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Aliya Shabbir
Honors 205A
November 12, 2018
Inquiry Paper Two

Needles, Blood, and Everything in Between

Suzy sat in and buckled in her car seat, crying as her mother revved the engine and steered

the car out of the driveway. Upon arriving at the doctor’s office, she was no less consoled – the

sights and sounds of the waiting room reminded her of all the previous times she visited, from

annual check-ups to blood draws to vision and hearing tests. As the nurse calls her into the exam

room and asked her to sit on the examination table, Suzy’s anxiety worsens and her heart beat

faster. She knows what is coming next. The nurse explains the procedure to Suzy’s mother, who

nods her head in agreement. Afterwards, she pulls out an intimidating needle, stopping to first

wipe Suzy’s arm with an alcohol pad. “Brace yourself,” she warns, and Suzy winces as the nurse

quickly pushes the syringe, inserting the needle in her arm. “3, 2, 1, ….”. After shutting her eyes

tightly, Suzy wobbles her head left and right from feeling a little nauseous and dizzy. She

focuses her thoughts on the needle being inserted into her arm. Suzy feels herself swirling around

and opens her eyes as she lands in an unfamiliar place, surrounded by red circles and liquid.

“Welcome to your body’s immune system!” A voice shouts from behind, causing Suzy to

jump. “My name is Emily, and today I’ll be travelling with you through a tour of your shot and

how it works in your body. Grab a seat in the mobile, sit tight, and get ready to learn!”

Suzy sits in the center of the second row, afraid of what’s to come in this unfamiliar place.

The engine of the mobile is turned on, and Suzy and Emily are flown off within her body.

Emily turns on a switch in the mobile, and a deep voice emerges from a loudspeaker above.

“Again, welcome to your body! My name is Chris and I will be your virtual tour guide
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throughout your ride. Feel free to pause this recording or stop your mobile at any time to ask

Emily if you have any questions.”

Chris continues as the mobile zooms into Suzy’s blood. “Although they may appear scary or

dangerous at first glance, vaccines play an important role in keeping us all healthy and safe.

Throughout childhood, we are required to have an average of 24 shots, mostly to keep us in

school or in the workplace. Vaccines protect us from some of the world’s most life-threatening

illnesses, such as polio, smallpox, HPV, chickenpox, measles, tetanus, and influenza (the flu).

But how exactly do vaccines work against these diseases? Why do we need them so much,

especially as children? Stick around, and you’ll find out!”

Blood Cells Come in Three Different Forms

“To understand how and why vaccines work, it’s important to first recognize how the body’s

immune system fights off diseases without help. The human body can be divided into trillions of

cells, small pieces of matter floating around us, which are also known as the building blocks of

life. Cells have many different parts and functions, ranging from providing structure to our body

to giving us energy from eating food. Within our blood, there are three specific types of cells that

work to fight off infection: red blood cells, white blood cells, and platelets. Red blood cells, to
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your right, mainly carry oxygen to tissues and organs, while white blood cells serve to fight

infection. White blood cells, on your left, exist in three different forms, as macrophages,

lymphocytes, and t-lymphocytes, each of which serve a separate purpose in defending the body

and fighting germs or other infections.”

Macrophage Using Phagocytosis to Absorb a Pathogen

“Now, let’s explore the different types of white blood cells in detail. Macrophages, also

known as “big eaters,” are a type of white blood cell that digests and destroys bacteria and other

harmful organisms, or individual life forms, that infect our body. This process is called

phagocytosis, and it begins with macrophages first detecting harmful organisms through a

combination of “toll-like receptors” on their surfaces. These objects warn the macrophage that an

invader is arriving and give time for the macrophage to prepare its defense. When the invader, or

pathogen, finally arrives at the macrophage, the macrophage traps and digests it, ultimately

processing the pathogen and releasing it as waste so that it cannot come into and harm the body

again. To make this simpler, imagine if you ended up eating all the undesirable food on your

plate, such as Brussel sprouts or broccoli. If you were a macrophage going through phagocytosis,

you would be inactivating the “threatening” nature of those vegetables (such as their bland taste)

by swallowing them and removing them from your immediate environment. Weird, right?”
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B Cell Using Antibodies Against a Pathogen’s Antigen

“In addition to macrophages, B lymphocytes, more commonly known as B cells, are another

type of white blood cell. B cells are defenders, with each one fighting specific types of germs or

infections. They are mainly located in our bones (in a big group of cells called bone marrow) but

work with other cells to make sure their effects spread to the rest of the body. When the body is

infected with a particular type of bacteria or germ, B cells will recognize it through the

pathogen’s antigens. Antigens are substances that make up the pathogen to which the B cell

detects and plans a response to the threat. In some diseases, antigens are part of the macrophage

itself, but for vaccines or external diseases, they are mainly found in the pathogen. With the help

of T lymphocytes or T cells, another type of white blood cell, B cells produce something called

an antibody. Antibodies circulate and attach themselves to the antigen like a lock and key,

destroying and preventing it from harming the body. We can apply the interaction between an

antibody and antigen into our everyday lives. For example, if you pick up trash off the floor and

do not drop it, you would be preventing it from tarnishing or ruining anything around you. Just

like the antibody binds itself to the antigen before destroying it, you would be holding the trash

before throwing it away.”

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The mobile travels through a cluster of large, puffy blue cells. Emily gestures to the right,

predicting what Chris will explain next.

“T lymphocytes, or T cells, are another type of white blood cell that perform many

functions, but mainly help the B cell respond to antigens within pathogens infecting the body.

With these helper T cells, B cells can respond to every type of pathogen and help our bodies

tolerate the presence of disease. This is because unlike B cells, T cells come from the bone but

travel to other parts of the body and can therefore identify more antigens. T cells also serve an

important purpose as “memory cells,” as they remember all the antigens of the pathogens they

have encountered before. This means that when the body is presented with that infection again,

the memory T cells will direct B cells to produce more antibodies and exterminate it much more

quickly because it has recognized that pathogen’s antigen. Our brains can have the same abilities

as memory T cells. Similar to how we can solve a difficult math problem more quickly after

practicing it multiple times, our memory T cells learn to rapidly respond to familiar threats.”

Suzy pauses the recording and turns to Emily. “But how do all these B cells and T cells relate

to vaccines?”

Emily pauses before responding. “Good question! Vaccines are created using the body’s

immune response. When injected into the human body, vaccines serve as a weaker version of the

infection they are attempting to remove. For instance, the polio vaccine follows the path of the

natural polio virus and attempts to destroy the same groups of cells. Most of the time, these shots

would be administered directly to your arm or thigh because they have the most muscle cells.

The more muscle there is, the greater the amount of blood that can flow, which allows the

pathogen in the vaccine to spread faster. Because a vaccine is a disease, you might feel as if you

had a cold or a fever, simply because those are the signs of any infection. These symptoms are
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also why no one can receive a vaccine while they are already sick. The effects are extremely

unpredictable, and you will likely end up feeling much worse because there are already multiple

infections in your body.”

“However, if you are perfectly healthy, feeling slightly ill after receiving a shot is normal and

temporary, as this weaker infection is supposed to trigger the body’s natural response. The

physical effects of a vaccine’s natural response, including coughing or headaches, can last from a

couple hours to a couple days. Again, this is when B cells, with the help of T cells, produce

antibodies in response to the vaccine’s antigens. Just as in the natural infection response, some of

these T cells will become memory cells, which remain to recognize the disease’s antigens.

Memory cells allow for a faster production of antibodies by B cells, which effectively eliminate

the disease by binding to the antigens. So, if you happened to get in contact with the real virus,

your body would eliminate it faster because her memory cells have experience with that infection

already. Memory cells are also why vaccines work so well – in case you encounter the actual

virus, your body would be able to extinguish it much faster before it can seriously harm you.”

“Does that make sense?”

Vaccines Mimic a Natural Infection and the Body’s Response to It

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Suzy nods and continues the recording. “There are many types of vaccines, with each

differing depending on how it is produced, the infections it prevents, and how the human body

responds to it. Most come as live vaccines, which fight viruses and bacteria by becoming the

infection itself, as discussed earlier. They teach the body how to defend itself if an actual

infection strikes. Because it replicates the actual pathogen, the live vaccine is very strong and

produces many memory cells, therefore allowing one shot to last a lifetime. Some examples of

live vaccines include measles, mumps, rubella (MMR), chicken pox, and rotavirus vaccines.

However, one concern with live vaccines is the potential for the weak virus to change itself and

cause illness rather than prevent it. Scientists are working to solve this through creating different

types of vaccines.”

“Another type of vaccine is the inactivated or “killed” vaccine, which kills the germs before

the vaccine is inserted by heating it to a very high temperature. When taken, live vaccines

weaken the body’s response because the body’s initial immune response to it was not strong in

itself. The good news is that because they are not the live virus itself, inactivated vaccines carry

little to no risk of harming anyone. However, this also means that inactivated vaccines provide a

small amount of protection and require multiple doses for our long-term health. The limited

protection of an inactivated vaccines is why you are required to show up to the doctor’s office

every few months for another “booster” dose of the same shots. The most commonly used

inactivated vaccines today are the polio and Hepatitis A vaccines.”

“Toxoid vaccines, on the other hand, are designed to prevent diseases caused by a type of

cells called bacteria. These vaccines are created by inactivating the poison produced by toxic

bacteria. When inserted, toxoid vaccines produce the same response as an inactivated vaccine,

but only work to remove the poison, not the entire bacteria. As a result, they are safer than live
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vaccines but require booster shots. Toxoid vaccines are in a sweet spot where they weaken the

poison so that it cannot make us sick but can also allow our bodies to fight off the natural poison.

The DTaP vaccine, a combination of diphtheria and tetanus, is a type of toxoid vaccine to avoid

whooping cough and other deadly diseases. Because the vaccine is weak, children are required to

take it 5 times before the age of 7. Afterwards, many children take a modified version of this

vaccine before starting middle school at age 11.”

“Subunit vaccines, like inactivated and toxoid vaccines, do not contain a live virus.

However, they differ in that they only contain pieces of the bacteria or germ they are protecting

against. These pieces contain the essential antigens for each pathogen, making it easier for B

cells to identify them and respond quickly using antibodies and memory cells. These small

amounts of the pathogen mean that the subunit vaccine is less likely to cause severe illness or

any other side effects. Therefore, a subunit vaccine can be administered to children with

undeveloped or weak immune systems, such as those undergoing cancer, because the risk for

disease is very low. Children and teenagers in the US are required to take subunit vaccines such

as the Hepatitis B and HPV vaccines multiple times before adulthood.”

“The fifth and final type of vaccine is the conjugate vaccine, which is created using different

pieces of bacteria. However, instead of containing antigens, these pieces are from the outer

coating of bacteria. Some forms of bacteria deviously cover themselves with a thick shell to

mask themselves from our body’s defenses. To combat this deceptive coating, conjugate

vaccines come with special biological materials called “proteins”. These specific proteins allow

our bodies to detect the extra coating and prepare a strong immune response. Conjugate vaccines

are especially strong because they come with technology that binds the proteins tightly to the

outer coating, and the pathogen can be removed more quickly. This technology can be thought of
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in a simpler way. For example, if you are looking for your mom after school in the crowded

school parking lot, you will have difficulty looking for her because she may be sitting inside her

car. Therefore, you look to recognize the car she is surrounded in, not your mom herself.

Conjugate vaccines work in the same way, looking to recognize the outer coating rather of a

pathogen rather than the antigen itself. Because they offer heavy protection, conjugate vaccines

are often given to infants and young children. For example, children under the age of 5 take the

Hib vaccine to prevent a bacterial disease that damages the brain and lungs.”

“While you may not recognize the Hib, MMR, or dTaP vaccines, you are probably familiar

with the flu vaccine, which you are receiving today. Influenza, also known as the “flu,” is a virus

that attacks the lungs, nose, and throat and can cause cough or fever. It spreads easily from

person to person through touching or simply sharing drinks, but it can also be prevented using a

seasonal flu vaccine. The flu shot applied through a needle is an inactivated vaccine, which

provides a weaker response to the virus but still produces antibodies in our B cells to fight off the

infection. This vaccine is commonly administered right before the flu virus is frequently

circulating, from October to February. The flu virus is unique in that it changes every year

depending on the type of antigens present. Because these antigens are always changing, the

antibodies our body uses to fight the old virus will no longer work, and we can get sick again.

The seasonal flu vaccine, therefore, changes every year depending on the types of antibodies

present in that year’s flu virus. This is why it is strongly recommended that anyone 6 months or

older gets a new flu shot as each new virus spreads.”

The mobile slows down to a stop. Suzy looks over to Emily, waiting for a signal to open the

door and leave. However, Emily remains still and nods towards the loudspeaker.
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“Vaccines are the miracles of the modern era. Over the past century, scientists have been able

to create vaccines that fight and eradicate the world’s deadliest diseases. For example, through

the creation of vaccines among other factors, our life spans have shot up by 40 years. In fact, the

measles vaccine is thought to have prevented over 1 million deaths every year. If more people

worldwide get vaccinated, the chances of an outbreak of any of these diseases is low because the

virus cannot spread, and patients can recover quickly.”

“Because these vaccines grant us the basic health, safety, and security to survive, they allow

for humans to focus on other challenges in the world. For example, innovative technologies like

smartphones or virtual reality or self-driving cars exist because people have the time and energy

to devote to research. We can create powerful and uplifting artwork including movies, television,

music, poetry, or literature when we have the luxury of not worrying about our health.”

“How does –?” But before Suzy has the chance to finish asking her question, her body starts

swirling. She flickers her eyes and falls out of her daze, finding herself back in the nurse’s exam

room. The vaccine is still being applied as if no time had passed since before Suzy’s adventure.

The nurse gently removes the needle from Suzy’s arm, wiping and covering the scar with a Hello

Kitty Band-Aid.

“That wasn’t so bad, was it?” asks the nurse. Suzy nods her head and breathes a sigh of

relief as the nurse packs her supplies. “Now before you leave, I just need your mom to sign a

couple forms. Other than that, you’re good to go. I look forward to seeing you again next year

for a new flu shot!”

Suzy’s mother hurriedly signs the forms and the two walk together back to the car. Suzy’s

mother smiles at Suzy before getting into the driver’s seat. “So, do you think you are more

comfortable with shots now?”

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Suzy laughs to herself. “A little too comfortable.”

Works Cited*

“Red Blood Cells.” The Franklin Institute, 19 May 2017, www.fi.edu/heart/red-blood-cells.

“Phagocyte-Macrophage Phagocytosis Diagram.” PNG,

www.kisspng.com/png-phagocyte-macrophage-phagocytosis-diagram-lymphocy-

6315397/

“Vaccines.” EUPATI, EUPATI, 19 Apr. 2017, www.eupati.eu/types-of-medicines/vaccines/.

“Antibodies: MedlinePlus Medical Encyclopedia Image.” MedlinePlus, U.S. National Library of

Medicine, www.medlineplus.gov/ency/imagepages/9069.htm.

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*for images only