Immunization, Vaccination

8/6/2019 Immunization, Vaccination

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PRESENTATION ONIMMUNIZATION, VACCINATION


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History

Jenner: Cowpox vaccine 1796

Pasteur: Rabies prophyl axis 1885EPI: WHO 1974, India 1978UIP: India 1985Child vaccine initiative: with support from sever al

intern ation al agen cies 1991Globa l pro gr amme on vaccines: WHO 1993Globa l alliance for vaccine and immunization - 1999


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Import ance of immunis ation

The most effective inter vention (most effective publiche alth inter vention after clean water)Globa lly, 3 million de aths per year and 750,000children disab led by vaccine-pre vent ab le infections1in 4 children (~30 million) have no access to

vaccination for 6 EPIdiseases (me asles , polio ,pertussis , diphtheri a, tet anus , TB)


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30 million infants have no access to basic immunis ation each year.

In almost 50 nations , 60 per cent of the children are not immunised.

A child in the de velopin g world is ten times more likely to die a vaccine-pre vent ab le de ath th an a child in an industri alised nation. One child can be fully immunised for $17 (about 30)Every $1spent on immunis ation saves society up to $29.


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Types of Immunis ation

Passive

Tempor ary prote ction , e.g. immuno globulin (spe cific protein substance produ ced by plasma cells to fight infection)Taken from infected individuals, good for people whose immune systems are not stron g

Active

Longer term prote ction leading to the formation of antibodiesExploring new delivery systems e.g. aerosols , edible vaccines , topi cal


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Active immunization

Active immunization can occur natur ally when a person

comes in cont act with , for example , a microbe. If the person has not yet come into cont act with the microbe and has no pre -made antibodies for de fen ce (like in passive immunization) , the person becomes immunized. The immune system will eventu allycreate antibodies and other de fen ces aga inst the microbe. The next time , the immune response aga inst this microbe can be very efficient; this is the case in many of the childhood infections th at a person only contr acts on ce , but then is immune.


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Passive immunization

Passive immunization is where pre -synthesized elements ofthe immune system are tr ansferred to a person so th at the body does not need to produ ce these elements itsel f. Currently , antibodies can be used for passive immunization. This method of immunization begins to work very quickly,but it is short lasting, because the antibodies are natur ally

broken down , and if there are no B cells to produ ce more antibodies , they will disappe ar.Passive immunization occurs physiolo gically, when antibodies are tr ansferred from mother to fetus durin gpre gnancy, to prote ct the fetus before and shortly after birth.


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Contr a indications to immunis ation

Very few real contr a-indications

1. A con firmed anaphylactic reaction to a pre vious dose of the vaccine2. A con firmed anaphylactic reaction to a component of

the vaccine

3. Immunosuppression (live vaccines)Che ck Green Book for nation al recommend ations; WHO recommend ations & manufacturer s data sheet


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D evelopin g immunis ation

str ate gy........

Mass immunis ation or sele ctive immunis ationSelective:

tr avel, e.g. HAVoccupation al, e.g. HBV for health care workersChroni c disease , e.g. pneumo coccal out break, e.g. HAV


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Types of

vaccines

Live bac teri a- BCG, Ty 21 aLive virus OPV, MMRKilled bac teri a Pertussis , S.typhiKilled virus IPV, Rabies, HAV

ToxoidD

T, TTCapsular polysaccharide HiB, Pneumo , Menin goVir al subunit - HBsAgBacteri al subunit Acellular pertussis


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F actors asso ciated with low cover age

1. Socio-demo gr aphic variab lesD epri ved , inner city areasMobile families (i.e. don t register with GP or miss appointments)Lar ger family sizeChildren with chroni c illnessEthni c st atus


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Implement ation of vaccination policy

Choice of policy (mass or sele ctive)Publish recommend ations ( green book )License vaccinePur chase vaccine

Media campaign and st art giving vaccinations


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Com bination vaccines

D PT/HiB/HepBBene fits:1. Redu ced num ber of injections2. Redu ced pain and parent al anxiety3. High compliance , low drop out r ates ,enh anced cover age4. Redu ced no: of visits5. Less stor age space6. Less burden on cold chain

Immunization, Vaccination

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