Immunization

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Vaccination or developing immunity has gained significant attention during SARS-COVID-19 pandemic. Vaccines are developed to target a specific antigen and prevent a specific disease. This can be included in offense strategy or disease-centric strategy of healthcare systems. Ayurveda emphasizes on building a strong defense system, that can fight with any type of antigen. This shows the patient-centric (purusha) views of healthcare in the ancient system of medicine originated in India. The article describes a comprehensive understanding of concepts of immunization in contemporary systems and ancient practices of strengthening immunity.

Contributors
Section/Chapter/topic Sharira / Immunization and vaccination in Ayurveda
Authors Karthik K.P.1, Deole Y.S.2
Reviewers Rekhi Rachna 3 Basisht G.2,
Editor Basisht G.2
Affiliations

1 Department of Kaumarabhritya, A.I.I.A. , New Delhi, India

2 Department of Kayachikitsa, G.J. Patel Institute of Ayurvedic Studies and Research, Anand, India

3Pediatrician, Daly City, CA, U.S.A.
Correspondence email kpkarthik131@gmail.com, carakasamhita@gmail.com
Date of first publication: January05, 2022
DOI under process

Immunity, immunization, and vaccination: current understanding

Immunity is the ability of the body to resist pathogens, the failure of which results in diseases. It is basically of two types: innate and acquired. The inborn ability of the body to resist pathogens is called ‘innate immunity’. It is the initial and generalized defense mechanism, hence also known as non-specific immunity. The specific resistance developed by the body in the course of life against specific pathogens is called ‘acquired or specific immunity.

Immunization is the process of preparing the body to fight against pathogens or disease. Two types of immunization exist: passive and active. Passive immunization involves supplementing the body of a non-immune person with antibodies. These antibodies are taken from an immune person. Hence, these do not challenge the immune system of the recipient. On the contrary, active immunization is the process wherein a disease or disease-like condition occurs or is induced in the body. It demands the body itself to produce antibodies.

Passive immunization is of two types: Natural and artificial. Natural passive immunization is acquired from the mother before and after birth. Before birth, maternal antibodies are transferred to the fetus via the placenta (IgG, placental antibody). After birth, antibodies (especially IgA) from the mother are transferred via breastmilk.

In artificial passive immunization, serum containing antibodies for a particular disease is introduced into the body of the non-immune individual. They are usually taken from an immune human or an artificially immunized animal. Artificial passive immunization is mainly used in situations where immediate protection against disease is required, as an acute infection. It is also used as a prophylactic measure to prevent disease. Usually, the immunity provided by passive immunization lasts for a shorter duration.

Active immunization is divided into natural and artificial subtypes. Natural active immunization occurs when an individual encounters the pathogen resulting in a clinical or subclinical infection. In clinical infection, the antigen-antibody reaction leads to evident signs and symptoms. Whereas in subclinical infection, the B-lymphocyte activation leads to minimal signs and symptoms.

The artificial form of active immunization involves injecting dead or live-but-attenuated pathogens into the non-immune individual and making the immune system produce the antibodies. When the pathogens are injected, it is called a vaccine. When the toxic material secreted by the pathogen, weakened by preserving its immunogenicity is injected, it is called a toxoid. The duration of protection that an active immunization varies from disease to disease.

Concept of immunity in Ayurveda

In Ayurveda, the concepts of immunity, vitality, strength, and resilience are known with the terms ‘Bala, Ojas, and Vyadhikshamatva’. Bala means strength or power. Ojas is the essence. Vyadhikshamatva means the ability to pacify diseases. It includes the ability to prevent disease occurrence, too. These terms are often used synonymously, though slight differences exist. Bala is characterized by firm and well-built contour, ability to perform all activities involving body, mind, and speech, and efficiency of the sensory and motor organs (indriya) in performing their duties.[Su.Sa.Sutra Sthana. 15/20][1]

Types of bala

Three types of bala are enunciated in the Ayurvedic classics. The first is innate component (sahaja bala), which is constant throughout the lifetime for an individual of a particular physical and mental constitution. The second type is determined by time or temporal (kalaja). This oscillates with the age of the individual and the seasons. The third component is acquired (yuktikrita) through one’s diet, lifestyle, and other efforts like rejuvenation therapies. [Cha.Sa.Sutra Sthana 11/36]

Immunization practices in Ayurveda

The ayurvedic medical system follows procedures that aid normal pregnancy, puerperium, and healthy progeny. These procedures start from preconceptional period till the adolescence of the progeny. Some of them are socio-cultural practices with medical importance. The sixteen sacred rites (shodasha samskara) are practiced in India with vernacular variations. They are conception (garbhadhana), ensuring a healthy progeny (pumsavana), hair-parting (simantonayana), birth rites (jatakarma), naming ceremony (namakarana), taking the child outside the home for the first time (nishkramana), giving solid food (annaprashana), shaving head (chudakarana), earlobe-piercing (karnavedhana), sacred-thread initiation ceremony (upanayana), starting to study veda and learning (vedarambha), graduating (samavartana), marriage (vivaha), renouncing the familial responsibilities (vanaprastha), complete renunciation (sanyasa) and death rites (antyeshti).[2] The rites having a significant impact on developing immunity are discussed below.

The procedures can be divided into three parts according to the time of observation.

  1. Preconception
  2. Gestational period
  3. After the birth of baby

Preconception practices

1. Garbhadhana (conception)

Planning for healthy progeny starts with the improvement in the reproductive health of parents for the normal conception and development of the embryo. These are called ‘preconception practices’.

The male is administered ghee and milk fortified with drugs that are sweet in taste and the female with oil and black gram-based food. [Cha.Sa. Sharira Sthana 8/4] [Su.Sa. Sharira Sthana 2/28][1] [3] The couple are advised to spare seven days starting from the first day of menstruation. Then involve in coitus for a desirable child up to 12 days. The later the day, the more conducive it becomes for the longevity, health, physical and mental strength, and excellence of the senses of the progeny. Day 13 or further is not encouraged for conception. This indicates the days of conception can influence the health of progeny. Medicinal formulations like Mahakalyanaka ghee and Phala sarpi are advised in this context. These formulations are used in the first trimester and to treat cases of infertility. [Arunadatta on A.H. Sharira Sthana 1/18][4]

Gestational period

Pumsavana

Pumsavana, literally means practices for a healthy progeny. When applied in the best of places and times, these procedures always bear the desired fruit. After examining the woman who has conceived recently, before the signs of gestation become apparent, (the physician) should administer pumsavana (procedures to beget a healthy offspring) on her.

The practices include the following procedures:

  • On the day of Pushya constellation, banyan leaf buds are given orally with curd and two grains of masha (Phaseolus radiatus Linn - black gram) or shweta sarshapa (Sinapis alba).
  • Milk processed in the paste of all or each of herbs like Jivaka, Rishabhaka, Apamarga, and Sahachara is administered orally.
  • On the day of Pushya constellation, a handful of water with kudyakitaka (a type of insect) or matsyaka (a type of fish) is given orally.
  • Curd, milk, or water with the miniature male statuettes made of gold, silver, or iron are given to drink.
  • Vapors of rice paste that is being cooked are inhaled, and the drops of water from the same pot have to be self-administered into her nostrils.

These practices need more focused research to validate scientifically.[5]

Preconception dietary and lifestyle regimens of various kinds have been found to have conducive effects on the growth of the fetus. Lipid-based supplementation of micronutrients along with polyunsaturated fatty acids, and minimal amounts of protein and energy along with improved environmental conditions to women planning for conception at least 3 months before conception showed decreases of 44% in stunting, 24% in wasting, and 26% SGA in comparison to the control group in which no preconceptional dietary modification was given.[6] Preconceptional diet predominant in fruits, with minimal fast foods, sugar-sweetened beverages, and glycemic load, has been found to improve fertility and reduce time to pregnancy.[7]

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  2. I.P. Pandurang, I.P. Pandurang, CONCEPT OF SHODASHA SAMSAKARA, (2015) 5.
  3. Dr.H.V. P., GARBHADHANA VIDHI - A CONCEPTUAL STUDY, World J. Pharm. Pharm. Sci. (2017) 448–454. https://doi.org/10.20959/wjpps20174-8873.
  4. Vagbhata. Ashtanga Hridayam. Edited by Harishastri Paradkar Vaidya. 1st ed. Varanasi: Krishnadas Academy;2000.
  5. P. Rai, A. Ganguli, S. Balachandran, R. Gupta, S.B. Neogi, Global sex selection techniques for family planning: a narrative review, J. Reprod. Infant Psychol. 36 (2018) 548–560. https://doi.org/10.1080/02646838.2018.1508871.
  6. S.M. Dhaded, K.M. Hambidge, S.A. Ali, M. Somannavar, S. Saleem, O. Pasha, U. Khan, V. Herekar, S. Vernekar, Y. Kumar S., J.E. Westcott, V.R. Thorsten, A. Sridhar, A. Das, E. McClure, R.J. Derman, R.L. Goldenberg, M. Koso-Thomas, S.S. Goudar, N.F. Krebs, Preconception nutrition intervention improved birth length and reduced stunting and wasting in newborns in South Asia: The Women First Randomized Controlled Trial, PLoS ONE. 15 (2020) e0218960. https://doi.org/10.1371/journal.pone.0218960.
  7. J.A. Grieger, Preconception diet, fertility, and later health in pregnancy, Curr. Opin. Obstet. Gynecol. 32 (2020) 227–232. https://doi.org/10.1097/GCO.0000000000000629.