0616 Immuniz

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  • 1.Immunization Abdul Ghaffar Microbiology and Immunology

2. Milestones in immunization

  • 1500BC
    • Turks introduce variolation
  • 3000BC
    • Evidence of sniffing powdered small pox crust in Egypt
  • 2000BC
    • Sniffing of small pox crust in China
  • 1700AD
    • Introduction of variolation in England and later in the US

3.

  • The wife of the British Ambassador in
  • Turkey, in March 1717 wrote, following
  • the variolation of her son, to a friend in
  • England: The small pox, so fatal, so general
  • amongst us, is entirely harmless here
  • by the invention of ingrafting.I am
  • patriot enough to bring this invention into
  • fashion in England.

Introduction of variolation 4. Milestones in immunization

  • 1780AD
    • Edward Jenner discovers small pox vaccine

5. Edward Jenner Discovery of small pox vaccine 6. Edward Jenner Among patients awaiting small pox vaccination 7. Modern era of the vaccine

  • 1920s
    • Diphtheria and Tetanus
  • 1934
    • Pertussis
  • 1955
    • Salk polio
  • 1885
    • Rabies vaccine (Pasteur)

8. Modern era of the vaccine

  • 1960s
    • Mumps measles and rubella virus
    • Sabin polio
  • 1990s
    • Hepatitis and varicella
  • 1985
    • Haemophilus

9. Pre- & post-vaccine incidence of common preventable diseases 10. Different modes of acquiring immunity Immunity Natural resistance Artificial Natural Passive Artificial Natural Active Acquired 11. Passive Immunity

  • Colostral transfer of IgA
  • Placental transfer of IgG
  • Antibodies or immunoglobulins
  • Immune cells

Natural Artificial 12. Passive Immunization disease indication antibody source human, horse diphtheria, tetanus prophylaxis, therapy vericella zoster human immunodeficiencies gas gangrene, botulism, snake bite, scorpion sting horse post-exposure rabies, human post-exposure hypogamma-globulinemia human prophylaxis 13. Advantages and Disadvantages of Passive Immunization

  • serum sickness
  • immediate protection
  • no long term protection
  • graft vs. host disease ( cell graft only )
  • risk of hepatitis and Aids

Advantages Disadvantages 14. Active Immunization

  • exposure to sub-clinical infections
  • Attenuated organisms
  • killed organisms
  • sub-cellular fragments
  • toxins
  • others

Natural Artificial 15. Live Attenuated Vaccines

  • tuberculosis
    • not used in this country
  • polio*
    • not used in std. schedule
  • measles, mumps & rubella
  • yellow fever
    • Military and travelers
    • Varicella zoster
    • children with no history of chicken pox
  • hepatitis A
    • not required in SC

16. Killed Whole-Organism Vaccines

  • polio
  • influenza
    • elderly and at risk
  • typhoid, cholera, plague
    • epidemics and travelers
    • rabies
      • post exposure
  • pertussis
    • replaced by the acellular vaccine
  • Q fever
    • population at risk

17. Microbial Fragment Vaccines

  • Bordetella. Pertussis
    • virulence factor protein
  • Haemophilus influenzae B
    • protein conjugated polysaccharide
  • Streptococcus pneumoniae
    • Polysaccharide mixture
  • Neisseria meningitidis
    • polysaccharide

18. Microbial Fragment Vaccines

  • Clostridiumtetani (tetanus)
    • inactivated toxin (toxoid)
  • Corynebacterium diphtheriae
    • inactivated toxin (toxoid)
  • Vibrio cholerae
    • toxin subunits
  • Hepatitis B virus
    • cloned in yeast

19. Modification of Toxin to Toxoid Toxin toxin moiety antigenic determinants chemical modification Toxoid 20.

  • anti-Idiotype Vaccine

Future Vaccines

  • Immuno-dominant peptide
  • DNA

21. Recommended Childhood Immunization Schedule 22. Adverse Events Occurring Within 48 Hours DTP of Vaccination Event Frequency

  • local
    • redness, swelling, pain

1 in 2-3 doses

  • systemic: Mild/moderate
    • fever, drowsiness, fretfulness vomiting
    • anorexia

1 in 2-3 doses 1 in 5-15 doses

  • systemic: more serious
    • persistent crying, fever
    • collapse, convulsions
    • acute encephalopathy
    • permanent neurological deficit

1 in 100-300 doses 1 in 1750 doses 1 in 100,000 doses 1 in 300,000 doses