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|title=Concept and practices of immunization and vaccination in Ayurveda  

|title=Concept and practices of immunization and vaccination in Ayurveda  

|titlemode=append

|titlemode=append

|keywords=Immunization, Charak samhita, carakasamhitaonline, Indian System of Medicine, bala  

|keywords=Immunization, Charak samhita, carakasamhitaonline, Indian System of Medicine, bala, vaccination in ayurveda, immunity development, immunity boosters, holistic system of medicine, suvarnaprashana, ayurvedic concept of immunization, vaccination

|description=Concept of immunization in Ayurveda & contemporary systems  

|description=Concept of immunization in Ayurveda & contemporary systems  

|image=http://www.carakasamhitaonline.com/resources/assets/ogimgs.jpg

|image=http://www.carakasamhitaonline.com/resources/assets/ogimgs.jpg

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<p style="text-align:justify;">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.

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.

 

{{Infobox

{{Infobox

|label3 = Reviewers  

|label3 = Reviewers  

|data3 = Rekhi Rachna ³ Basisht G.²,

|data3 = Rekhi Rachna ³, Basisht G.⁴

|label4 = Editor

|label4 = Editor

|data4 = Basisht G.²

|data4 = Basisht G.⁴

|label5 = Affiliations

|label5 = Affiliations

³Pediatrician, Daly City, CA, U.S.A.

³Pediatrician, Daly City, CA, U.S.A.

|label6 = Correspondence email

|label6 = Correspondence email

|data6 = kpkarthik131@gmail.com, carakasamhita@gmail.com

|data6 = kpkarthik131@gmail.com, carakasamhita@gmail.com

|label7 = Date of first publication:

|label7 = Publisher

|data7 = January05, 2022

|data7 = [[Charak Samhita Research, Training and Development Centre]], I.T.R.A., Jamnagar, India

|label8 = DOI

|label8 = Date of first publication:

|data8 = under process

 

|label9 = DOI

|data9 = 10.47468/CSNE.2022.e01.s09.078

}}

}}

==Immunity, immunization, and vaccination: current understanding==

==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.  

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.

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.

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.

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.

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]]==

==Concept of immunity in [[Ayurveda]]==

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]

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==

==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).<ref>I.P. Pandurang, I.P. Pandurang, CONCEPT OF SHODASHA SAMSAKARA, (2015) 5.</ref> The rites having a significant impact on developing immunity are discussed below.

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).<ref>I.P. Pandurang, I.P. Pandurang, CONCEPT OF SHODASHA SAMSAKARA, (2015) 5.</ref> The rites having a significant impact on developing immunity are discussed below.

The practices include the following procedures:

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).  

*On the day of Pushya constellation, banyan leaf buds are given orally with curd and two grains of black gram (masha - Phaseolus radiatus Linn) or Sinapis alba (shweta sarshapa).  

*Milk processed in the paste of all or each of herbs like Jivaka, Rishabhaka, Apamarga, and Sahachara is administered orally.

*Milk processed in the paste of all or each of herbs like Crepidium acuminatum (jivaka), Rishabhaka, Achyranthes aspera L. (apamarga), and Barleria cristata L.(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.

*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.

*Curd, milk, or water with the miniature male statuettes made of gold, silver, or iron are given to drink.

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.<ref>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.</ref> 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.<ref>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.</ref>

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.<ref>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.</ref> 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.<ref>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.</ref>

Diet and lifestyle during pregnancy also play a significant role in framing the strength and immunity of the child. This is knowns as prenatal regimen ([[garbhini paricharya]]). The diet in each trimester has been designed in synchronization with the fetal developments. The first-trimester diet comprises food items that are sweet in taste, cold in potency, and is predominantly liquid. This ensures proper nutrition and prevents dehydration. The second-trimester diet focuses on the formation and growth of muscles and organs. It is rich in proteins. The third-trimester diet is mostly about dealing with constipation, water retention, and facilitating the process of parturition. This includes mild laxatives and enemas.<ref>D.B. Koli, PA01.78. Ayurvedic diet in pregnancy, Anc. Sci. Life. 32 (2012) S128.</ref> Epigenetic modifications are changes in gene expression without changes in DNA sequences. They occur due to factors like DNA methylations, histone modifications, and miRNA expression modulation. The presence of excess methyl donors in the maternal diet may lead to an increased risk of allergic airway disease in the offspring, whereas sensitization to certain pathogens reduces the risk. An inappropriately high-fat diet has been identified to be a potential risk factor of fetal non-alcoholic fatty liver disease. The deficiency of polyunsaturated fatty acids was found associated with an increased risk of cardiovascular diseases.<ref>A.A. Geraghty, K.L. Lindsay, G. Alberdi, F.M. McAuliffe, E.R. Gibney, Nutrition During Pregnancy Impacts Offspring’s Epigenetic Status—Evidence from Human and Animal Studies, Nutr. Metab. Insights. 8 (2016) 41–47. https://doi.org/10.4137/NMI.S29527.</ref>

Diet and lifestyle during pregnancy also play a significant role in framing the strength and immunity of the child. This is knowns as prenatal regimen (garbhini paricharya). The diet in each trimester has been designed in synchronization with the fetal developments. The first-trimester diet comprises food items that are sweet in taste, cold in potency, and is predominantly liquid. This ensures proper nutrition and prevents dehydration. The second-trimester diet focuses on the formation and growth of muscles and organs. It is rich in proteins. The third-trimester diet is mostly about dealing with constipation, water retention, and facilitating the process of parturition. This includes mild laxatives and enemas.<ref>D.B. Koli, PA01.78. Ayurvedic diet in pregnancy, Anc. Sci. Life. 32 (2012) S128.</ref> Epigenetic modifications are changes in gene expression without changes in DNA sequences. They occur due to factors like DNA methylations, histone modifications, and miRNA expression modulation. The presence of excess methyl donors in the maternal diet may lead to an increased risk of allergic airway disease in the offspring, whereas sensitization to certain pathogens reduces the risk. An inappropriately high-fat diet has been identified to be a potential risk factor of fetal non-alcoholic fatty liver disease. The deficiency of polyunsaturated fatty acids was found associated with an increased risk of cardiovascular diseases.<ref>A.A. Geraghty, K.L. Lindsay, G. Alberdi, F.M. McAuliffe, E.R. Gibney, Nutrition During Pregnancy Impacts Offspring’s Epigenetic Status—Evidence from Human and Animal Studies, Nutr. Metab. Insights. 8 (2016) 41–47. https://doi.org/10.4137/NMI.S29527.</ref>

===After birth===

===After birth===

====Jatakarma (Birth rites)====

====Jatakarma (birth rites)====

The birth rites involve the administration of honey and ghee, gold, and breastmilk.  It marks the first nutritional input as well as the first immunological challenge for the neonate. Prelacteal feeds (food items given before breastfeeding) are not generally recommended nowadays, as they hinder the intake of breastmilk. However, this may deprive the neonate of the nutritional and immunological benefits imparted by traditional practices.  Swarna bhasma (calcined powder of gold), honey and ghee, when administered in infants, though not as prelacteal feeds, are found to be safe and have effective immunomodulatory activity.<ref>J.K. Bhaskaran, K.S. Patel, R. Srikrishna, Immunomodulatory activity of Swarna Prashana (oral administration of gold as electuary) in infants - A randomized controlled clinical trial, Ayu. 40 (2019) 230–236. https://doi.org/10.4103/ayu.AYU_33_19.</ref>

The birth rites involve the administration of honey and ghee, gold, and breastmilk.  It marks the first nutritional input as well as the first immunological challenge for the neonate. Prelacteal feeds (food items given before breastfeeding) are not generally recommended nowadays, as they hinder the intake of breastmilk. However, this may deprive the neonate of the nutritional and immunological benefits imparted by traditional practices.  Swarna bhasma (calcined powder of gold), honey and ghee, when administered in infants, though not as prelacteal feeds, are found to be safe and have effective immunomodulatory activity.<ref>J.K. Bhaskaran, K.S. Patel, R. Srikrishna, Immunomodulatory activity of Swarna Prashana (oral administration of gold as electuary) in infants - A randomized controlled clinical trial, Ayu. 40 (2019) 230–236. https://doi.org/10.4103/ayu.AYU_33_19.</ref>

! Weaning dumpling (Modaka)  !! Therapeutic action

! Weaning dumpling (Modaka)  !! Therapeutic action

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| | Buchanania latifolia (Priyala) fruit rind, Glycyrrhiza glabra (Madhuka), honey, parched rice, sugar candy<ref>A.N. Baldota, M. Deodas, P. Wankhede, S. Singh, COMPLIMENTARY FEEDING IN INFANT- AN AYURVEDIC PERSPECTIVE, World J. Pharm. Res. (n.d.) 7.</ref> || Nourishing (prinana)

| | Buchanania latifolia (priyala) fruit rind, Glycyrrhiza glabra (madhuka), honey, parched rice, sugar candy<ref>A.N. Baldota, M. Deodas, P. Wankhede, S. Singh, COMPLIMENTARY FEEDING IN INFANT- AN AYURVEDIC PERSPECTIVE, World J. Pharm. Res. (n.d.) 7.</ref> || Nourishing (prinana)

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| | Unripe fruit of Aegle marmelos (Bala vilva), Elettaria cardamomum (Ela), sugar candy, and parched rice<ref>A. R, C.K. Vk, Preparation of Balabilwadi modaka: Ayurvedic complementary food, Pharma Innov. J. 5 (2016) 33–38.</ref> || Carminative ([[dipana]])

| | Unripe fruit of Aegle marmelos (bala bilva), Elettaria cardamomum (ela), sugar candy, and parched rice<ref>A. R, C.K. Vk, Preparation of Balabilwadi modaka: Ayurvedic complementary food, Pharma Innov. J. 5 (2016) 33–38.</ref> || Carminative ([[dipana]])

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| | Woodfordia fruticosa (Dhataki) flower, sugar candy, puffed rice soaked in water (tarpana) || Styptic (sangrahi)

| | Woodfordia fruticosa (dhataki) flower, sugar candy, puffed rice soaked in water (tarpana) || Styptic (sangrahi)

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'''[[Rasayana]] (rejuvenation therapy)'''

'''[[Rasayana]] (rejuvenation therapy)'''

Rejuvenation therapy is one of the eight branches of [[Ayurveda]], concerned with healthy ageing, increasing longevity, intellect, strength, immunity, and also cure of the diseases that have occurred. [[Rasayana]], when administered in the early or middle years of life, with proper preparatory measures (like prior cleansing of the body, pleasant mind, etc.) bestows the individual with longevity, intellect, memory, youth, luster, sweetness of voice, the strength of body and senses, etc. It is considered to be the most superior way to bring the excellence of bodily tissues, hence bringing about their optimal functioning and enhancing the [[Bala]] or immunity. While most of the [[rasayana]] are general promoters of health, some are specifically dedicated to providing protection against some diseases. Some are designed to be used in the management of particular diseases.  

Rejuvenation therapy is one of the eight branches of [[Ayurveda]], concerned with healthy ageing, increasing longevity, intellect, strength, immunity, and also cure of the diseases that have occurred. [[Rasayana]], when administered in the early or middle years of life, with proper preparatory measures (like prior cleansing of the body, pleasant mind, etc.) bestows the individual with longevity, intellect, memory, youth, luster, sweetness of voice, the strength of body and senses, etc. It is considered to be the most superior way to bring the excellence of bodily tissues, hence bringing about their optimal functioning and enhancing the [[bala]] or immunity. While most of the [[rasayana]] are general promoters of health, some are specifically dedicated to providing protection against some diseases. Some are designed to be used in the management of particular diseases.  

Tinospora cordifolia (guduchi) is a [[rasayana]] drug that has been extensively studied and established for its immunomodulatory activity. It acts primarily on the non-specific immune mechanism, stimulating the same. Besides the immune-boosting activity, it has been studied for antioxidant, adaptogenic, antimicrobial, anti-cancer, anti-anxiety activities, and also the protective effect on liver, heart, bones, etc.<ref>K. Dhama, S. Sachan, R. Khandia, A. Munjal, H.M.N. Iqbal, S.K. Latheef, K. Karthik, H.A. Samad, R. Tiwari, M. Dadar, Medicinal and Beneficial Health Applications of Tinospora cordifolia (Guduchi): A Miraculous Herb Countering Various Diseases/Disorders and its Immunomodulatory Effects, Recent Pat. Endocr. Metab. Immune Drug Discov. 10 (2017) 96–111. https://doi.org/10.2174/1872214811666170301105101.</ref>

Tinospora cordifolia (guduchi) is a [[rasayana]] drug that has been extensively studied and established for its immunomodulatory activity. It acts primarily on the non-specific immune mechanism, stimulating the same. Besides the immune-boosting activity, it has been studied for antioxidant, adaptogenic, antimicrobial, anti-cancer, anti-anxiety activities, and also the protective effect on liver, heart, bones, etc.<ref>K. Dhama, S. Sachan, R. Khandia, A. Munjal, H.M.N. Iqbal, S.K. Latheef, K. Karthik, H.A. Samad, R. Tiwari, M. Dadar, Medicinal and Beneficial Health Applications of Tinospora cordifolia (Guduchi): A Miraculous Herb Countering Various Diseases/Disorders and its Immunomodulatory Effects, Recent Pat. Endocr. Metab. Immune Drug Discov. 10 (2017) 96–111. https://doi.org/10.2174/1872214811666170301105101.</ref>

#O P Gupta (1991): To study controlled trial of Rasayana in case of Kshaya w.s.r. to general Vyadhikshamatva (Bala). (Kaya Chikitsa).  

#O P Gupta (1991): To study controlled trial of Rasayana in case of Kshaya w.s.r. to general Vyadhikshamatva (Bala). (Kaya Chikitsa).  

#S N Tewari (2005): Ayurvedic concept of Immunity and drug for immunotherapeuticuses. (Basic Principles), ASP University Rewa.

#S N Tewari (2005): Ayurvedic concept of Immunity and drug for immunotherapeuticuses. (Basic Principles), ASP University Rewa.

==References==

==References==