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Epidemiology and Prevention of Vaccine-Preventable Diseases

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Epidemiology and Prevention of Vaccine-Preventable Diseases National Center for Immunization and Respiratory Diseases Centers for Disease Control and Prevention – PowerPoint PPT presentation

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Title: Epidemiology and Prevention of Vaccine-Preventable Diseases


1
  • Principles of Vaccination

Epidemiology and Prevention of Vaccine-Preventable
Diseases National Center for Immunization and
Respiratory Diseases Centers for Disease Control
and Prevention
Revised April 2009
2
Diphtheria
3
Tetanus
4
Whooping cought
5
Meningitis Hib, Streptococcus, Neisseria
6
Measels
7
Poliomyelitis
8
Iron lung after poliomyelitis
9
Jenner, Variolisation, Ramses, eradication
10
Principles of Vaccination
Immunity
  • Self vs. nonself
  • Protection from infectious disease
  • Usually indicated by the presence of antibody
  • Very specific to a single organism

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12
Principles of Vaccination
Active Immunity
  • Protection produced by the person's own immune
    system
  • Usually permanent
  • Protection transferred from another person or
    animal
  • Temporary protection that wanes with time

Passive Immunity
13
Way to get immunised
Aktívna imunita Pasívna imunita
passively transplacentarly immunisation
immunotherapy immune sera
actively disease vaccination
Prirodzene získaná Prirodzene získaná
Naturally
Artificially
Umelo navodená Umelo navodená
Stávame sa imúnnymi prirodzenou cestou alebo
umelo. Ockovaním si vytvárame umelo získanú
aktívnu imunitu voci chorobám.
14
Principles of Vaccination
Antigen
  • A live or inactivated substance (e.g., protein,
    polysaccharide) capable of producing an immune
    response
  • Protein molecules (immuno-globulin) produced by B
    lymphocytes to help eliminate an antigen

Antibody
15
Protilátky Antigény Epitopy
Protilátky produkované bunkami imunitného systému
rozpoznávajú cudzie antigény ich
charakteristické molekuly antigénne
determinanty - epitopy
16
Passive Immunity
  • Transfer of antibody produced by one human or
    other animal to another
  • Temporary protection
  • Transplacental most important source in infancy

17
Sources of Passive Immunity
  • Almost all blood or blood products
  • Homologous pooled human antibody (immune
    globulin)
  • Homologous human hyperimmune globulin
  • Heterologous hyperimmune serum (antitoxin)

18
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

19
Vaccination
  • Active immunity produced by vaccine
  • Immunity and immunologic memory similar to
    natural infection but without risk of disease

20
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25
Classification of Vaccines
  • Live attenuated
  • viral
  • bacterial
  • Inactivated

26
Inactivated Vaccines
Whole
  • viruses
  • bacteria
  • protein-based
  • toxoid
  • subunit
  • polysaccharide-based
  • pure
  • conjugate

Fractional
27
  • 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
28
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
29
Live Attenuated Vaccines
  • Severe reactions possible
  • Interference from circulating antibody
  • Fragile must be stored and handled carefully

30
Live Attenuated Vaccines
  • Viral measles, mumps, rubella,
    varicella/zoster, yellow fever, rotavirus,
    intranasal influenza, rotavirus,
    vaccinia
  • Bacterial BCG, oral typhoid

31
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

32
Inactivated Vaccines
Whole-cell vaccines
  • Viral polio, hepatitis A, rabies,
    influenza
  • Bacterial pertussis, typhoid cholera,
    plague

not available in the United States
33
Inactivated Vaccines
Fractional vaccines
  • Subunit hepatitis B, influenza, acellular
    pertussis, human papillomavirus, anthrax
  • Toxoid diphtheria, tetanus

34
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

35
Polysaccharide Vaccines
Pure polysaccharide
  • pneumococcal
  • meningococcal
  • Salmonella Typhi (Vi)
  • Haemophilus influenzae type b
  • pneumococcal
  • meningococcal

Conjugate polysaccharide
36
Future of vaccine
  • Antiidiotype vaccines, DNA vaccines,
  • One, not hurting, for everybody, immunogenic, not
    harming, protecting against all diseases, only
    one disadvantage not real
  • Multivalent vaccines more immunogenic

37
Fases of new vaccines development laboratory,
preclinical
38
Field, clinical study
Skôr ako je vakcíne udelená licencia, prebieha
testovanie jej bezpecnosti a stanovenie úcinnosti
u dobrovolníkov v niekolkých fázach s presne
stanovenými podmienkami
39
Risks of immunisation
  • Side effects on any part of vaccine - redness,
    indurance, ache, fever, cry, alergy
  • Immunisation small regulated infection - mild
    reaction, not target tissue infection
  • Not real expectances

40
Population immunity
  • Collectove immunity more than 85 vaccinated
    against infection spread from 1 to the other
  • Protection of not immunisable or not immunised
    herd effect
  • Not present for tetanus, rabies

41
Surveillance a immunological surveys
  • Surveillance system of epidemiological
    patrolling
  • Immunological surveys targeted sampling of sera
    from different age groups to find not protected
    groups, to organise aimed vaccination - mopping,
    or catch up vaccination or changes of
    immunisation schedule

42
Decrease of morbidity for DTP after introduction
of DTP vaccination
43
INCIDENCE of HIb MENINGITIS - decrease influenced
by the amount of applicated vaccines
všetky 0 rokov 1- 4 rokov
94 95 96 97 98 99 00 01 02
44
Antivaccination activity
  • Vaccination mostly in child population
  • very sesitive topic, period of discovery of many
    diseases and handicapes in children
  • demagogical arguments,
  • not causal connection,
  • medialisation, not medically graduated people,
    usually educated in other vague topics ecology,
    homeopathy.....
  • Dangerous more people affected by vaccination
    preventable diseases in USA and Germany then for
    bioterroristic threat

45
Kontraindikácie ockovania
  • Akútne ochorenie, horúcka
  • Individuálne u pacientov s neurologickým
    postihutím, predchádzajúcou reakciou na ockovanie
  • Nepodávat živú OL tehotným alebo
    imunosuprimovaným (BCG?)
  • Jasne vyhodnotit riziko ockovania a jeho
    odmietnutia
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