How Are Vaccines Made?

Eugeneonline/iStock via Getty Images
Eugeneonline/iStock via Getty Images

Vaccines have long been hailed as one of our greatest public health achievements. They can be made to protect us from infections with either viral or bacterial microbes. Measles and smallpox, for example, are viruses; Streptococcus pneumoniae is a bacterium that causes a range of diseases, including pneumonia, ear and sinus infections, and meningitis. Hundreds of millions of illnesses and deaths have been prevented due to vaccines that eradicated smallpox and significantly reduced polio and measles infections. However, some misunderstanding remains regarding how vaccines are made, and why some scary-sounding ingredients [PDF] are included in the manufacturing process.

The production of our vaccines has evolved a lot since the early days, when vaccination was potentially dangerous. Inoculating an individual with ground-up smallpox scabs usually led to a mild infection (called "variolation"), and protected them from acquiring the disease the "regular" way (via the air). But there was always a chance the infection could still be severe. When Edward Jenner introduced the first true vaccination with cowpox, protection from smallpox became safer, but there were still issues: The cowpox material could be contaminated with other germs, and sometimes was transmitted from one vaccinated person to another, leading to the inadvertent spread of blood-borne pathogens. We’ve come far in the last 200 years.

There are different kinds of vaccines, and each requires different processes to move from the laboratory to your physician's office. The key to all of them is production of one or more antigens—the portion of the microbe that triggers a host immune response.

Live Attenuated Vaccines and Dead, "Inactivated" Vaccines

There are several methods to produce antigens. One common technique is to grow a virus in a cell culture. Typically grown in large vats called bioreactors, living cells are inoculated with a virus and placed in a liquid growth medium that contains nutrients—proteins, amino acids, carbohydrates, essential minerals—that help the virus grow in the cells, producing thousands of copies of itself in each infected cell. At this stage the virus is also getting its own dose of protective medicine: antibiotics like neomycin or polymyxin B, which prevent bacterial and fungal contamination that could kill the cells serving as hosts for the virus.

Once a virus completes its life cycle in the host cell, the viruses are purified by separating them from the host cells and growth media, which are discarded. This is often done using several types of filters; the viruses are small and can pass through holes in the filter that trap larger host cells and cell debris.

This is how "live attenuated vaccines" are created. These vaccines contain viruses that have been modified so that they are no longer harmful to humans. Some of them are grown for many generations in cells that aren't human, such as chicken cells, so that they have mutated to no longer cause harm to humans. Others, like the influenza nasal mist, were grown at low temperatures until they lost the ability to replicate in the warmer temperatures of the lungs. Many of these vaccines you were probably given as a child: measles, mumps, rubella, and chickenpox.

Live attenuated vaccines replicate briefly in the body, triggering a strong—and long-lasting—response from your immune system. Because your immune system kicks into high gear at what it perceives to be a major threat, you need fewer doses of the vaccine for protection against these diseases. And unlike the harmful form of the virus, it is extremely unlikely (because they only replicate at low levels) that these vaccines will cause the host to develop the actual disease, or to spread it to other contacts. One exception is the live polio vaccine, which could spread to others and, extremely rarely, caused polio disease (approximately one case of polio from 3 million doses of the virus). For this reason, the live polio virus was discontinued in the United States in 2000.

Scientists use the same growth technique for "killed" or "inactivated" vaccines, but they add an extra step: viral death. Inactivated viruses are killed, typically via heat treatment or use of a chemical such as formaldehyde, which modifies the virus's proteins and nucleic acids and renders the virus unable to replicate. Inactivated vaccines include Hepatitis A, the injected polio virus, and the flu shot.

A dead virus can't replicate in your body, obviously. This means that the immune response to inactivated vaccines isn't as robust as it is with live attenuated vaccines; replication by the live viruses alerts many types of your immune cells of a potential invader, while killed vaccines primarily alert only one part of your immune system (your B cells, which produce antibodies). That's why you need more doses to achieve and maintain immunity.

While live attenuated vaccines were the primary way to make vaccines until the 1960s, concerns about potential safety issues, and the difficulty of making them, mean that few are attempting to develop new live attenuated vaccines today.

Combination, Bacterial, and Genetically Engineered Vaccines

Other vaccines aren't made of whole organisms at all, but rather bits and pieces of a microbe. The combination vaccine that protects against diphtheria, pertussis, and tetanus—all at once—is one example. This vaccine is called the DTaP for children, and Tdap for adults. It contains toxins (the proteins that cause disease) from diphtheria, pertussis, and tetanus bacteria that have been inactivated by chemicals. (The toxins are called "toxoids" once inactivated.) This protects the host—a.k.a. you, potentially—from developing clinical diphtheria and tetanus disease, even if you are exposed to the microorganisms. (Some viruses have toxins—Ebola appears to, for example—but they're not the key antigens, so they're not used for our current vaccines.)

As they do when developing live attenuated or inactivated vaccines, scientists who create these bacterial vaccines need some target bacteria to culture. But because the bacteria don't need a host cell to grow, they can be produced in simple nutrient broths by vaccine manufacturers. The toxins are then separated from the rest of the bacteria and growth media and inactivated for use as vaccines.

Similarly, some vaccines contain just a few antigens from a bacterial species. Vaccines for Streptococcus pneumoniae, Haemophilus influenzae type B, and Neisseria meningitidis all use sugars that are found on the outer part of the bacteria as antigens. These sugars are purified from the bacteria and then bound to another protein to enhance the immune response. The protein helps to recruit T cells in addition to B cells and create a more robust reaction.

Finally, we can also use genetic engineering to produce vaccines. We do this for Hepatitis B, a virus that can cause severe liver disease and liver cancer. The vaccine for it consists of a single antigen: the hepatitis B surface antigen, which is a protein on the outside of the virus. The gene that makes this antigen is inserted into yeast cells; these cells can then be grown in a medium similar to bacteria and without the need for cell culture. The hepatitis B surface antigen is then separated from the yeast and serves as the primary vaccine component.

Other Ingredients in Vaccines (and Why They're There)

Once you have the live or killed viruses, or purified antigens, sometimes chemicals need to be added to protect the vaccine or to make it work better. Adjuvants, such as aluminum salts, are a common additive; they help enhance the immune response to some antigens by keeping the antigen in contact with the cells of the immune system for a longer period of time. Vaccines for DTaP/Tdap, meningitis, pneumococcus, and hepatitis B all use aluminum salts as an adjuvant.

Other chemicals may be added as stabilizers, to help keep the vaccine working effectively even in extreme conditions (such as hot temperatures). Stabilizers can include sugars or monosodium glutamate (MSG). Preservatives can be added to prevent microbial growth in the finished product.

For many years, the most common preservative was a compound called thimerosal, which is 50 percent ethylmercury by weight. Ethylmercury doesn't stick around; your body quickly eliminates it via the gut and feces. (This is different from methylmercury, which accumulates in fish and can, at high doses, cause long-lasting damage in humans.) In 2001, thimerosal was removed from the vaccines given in childhood due to consumer concerns, but many studies have demonstrated its safety.

Finally, the vaccine is divided into vials for shipping to physicians, hospitals, public health departments, and some pharmacies. These can be single-dose or multi-dose vials, which can be used for multiple patients as long as they're prepared and stored away from patient treatment areas. Preservatives are important for multi-dose vials: bacteria and fungi are very opportunistic, and multiple uses increase the potential for contamination of the vaccine. This is why thimerosal is still used in some multi-dose influenza vaccines.

Though some of the vaccine ingredients sound worrisome, most of these chemicals are removed during multiple purification steps, and those that remain (such as adjuvants) are necessary for the vaccine's effectiveness, are present in very low levels, and have an excellent track record of safety.

12 Creative Ways to Spend Your FSA Money Before the Deadline

stockfour/iStock via Getty Images
stockfour/iStock via Getty Images

If you have a Flexible Spending Account (FSA), chances are, time is running out for you to use that cash. Depending on your employer’s rules, if you don’t spend your FSA money by the end of the grace period, you potentially lose some of it. Lost cash is never a good thing.

For those unfamiliar, an FSA is an employer-sponsored spending account. You deposit pre-tax dollars into the account, and you can spend that money on a number of health care expenses. It’s kind of like a Health Savings Account (HSA), but with a few big differences—namely, your HSA funds roll over from year to year, so there’s no deadline to spend it all. With an FSA, though, most of your funds expire at the end of the year. Bummer.

The good news is: The law allows employers to roll $500 over into the new year and also offer a grace period of up to two and a half months to use that cash (March 15). Depending on your employer, you might not even have that long, though. The deadline is fast approaching for many account holders, so if you have to use your FSA money soon, here are a handful of creative ways to spend it.

1. Buy some new shades.

Head to the optometrist, get an eye prescription, then use your FSA funds to buy some new specs or shades. Contact lenses and solution are also covered.

You can also buy reading glasses with your FSA money, and you don’t even need a prescription.

2. Try acupuncture.

Scientists are divided on the efficacy of acupuncture, but some studies show it’s useful for treating chronic pain, arthritis, and even depression. If you’ve been curious about the treatment, now's a good time to try it: Your FSA money will cover acupuncture sessions in some cases. You can even buy an acupressure mat without a prescription.

If you’d rather go to a chiropractor, your FSA funds cover those visits, too.

3. Stock up on staples.

If you’re running low on standard over-the-counter meds, good news: Most of them are FSA-eligible. This includes headache medicine, pain relievers, antacids, heartburn meds, and anything else your heart (or other parts of your body) desires.

There’s one big caveat, though: Most of these require a prescription in order to be eligible, so you may have to make an appointment with your doctor first. The FSA store tells you which over-the-counter items require a prescription.

4. Treat your feet.

Give your feet a break with a pair of massaging gel shoe inserts. They’re FSA-eligible, along with a few other foot care products, including arch braces, toe cushions, and callus trimmers.

In some cases, foot massagers or circulators may be covered, too. For example, here’s one that’s available via the FSA store, no prescription necessary.

5. Get clear skin.

Yep—acne treatments, toner, and other skin care products are all eligible for FSA spending. Again, most of these require a prescription for reimbursement, but don’t let that deter you. Your doctor is familiar with the rules and you shouldn’t have trouble getting a prescription. And, as WageWorks points out, your prescription also lasts for a year. Check the rules of your FSA plan to see if you need a separate prescription for each item, or if you can include multiple products or drug categories on a single prescription.

While we’re on the topic of faces, lip balm is another great way to spend your FSA funds—and you don’t need a prescription for that. There’s also no prescription necessary for this vibrating face massager.

6. Fill your medicine cabinet.

If your medicine cabinet is getting bare, or you don’t have one to begin with, stock it with a handful of FSA-eligible items. Here are some items that don’t require a prescription:

You can also stock up on first aid kits. You don’t need a prescription to buy those, and many of them come with pain relievers and other medicine.

7. Make sure you’re covered in the bedroom.

Condoms are FSA-eligible, and so are pregnancy tests, monitors, and fertility kits. Female contraceptives are also covered when you have a prescription.

8. Prepare for your upcoming vacation.

If you have a vacation planned this year, use your FSA money to stock up on trip essentials. For example:

9. Get a better night’s sleep.

If you have trouble sleeping, sleep aids are eligible, though you’ll need a prescription. If you want to try a sleep mask, many of them are eligible without a prescription. For example, there’s this relaxing sleep mask and this thermal eye mask.

For those nights you’re sleeping off a cold or flu, a vaporizer can make a big difference, and those are eligible, too (no prescription required). Bed warmers like this one are often covered, too.

Your FSA funds likely cover more than you realize, so if you have to use them up by the deadline, get creative. This list should help you get started, and many drugstores will tell you which items are FSA-eligible when you shop online.

10. Go to the dentist.

While basics like toothpaste and cosmetic procedures like whitening treatments aren’t FSA eligible, most of the expenses you incur at your dentist’s office are. That includes co-pays and deductibles as well as fees for cleanings, x-rays, fillings, and even the cost of braces. There are also some products you can buy over-the-counter without ever visiting the dentist. Some mouthguards that prevent you from grinding your teeth at night are eligible, as are cleaning solutions for retainers and dentures.

11. Try some new gadgets.

If you still have some extra cash to burn, it’s a great time to try some expensive high-tech devices that you’ve been curious about but might not otherwise want to splurge on. The list includes light therapy treatments for acne, vibrating nausea relief bands, electrical stimulation devices for chronic pain, cloud-connected stethoscopes, and smart thermometers.

12. Head to Amazon.

There are plenty of FSA-eligible items available on Amazon, including items for foot health, cold and allergy medication, eye care, and first-aid kits. Find out more details on how to spend your FSA money on Amazon here.

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It's Black Birders Week—Here's Why Celebrating Black Scientists and Naturalists Matters

Rawpixel/iStock via Getty Images
Rawpixel/iStock via Getty Images

BlackAFInSTEM, a community of Black scientists, kicked off the inaugural Black Birders Week from May 31 through June 5. What started as a group chat organized by birder Jason Ward evolved, in a matter of mere days, into a week-long celebration of Black naturalists. “It is a movement that was started out of pain, and its goal is not necessarily pleasure, but uplifting,” Alexander Grousis-Henderson, a zookeeper and member of BlackAFInSTEM, tells Mental Floss. “We want people, especially our community, to come out of this stronger and better.”

The movement started after a video of a white woman harassing and threatening Christian Cooper, a Black birder, went viral. As part of Black Birders Week, you can follow along as professional and amateur Black naturalists, scientists, and outdoor enthusiasts share their expertise and experiences and celebrate diversity in the outdoors. Throughout the week, members of BlackAFInSTEM are facilitating online events and conversations like #AskABlackBirder and #BlackWomenWhoBird.

Though Black Birders Week was created for Black nature enthusiasts, everyone is welcome to participate. Follow along the #BlackBirdersWeek hashtag, or check out the @BlackAFInSTEM Twitter account. Ask questions, engage with their posts, or simply retweet the scientists to help amplify their voices.

Scroll through the hashtags on Twitter and Instagram, and you’ll find a stream of Black naturalists honoring their love of the outdoors. “We want kids to see our faces and attach them to the outdoors, and we want our peers to recognize that we belong here too,” Grousis-Henderson tells Mental Floss.

Not only does Black Birders Week make space for Black birders to share their passion, it’s also a way for the community to raise awareness of their unique experiences and address systemic racism in nature and STEM (science, technology, engineering, and math). According to Grousis-Henderson, it’s an opportunity to foster a dialogue within the birding community; to prompt conversations about diversity within the outdoors.

“We wanted to draw on what we know about the diversity of biological systems and bring that perspective to social systems,” Grousis-Henderson says. “A diverse ecosystem can stand up to a lot of change, but a non-diverse ecosystem, one lacking biodiversity, is easy to topple.”

The movement goes beyond birding. Alongside Black Birders Week, Black outdoorspeople are sharing their experiences of what it’s like to be a Black person in nature—a space where they’re far too often made to feel unwelcome and unsafe. Organizations like Backyard Basecamp, Melanin Base Camp, and Outdoor Afro continue to foster the Black community's connection to nature.

"Black Birders Week is an opportunity to highlight joy and belonging, to showcase expertise, and to remind people that Black people have been inextricably connected to nature for generations," Yanira Castro, communications director for Outdoor Afro, tells Mental Floss in an email. "It is a celebration of that relationship."