? -
3:35 - 3:37Let me show you something.
-
3:38 - 3:40Imagine for a moment
-
3:40 - 3:42we are in a city
-
3:42 - 3:45that has never had a case
of a particular disease, -
3:45 - 3:47such as measles.
-
3:47 - 3:52This would mean that in this city no one
has ever had contact with the disease. -
3:52 - 3:57No one has either the natural defenses
nor been vaccinated against measles. -
3:58 - 4:02If one day, a person ill with measles
appears in this city -
4:03 - 4:07the disease won't find much resistance
-
4:07 - 4:09and will begin spreading
from person to person, -
4:09 - 4:13and in no time it will disseminate
throughout the community. -
4:14 - 4:16After a certain time
-
4:16 - 4:19a big part of the population will be ill.
-
4:20 - 4:24This happened when there were no vaccines.
-
4:25 - 4:29Now, imagine the complete opposite case.
-
4:29 - 4:32We are in a city
-
4:32 - 4:35where more than 90 percent
of the population -
4:35 - 4:37has defenses against measles.
-
4:37 - 4:41It means that they've had the disease,
and generated natural defenses. -
4:41 - 4:45They either survived,
or were immunized against measles. -
4:45 - 4:47And one day,
-
4:47 - 4:51a person sick with measles
appears in this city. -
4:51 - 4:55The disease will find much more resistance
-
4:55 - 4:58and won't be transmitted
that much from person to person. -
4:59 - 5:02The spread will probably remain contained
-
5:03 - 5:06and a measles outbreak won't happen.
-
5:07 - 5:10I would like you
to pay attention to something. -
5:11 - 5:13People who are vaccinated
-
5:13 - 5:16not only are protecting themselves,
-
5:16 - 5:20but by blocking the dissemination
of the disease -
5:20 - 5:22within the community
-
5:22 - 5:26they are indirectly protecting
the people from this community -
5:26 - 5:28who are not vaccinated.
-
5:29 - 5:32They create a kind of protective shield
-
5:32 - 5:35which prevents from getting in contact
with the disease, -
5:35 - 5:37so that these people are protected.
-
5:39 - 5:42This indirect effect of protection
-
5:42 - 5:45which unvaccinated people have
within a community, -
5:45 - 5:49simply by being surrounded
by vaccinated people, -
5:50 - 5:53is called herd immunity.
-
5:55 - 5:58Many people in the community
-
5:58 - 6:01depend almost exclusively
on this herd immunity -
6:01 - 6:04to be protected against disease.
-
6:05 - 6:08These people displayed in infographics
are not just hypothetical. -
6:09 - 6:13These people are our nephews,
our children, -
6:13 - 6:16who may be too young
to receive their first shots. -
6:17 - 6:19They are our parents, our brothers,
-
6:19 - 6:21our acquaintances,
-
6:21 - 6:23who may have a disease,
-
6:23 - 6:26or receive medication
which lowers their defenses. -
6:28 - 6:32There are also people
allergic to a particular vaccine. -
6:33 - 6:36They could even be among us,
-
6:36 - 6:38any of us who got vaccinated,
-
6:38 - 6:41but the vaccine
didn't produce the expected effect. -
6:41 - 6:46Because not all vaccines
are always 100 percent effective. -
6:46 - 6:50All these people depend almost exclusively
-
6:50 - 6:53on herd immunity
to be protected against diseases. -
6:54 - 6:59To achieve this effect of herd immunity,
-
6:59 - 7:04it is necessary that a large percentage
of the population is vaccinated. -
7:04 - 7:08This percentage is called threshold.
-
7:08 - 7:11This threshold depends on many variables.
-
7:11 - 7:14It depends on the germ's characteristics,
-
7:14 - 7:18and those of the immune response
that the vaccine generates. -
7:18 - 7:20But they all have something in common.
-
7:20 - 7:26If the percentage of the population
in a vaccinated community -
7:26 - 7:29is below this threshold number,
-
7:29 - 7:33the disease will begin
to spread more freely -
7:33 - 7:36and may generate an outbreak
-
7:36 - 7:38of this disease within the community.
-
7:38 - 7:40Even diseases
-
7:40 - 7:45which at some point were controlled
may reappear. -
7:47 - 7:49This is not just a theory.
-
7:49 - 7:51This happened and is still happening.
-
7:53 - 7:58In 1998, a British researcher
published an article -
7:58 - 8:01in one of the most important
medical journals, -
8:01 - 8:03saying that the MMR vaccine,
-
8:03 - 8:06which is given for measles,
mumps and rubella, -
8:06 - 8:08was associated with autism.
-
8:08 - 8:10This generated an immediate impact.
-
8:11 - 8:16People began to stop getting vaccinated,
and stop vaccinating their children. -
8:16 - 8:17And what happened?
-
8:17 - 8:20The number of people vaccinated,
-
8:20 - 8:24in many communities around the world,
fell below this threshold. -
8:24 - 8:28And there were outbreaks of measles
in many cities in the world. -
8:28 - 8:30In the U.S., in Europe.
-
8:30 - 8:32Many people got sick.
-
8:32 - 8:35People died of measles.
-
8:36 - 8:37What happened?
-
8:37 - 8:41This article also generated a huge stir
within the medical community. -
8:42 - 8:46Dozens of researchers began to assess
if this was actually true. -
8:47 - 8:50Not only could no one find
-
8:50 - 8:56a causal association between MMR
and autism at the population level, -
8:56 - 9:01but it was found that this article
had incorrect claims. -
9:01 - 9:03Even more, it was fraudulent.
-
9:04 - 9:07It was fraudulent.
-
9:07 - 9:11In fact, the journal publicly retracted
-
9:11 - 9:14from this article in 2010.
-
9:15 - 9:19One of the main concerns and excuses
for not getting vaccinated -
9:19 - 9:21are the adverse effects.
-
9:22 - 9:25Vaccines, like other drugs,
-
9:25 - 9:28can have potential adverse effects.
-
9:28 - 9:30Most are mild and temporary.
-
9:30 - 9:33But the benefits are always greater
-
9:33 - 9:36than possible complications.
-
9:38 - 9:40When we are ill,
-
9:40 - 9:42we want to heal fast.
-
9:42 - 9:44Many of us who are here
-
9:44 - 9:48take antibiotics
when we have an infection, -
9:48 - 9:51We take anti-hypertensives
when we have high blood pressure; -
9:51 - 9:53we take cardiac medications.
-
9:53 - 9:57Why? Because we are sick
and we want to heal fast. -
9:57 - 9:59And we don't question it much.
-
9:59 - 10:03Why is it so difficult
to think of preventing diseases, -
10:04 - 10:07by taking care of ourselves
when we are healthy? -
10:07 - 10:10We take care of ourselves a lot
when affected by an illness, -
10:10 - 10:13or in situations of imminent danger.
-
10:14 - 10:17I imagine most of us here,
-
10:17 - 10:21remember the influenza A pandemic
-
10:21 - 10:24which broke out in 2009
in Argentina and worldwide. -
10:24 - 10:28When the first cases
began to come to light, -
10:28 - 10:31we, here in Argentina,
were entering the winter season. -
10:32 - 10:34We knew absolutely nothing.
-
10:34 - 10:36Everything was a mess.
-
10:36 - 10:41People wore masks on the street,
ran into pharmacies to buy alcohol gel. -
10:41 - 10:44People would queue in the pharmacies
to receive a vaccine, -
10:44 - 10:47without even knowing
if it's the right vaccine -
10:47 - 10:49that would protect them
against this new virus. -
10:49 - 10:52We knew absolutely nothing.
-
10:52 - 10:55At that time, in addition to doing
my research scholarship -
10:55 - 10:57at the Infant Foundation,
-
10:57 - 11:01I worked as a home pediatrician
for a prepaid medicine company. -
11:02 - 11:05I remember that I started
my shift at 8 am -
11:05 - 11:09and already I had a list
of 50 scheduled visits. -
11:09 - 11:12It was chaos,
people didn't know what to do. -
11:13 - 11:17I remember the types of patients
that I was examining. -
11:18 - 11:22The patients were a little older
than what we were used to see in winter, -
11:22 - 11:24with longer fevers.
-
11:24 - 11:28And I remember I told my mentor
at the research scholarship, -
11:28 - 11:32and he, for his part, had heard
the same from a colleague, -
11:32 - 11:34about the large number
of pregnant women -
11:34 - 11:36and young adults
-
11:36 - 11:38being hospitalized
in intensive care, -
11:38 - 11:41with clinical profiles
difficult to handle. -
11:43 - 11:46At that time,
we set out to understand -
11:46 - 11:48what was happening.
-
11:49 - 11:52Monday, early morning,
we took the car -
11:52 - 11:55and we went to a hospital
in Buenos Aires province, -
11:55 - 11:58that was supposed to be
a reference hospital -
11:58 - 12:01for cases of the new influenza virus.
-
12:01 - 12:04We arrived at the hospital,
it was crowded. -
12:04 - 12:07All health staff was dressed
in NASA-like bio-safety suits. -
12:07 - 12:10We – with face masks in our pockets.
-
12:10 - 12:12Just like a hypochondriac,
I didn't breathe for two hours. -
12:12 - 12:16But we could see what was happening.
-
12:16 - 12:19Immediately, we started reaching out
to pediatricians -
12:19 - 12:23from six hospitals in the city
and the Buenos Aires province. -
12:23 - 12:27Our main goal was to find out,
-
12:27 - 12:31how this new virus behaves
in contact with our children, -
12:31 - 12:33in the shortest time possible.
-
12:33 - 12:36A marathon work.
-
12:36 - 12:39In less than three months
-
12:39 - 12:45we could see what effect
this new H1N1 virus had -
12:45 - 12:51on the 251 children
hospitalized by this virus. -
12:52 - 12:56We could see which children
got more seriously ill: -
12:56 - 12:59children under four,
especially those less than one year old; -
12:59 - 13:02patients with neurological diseases,
-
13:02 - 13:05And young children
with chronic pulmonary diseases. -
13:05 - 13:10Identifying these risk groups
was important -
13:10 - 13:13to include them as priority groups
-
13:13 - 13:16in the recommendations
for getting the influenza vaccine, -
13:16 - 13:18not only here in Argentina,
-
13:18 - 13:22but also in other countries
which the pandemic not yet reached. -
13:23 - 13:25A year later,
-
13:25 - 13:30when a vaccine was available
against the pandemic H1N1 virus, -
13:30 - 13:32we wanted to see what had happened.
-
13:32 - 13:35After a huge vaccination campaign
-
13:35 - 13:38aimed at protecting risk groups,
-
13:40 - 13:42these hospitals,
-
13:42 - 13:47with 93 percent
of the risk groups vaccinated, -
13:47 - 13:51had not a single patient
-
13:51 - 13:53with the pandemic H1N1 virus.
-
13:53 - 13:57(Applause)
-
13:59 - 14:00In 2009:
-
14:00 - 14:02251.
-
14:04 - 14:05In 2010:
-
14:06 - 14:07Zero.
-
14:07 - 14:11Vaccination is an act
of individual responsibility, -
14:12 - 14:15but it has a huge collective impact.
-
14:17 - 14:21If I get vaccinated,
not only am I protecting myself, -
14:22 - 14:25but I am also protecting others.
-
14:26 - 14:28Sol had whooping cough.
-
14:30 - 14:32Sol was very young,
-
14:32 - 14:36and she hadn't yet received
her first vaccine against whooping cough. -
14:37 - 14:41I still wonder
what would have happened -
14:41 - 14:45if everyone around Sol
-
14:45 - 14:47had been vaccinated.
-
14:48 - 14:51(Applause)
- Title:
- Herd immunity | Romina Libster | TEDxRíodelaPlata
- Description:
-
This talk was given at a local TEDx event, produced independently of the TED Conferences.
Romina Libster shares a quite unknown view on the impact of vaccination: herd immunity. Romina Libster is a scientific researcher and has led a series of studies on viruses that cause respiratory illnesses, especially influenza H1N1.
- Video Language:
- Spanish
- Team:
- closed TED
- Project:
- TEDxTalks
- Duration:
- 15:06
Helene Batt edited English subtitles for Inmunidad colectiva | Romina Libster | TEDxRíodelaPlata | ||
Sebastian Betti edited English subtitles for Inmunidad colectiva | Romina Libster | TEDxRíodelaPlata | ||
Sebastian Betti edited English subtitles for Inmunidad colectiva | Romina Libster | TEDxRíodelaPlata | ||
Sebastian Betti approved English subtitles for Inmunidad colectiva | Romina Libster | TEDxRíodelaPlata | ||
Sebastian Betti edited English subtitles for Inmunidad colectiva | Romina Libster | TEDxRíodelaPlata | ||
Sebastian Betti edited English subtitles for Inmunidad colectiva | Romina Libster | TEDxRíodelaPlata | ||
Sebastian Betti edited English subtitles for Inmunidad colectiva | Romina Libster | TEDxRíodelaPlata | ||
Romina Pol edited English subtitles for Inmunidad colectiva | Romina Libster | TEDxRíodelaPlata |