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Vaccination will never die, says infectious disease specialist Neha Paranjape

US-based infectious disease specialist Neha Paranjape speaks to Jayadev Calamur on the future of medicines, the doctor-patient relationship and if we will ever be disease-free

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Polio vaccination drop being given to a child
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Given that we evolve every second (even though major changes are seen over a long period of time), do you see the human body developing an auto-immune system to tackle infections without vaccination.

I do not believe we will ever be able to do without vaccines. It is impossible for our body to develop inherent immunity to diseases without ever being exposed. To know why, we need to understand that the immune system is our greatest defence against diseases. When a pathogen enters our body, the immune system is able to detect it as foreign, develop special proteins called antibodies to tackle it and most importantly memorise the process in order to protect the body against subsequent exposures. Vaccines use a weakened or dead organism that is ineffective in causing full-blown disease but is able to trigger immune protection. Without a functioning immune system, vaccines would be ineffective and without exposure to a pathogen, the immune system would not develop protection against it.
 
Will tropical nations be less susceptible to diseases in the future or will parasites develop new strains to tackle medical advancements in the next 30-40 years?
Every living creature evolves over a period of time as it is nature’s way of keeping things in check and to ensure survival of the fittest. With the discovery of penicillin, we were able to cure a large number of bacterial infections during WWII. Today it is scarcely effective. Multi-drug resistant strains are an unfortunate reality. Indiscriminate use of antibiotics, have played a major role to this effect, and the health care community is largely to blame for it. So while newer more effective agents are being discovered, pathogens are developing ways to get around them.

There is a whole new debate in the United States about vaccinations. Do you see medicine advancing to such an extent that disease will be eradicated and there will be no need for vaccines. I ask purely because of the number of people living up to 90 or older today?
 

Dr Neha Paranjape

Vaccines have made a major contribution to the increased life expectancy we see today. Till date, no authentic scientific study has indicated a link between vaccination and autism. In an era of evidence-based medicine, it is unfortunate that the educated do not realise the importance of vaccination. We have been able to eradicate smallpox with effective vaccination. Polio is another disease that has been notably eradicated in India by aggressive vaccination. However not all pathogens are that gracious. For example, the influenza virus mutates and changes its outer structure, mandating a new vaccine every flu season. Also, certain viruses such as HIV are able to evade the immune system making vaccines ineffective.

What is the future of medicine? Will doctors have a different role as compared to today i.e. or will everything - surgeries included - happen using robots with doctors remote controlling them?
Technology offers greater accuracy and precision and minimizes the possibility of human error. Robotic surgeries, telemedicine, digital learning, body sensors, portable diagnostics, recorders, artificial prosthesis, electronic medical records are all present day realities, but they still rely on the diagnostic skills of the clinician.  In the future, I believe a lot of diagnostics and monitoring will be done at home, possibly using smart phones. Genomics-based medicine wherein individual based treatment based on the person’s genetics’ and lifestyle would be made available. Virtual doctor visits, such as with telemedicine will become the norm. While advanced technology will greatly assist the medical professionals, it can never replace a real-time doctor-patient relationship.  MBBS from Grant Medical College Mumbai, then Masters in Public Health from University of Alabama at Birmingham, then Internal Medicine residency (MD) from Wayne State University Detroit and then Fellowship in Infectious Disease from University of Alabama at Birmingham.

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