Download Vaccination

Vaccination
Dr. Hussein Jdaitawi
Consultant of pediatric infectious
disease
Vaccination
Immunization: is very cost-effective
means of preventing infectious disease.
Public health programs based on
vaccination have led to global eradication
of smallpox, elimination of wild-type
polioviruses, reduction in (Hib) disease.
• Vaccination:
Is administration of any vaccine or toxoid for
prevention of disease.
• Immunization: is the process of inducing
immunity artificially by either vaccination or
administration of antibody.
• Immunizing agents include vaccines,
toxoids, antitoxins, and immune globulins
derived from human or animal donors.
• The current approaches to active
immunization are the use of
1.live-attenenuated infectious agents
2.inactivated or detoxified agents, their
extracts, or specific recombinant products.
Vaccination
• A preparation of proteins, polysaccharides ,
or nucleic acids of pathogens that are
delivered to the immune system as single
entities, as part of complex particles, or by
live-attenuated agents or vectors or
vectors, to induce specific responses that
inactivate, destroy, or suppress the
pathogen.
Toxoid
• A modified bacterial toxin that has been
made nontoxic but retains the capacity to
simulate the formation of antitoxin
Immune globulin
•
An antibody-containing solution derived
from human blood obtained by cold
ethanol fractionation of large pools of
plasma and used primarily for
maintenance of immunity of
immunodeficient persons or for passive
immunization, available in intramuscular
and intravenous preparations
• Antitoxin: An antibody derived from the serum of humans or
animals after stimulation with specific antigens, used to provide
passive immunity.
• Simultaneous Administration of multiple
vaccines.
• Vaccines with selective indications
•
•
•
•
•
Influenza
Pneumococcal
hepatitis A
Meningococcal
Rabies
Principles of Vaccination
•
•
•
•
Immunity
Self vs. nonself
Protection from infectious disease
Usually indicated by the presence of
antibody
• Very specific to a single organism
Principles of Vaccination
• Active Immunity
• Protection produced by the person's
own immune system
• Usually permanent
• Passive Immunity
• Protection transferred from another
person or animal
• Temporary protection that wanes with
time
Principles of Vaccination
• Antigen .
• A live or inactivated substance (e.g.,
protein, polysaccharide) capable of
producing an immune response .
• Antibody .
• Protein molecules (immuno-globulin)
produced by B lymphocytes to help
eliminate an antigen .
Passive Immunity
• Transfer of antibody produced by one
human or other animal to another .
• Temporary protection .
• Transplacental most important source
in infancy .
Sources of Passive Immunity
• Almost all blood or blood products .
• Homologous pooled human antibody
(immune globulin) .
• Homologous human hyperimmune
globulin .
• Heterologous hyperimmune serum
(antitoxin) .
Monoclonal Antibody
• Derived from a single type, or clone, of
antibody-producing cells (B cells).
• Antibody is specific to a single antigen
or closely related group of antigens.
• Used for diagnosis and therapy of
certain cancers and autoimmune and
infectious diseases .
Antibody for Prevention of
RSV
• Palivizumab (Synagis)
• monoclonal
• contains only RSV antibody
• will not interfere with the response to a live
virus vaccine
Vaccination
• Active immunity produced by vaccine.
• Immunity and immunologic memory
similar to natural infection but without
risk of disease .
Classification of Vaccines
• Live attenuated
• viral
• bacterial
• Inactivated
Inactivated Vaccines
• Whole
• viruses
• bacteria
– Fractional
•
•
•
•
•
•
protein-based
toxoid
subunit
polysaccharide-based
pure
conjugate
Principles of Vaccination
• General Rule .
• The more similar a vaccine is to the
disease-causing form of the organism,
the better the immune response to the
vaccine.
Live Attenuated Vaccines
• Attenuated (weakened) form of the
"wild" virus or bacterium .
• Must replicate to be effective .
• Immune response similar to natural
infection .
• Usually produce immunity with one
dose* .
• *except those administered orally
Live Attenuated Vaccines
• Severe reactions possible.
• Interference from circulating antibody
• Fragile – must be stored and handled
carefully .
Live Attenuated Vaccines
• Viral measles, mumps, rubella,
varicella, zoster, yellow fever, rotavirus,
intranasal influenza, rotavirus, vaccinia
• Bacterial BCG*, oral typhoid .
• *not available in the United States
Inactivated Vaccines
• Cannot replicate .
• Generally not as effective as live
vaccines .
• Less interference from circulating
antibody than live vaccines .
• Generally require 3-5 doses .
• Immune response mostly humoral .
• Antibody titer may diminish with time .
Inactivated Vaccines
• Fractional vaccines .
• Subunit hepatitis B, influenza, acellular
pertussis, human papillomavirus,
anthrax.
• Toxoid diphtheria, tetanus.
Polysaccharide Vaccines
•
•
•
•
Pure polysaccharide
pneumococcal
meningococcal
SalmonellaTyphi (Vi)
•
•
•
•
Conjugate polysaccharide
Haemophilusinfluenzae type b
pneumococcal
meningococcal
Pure Polysaccharide
Vaccines
• Not consistently immunogenic in
children younger than 2 years of age.
• No booster response .
• Antibody with less functional activity.
• Immunogenicity improved by
conjugation .
• Adverse events after vaccination
• Precaution and contraindications to
vaccination.
• Post exposure immunoprophylaxis
Types of Vaccines
Vaccine
Type of vaccine
Disease
Storage
temp.
Live attenuated
BCG
Bacteria
OPV ( Oral Live attenuated
Virus
Polio)
Tuberculosis
2 to 8 OC
Poliomyelitis
Can be
freezed
DPT
-D & T ( Fractional
(Toxoid)
-Pertussis (
Inactivated whole
bacteria)
_Diphtheria &
Tetanus
_ Pertussis
2 to 8 OC
Damaged by
freezing
Measles
Live attenuated
Virus
Measles
2 to 8 OC
Can be
freezed
Vaccines in the 1900s
1920s
1923 diphtheria
1926 pertussis
1927 tetanus
1950s
1957 DTPw
1958polio Sabin
1960s
1964 Measles
1967 Mumps
1970 Rubella
1980s
1981 HBsAg (plasma)
1986 HBsAg r-DNA
1990s
1992 PRP (Hib) conjugate
1996 DTP-HepB
1998 DTPw-HepB/Hib
Vaccines Types
Vaccine Type of
vaccine
Live attenuate
MMR
Virus
(Measles +Mumps+
Rubella)
Disease
Storage
temp.
Measles
-Mumps
-Rubella
2 to 8 OC Can
be freezed
HBV
Recombinant Hepatitis B
( HBSAg)
Hib
Fractional(
Conjugate
Polysaccharide)
IPV
Inactivated
polio virus
2 to 8 OC
Damaged by
freezing
Haemophil 2 to 8OC
us
Influenza B
O
2
to
8
C
Poliomyeliti
Damaged by
s
Vaccination schedule
Jordan 2008
age
1st contact
2 months
3 months
4 months
9 months
12 months
18 Months
1st & 10th class
vaccine
BCG
DTP + HepB1 +Hib1 + IPV+Rota
DTP+HepB2+Hib2 + IPV+OPV+Rota
DTP+HepB3+Hib3 + OPV+Rota
measles + OPV
MMR
MMR +DTP booster1+OPV booster1
Td (OPV for 1st class)
New vaccines
•
•
•
•
•
PCV
Chicken-pox
Rotavirus vaccine
Hepatitis A vaccine
Conjugated meningococcal vaccine