Here鈥檚 What We Know: How Vaccines Are Made

The very first vaccine was created at the tail end of the 18th century by Dr. Edward Jenner, an English physician and scientist, to protect against smallpox. He injected his patients with the cowpox virus, a related but far milder infection. And, lo and behold, it worked.

Jenner鈥檚 vaccine was refined later, but that 鈥渇irst鈥 was one of the most stunning discoveries in the history of medicine. Smallpox was declared eradicated globally in 1980, with the last case reported in Somalia in 1977.

In what follows, Dr. Sean Cullen鈥斕The Friedman Family Foundation Clinical Scholar in Newborn Medicine and听Assistant Professor of Pediatrics and听91麻豆精品鈥攅xplains the ins and outs of vaccines, including:

  • what they are
  • how they work
  • how 迟丑别测鈥檙别 tested and re-tested
  • some of the reasons for vaccine hesitancy
  • how infectious diseases spread and ways to contain them
  • why vaccines matter today

What are vaccines, and how do they work?

鈥淰accines are designed to teach the immune system how to fight off a particular infection,鈥 Dr. Cullen says. 鈥淭hey use antigens, which are specific parts of disease-causing bacteria or viruses, to help your immune system recognize infections and develop a defense against them. That defense comes in the form of antibodies鈥攕pecialized proteins that can prevent a disease from occurring altogether or mitigate its most severe symptoms.

A great vaccine success story

Dr. Cullen is too young to have encountered polio in his lifetime, but he names the polio vaccine as one of the best illustrations of what a vaccine can accomplish.

Polio is a highly contagious viral infection of the nervous system. Before the polio vaccine was developed and administered to children during the 1950s, the disease often resulted in partial or total paralysis, especially in children. It was even called infantile paralysis, although adults could sometimes contract it. That happened to Franklin Delano Roosevelt during his 30s. The disease left the future president unable to walk, and he was confined to a wheelchair for the rest of his life.

鈥淲hen I was in medical school, one of our lectures featured a film showing images of rows and rows of children in 鈥榠ron lung鈥 machines. Polio sometimes caused paralysis of the muscles that helped children breathe. Regrettably, many of these children were confined to iron lungs for life and often died early as a result.鈥

But starting in the 1950s, children in this country were routinely vaccinated against polio, and the disease was officially eradicated from the U.S. in 1979.

How vaccines are tested

Dr. Cullen goes on to explain how vaccines are developed, tested and re-tested to ensure their safety and efficacy.

Through a stepwise series of research studies and clinical trials, 丑别谤别鈥檚 how the process works:

  • First, in smaller studies, researchers aim to ensure that the vaccine and all of its components are safe and well-tolerated.
  • Next, there are tests to determine the right dosage and make sure the relevant antibodies are produced in sufficient amounts.
  • And finally, researchers conduct larger trials to confirm a vaccine鈥檚 efficacy; in other words, to make sure the vaccine does what it鈥檚 intended to do鈥攑revent the illness or reduce the severity of its symptoms.

鈥淓ven after a vaccine is approved for use,鈥 he says, 鈥渢here are even larger trials designed to ensure that there are no long-term side effects, including extremely rare side effects that only appear through testing a very large number of people. That added layer of monitoring is called VAERS: the Vaccine Adverse Event Reporting System.鈥

With VAERS, anyone can report any side effect 迟丑别测鈥檝别 experienced from any vaccine鈥攅ven vaccines that have been around for decades. These data are collected and monitored by the various government agencies assigned to the task.

Vaccine hesitancy

Dr. Cullen points to the very success of vaccine development as a major driver of hesitancy and skepticism.

There are upwards of 20 vaccine-preventable diseases that are part of the standard childhood immunization schedule recommended by the Centers for Disease Control and Prevention (CDC). 鈥淭hat means there are at least 20 diseases that children 补谤别苍鈥檛 getting at the rates they did in earlier periods. Or 补谤别苍鈥檛 getting at all, like polio.

鈥淧arents today may ask themselves why they should have their children vaccinated against diseases 迟丑别测鈥檝别 never heard of and have never seen,鈥 he continues.

Some wellness influencers on social media have also undermined confidence in vaccines. That has amplified vaccine hesitancy, leading to lower-than-optimal vaccination rates in some parts of the country.

Another reason for vaccine hesitancy? Parents鈥 fears of a link between vaccines鈥攅specially the MMR vaccine鈥攁nd autism. But no such link has been established.

鈥淭he idea of a link between vaccines and autism has been one of the most examined questions in modern pediatric research,鈥 Dr. Cullen says. I can say conclusively that there is no evidence for a causal link between routine childhood vaccines and autism spectrum disorders.

鈥淭he initial paper that came out and reported such findings was formally retracted in 2010,鈥 he continues. 鈥淔or interested parents, I鈥檇 like to recommend a book by Dr. Peter Hotez, titled Vaccines Did Not Cause Rachel鈥檚 Autism: My Journey as a Vaccine Scientist, Pediatrician, and Autism Dad.鈥 (Dr. Hotez, affiliated with Baylor College of Medicine, has an adult daughter with autism.)

Measles outbreaks

In the U.S., measles 飞补蝉苍鈥檛 exactly eradicated, but with the development of a highly effective measles vaccine in the late 1960s鈥攖he same one that is combined with vaccines for mumps and rubella today鈥攖his formerly prevalent childhood disease was declared eliminated in 2000. Elimination is different from eradication. When a disease is 鈥渆liminated,鈥 it means t丑别谤别鈥檚 an absence of its continuous spread over a period greater than 12 months.

However, according to the , measles has been making a comeback, with numerous听outbreaks across multiple states reported in 2025 thus far.

The MMR vaccine

The MMR vaccine contains live, very weakened forms of the three viruses, Dr. Cullen explains. Therefore, they 肠补苍鈥檛 replicate like the actual measles, mumps and rubella viruses. But t丑别谤别鈥檚 enough to train your immune system to recognize what the real viruses look like, and to develop those all-important antibodies mentioned above. 奥丑补迟鈥檚 more, the MMR vaccine confers lifelong immunity to all three diseases.

鈥淢easles is highly contagious,鈥 Dr. Cullen says. 鈥淚t can spread through a community like wildfire鈥濃攅specially when vaccination rates are suboptimal.

Protecting vulnerable children

The MMR vaccine 肠补苍鈥檛 be given to infants under a year old, but, Dr. Cullen notes, t丑别谤别鈥檚 another way to protect these vulnerable children from contracting measles, mumps and rubella: 鈥淢ake sure that those in closest contact with them who can be vaccinated are vaccinated.鈥

At a micro-level, that creates a phenomenon called herd immunity.

Herd immunity

Herd immunity means that enough people have acquired immunity against a virus or other infectious agent to make it extremely difficult for that infection to spread.鈥That occurs principally through vaccination.

Achieving herd immunity in the U.S., public health experts say, requires a vaccination rate of 95 percent of the population. At present, the national vaccination rate is at 93 percent.听

That may not sound like a big difference, but the drop 颈蝉苍鈥檛 evenly distributed. In Gaines County, Texas, for instance鈥攖he epicenter of the most recent measles outbreak鈥攁 large Mennonite community remains unvaccinated; not due to anti-vaccine sentiment but to a lack of interaction with the medical system and a decided preference for alternative treatments. In Gaines County, vaccination rates are closer to 80 percent鈥攃learly an insufficient number to provide herd immunity.

In New York State, the vaccination rate for kindergartners is only around 90 percent. The State and City Departments of Health are concerned about that, and 迟丑别测鈥檙别 doing their utmost to raise awareness around the importance of childhood vaccines. The city experienced its own measles outbreak in 2019, and a repeat of that is to be avoided at all costs.

Pediatricians like Dr. Cullen are doing their part by listening to parents, addressing their concerns and making the case for childhood vaccinations by sharing his abundant knowledge with them. 鈥淧arents just want to do what鈥檚 best for their children,鈥 he says, 鈥渁nd my aim is to partner with them in that effort.鈥

To make an appointment with a pediatrician at 91麻豆精品, call (646) 962-5437 or visit the department鈥檚 website .听听