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Vaccines and Immunizations

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Title: Vaccines and Immunizations


1
Vaccines and Immunizations
  • Sidelsky
  • 2007

2
Immunization
  • The induction of artifical immunity
  • by giving preformed antibodies
  • ( immunoglobulins)
  • Administration of an antigen ( active
  • Immunization)

3
Immunity and immunoglobulins
  • Non Specific - collected from pooled serum of a
    high titer
  • Effective for short duration( 1-4 months)
  • Broken down in protein catabolism and recycled

4
Vaccines
  • Vaccines contain an antigen to which the immune
    system responds
  • Vaccines contain weakened or attenuated viruses
    or organisms, inactivated organisms
  • Portions of organisms
  • Toxoids which are inactivated toxins that are
    antigenic, but not harmful

5
Mechanism of response
  • Upon administration of the vaccine
  • The immune system reacts to it as
  • foreign
  • The response is a weaker version of the one that
    would occur in the face of the actual pathogen
  • The response of the immune system determines the
    efficacy of the immunzation and the extent of the
    immunity provided

6
Boosters
  • Required to sustain immunity
  • The first dose evokes a primary immune response
  • The subsequent doses help to stimulate a
    secondary immune response
  • This increases the length of time that antibodies
    are present to prevent disease
  • May also affect the strength of response to the
    organism if the individual is exposed

7
Type of vaccine
  • The route of administration of a disease can
    affect the quality of immunity
  • Comparable to the injection of vaccines into
    muscle, the response is more effective if the
    vaccine is administered through its normal route
    of entry

8
DTaP
  • Diptheria, Tetanus, and acellular Pertussis
  • Replaced old DTP
  • Safer to administer
  • Made by pruifying toxins as well as proteins
  • These are inactivated by formaldehyde

9
Protection and side effects
  • The DTaP protects vaccine protects against,
    Diptheria, Tetanus, and Pertussis
  • Pertussis is the most problematic aspect of the
    disease
  • Protects agains whooping cough
  • Hooping cough is an upper respiratory infection
    that is caused by Bordatella pertussis

10
Whooping Cough ( continued)
  • The old vaccine caused fever, redness, at the
    injection site, malaise.
  • Crying persistently was also a side effect
  • Seizures were observed in some
  • In Japan they stopped administration of the
    vaccine.
  • A the time they stopped there wer 400 cases a
    year, this increased to 13.000 with much higher
    mortality

11
Diptheria
  • Diptheria is caused by an organism called
    Cornybacterium diptheriae
  • The disease itself is caused by a toxin
  • The toxin causes the formation of a membrane
    across the back of the throat making it difficult
    to breath

12
Diptheria
  • Early stages Sore throat. Low fever.
  • Swollen neck glands.
  • Late stages Airway obstruction and breathing
    difficulty. Shock (low blood pressure, rapid
    heartbeat, paleness, cold skin, sweating, and
    anxious appearance) (Kadirova, R. et al. Journal
    of Infectious Diseases, 2000181S110-S115
    Hadfield, T. L. et al. Journal of Infectious
    Diseases, 2000181S116-S120.

13
Diptheria
14
Tetanus
  • Caused by the bacteria, Clostridium tetani
  • Natural soil baterium
  • Enters the body through a wound
  • The bacterium produces a toxin that affects the
    skeletal muscle
  • Vaccine provides immunity
  • Td
  • Requires booster every 10 years

15
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16
Tetanus
17
Polio
  • Caused by an enterovirus
  • Enters the body through the oral route
  • Enters through the gastrointestinal route

18
Polio
  • Causes fever, diarrhea,vomiting, and still neck
    in some children
  • More severe form paralysis
  • Usually legs and arms are paralyzed - some times
    chest muscles that involve breathing.

19
Global Incidence of Polio - 1995
20
Polio Pioneers
21
Philadephia Connection Dr. Hilary Koprowski
22
Polio vaccines
  • OPV - oral vaccine - changes the genetics of the
    virus
  • The virus can survive in the GI tract, but cannot
    enter the nervous system
  • Antibodies are made on the surface of the gastric
    mucosa as well as the blood

23
IPV
  • IPV made by inactivating the virus with
    formaldehyde
  • Administered as an IM shot
  • Provides more immunity in blood but does not
    protect the gastrointestinal route
  • IPV provides a second line of defense against the
    organism

24
Vaccine administration and recommendations
  • Two doses of IVP followed by two doses of OVP(
    new vaccine eIVP) enhanced potency inactivated
    polio vaccine)
  • Replaces old schedule for just oral vaccines

25
Risks from administration of polio vaccine
  • Vaccine( OPV) causes 8-10 cases of paralysis a
    year
  • Paralysis is transitory in most
  • Replicates in gastric mucosa and if it sustains
    mutations it can cause disease
  • IPV - no serious side effects

26
MMR
  • Measles, mumps, rubella vaccine
  • Deaths from measles has dropped from 3000 a year
    to almost none
  • Fever and rash are the most common side effects

27
Mumps
  • Paramyxovirus
  • Transmitted via aerosolized droplets
  • Infects the parotid glands in the neck( enters
    through the ducts of the salivary glands)
  • Causes fever, extreme swelling of the neck. The
    neck becomes very hard
  • It used to be one of the major causes of
    meningitis prior to the development of the
    vaccine

28
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29
Swollen Parotid Glands
30
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31
Measles
  • Before the vaccine there were 3-4 million cases
    of measles per year
  • There were 3000 deaths
  • Since 1995 there have been no deaths
  • 240 million doses of the vaccine and no
    significant problems

32
Measles
  • Measles, also called Rubeola, is a highly
    contagious - but rare - respiratory infection
    that's caused by a virus.
  • It causes a total-body skin rash and flu-like
    symptoms, including a fever, cough, and runny
    nose.

33
Worldwide Immunization
34
Comparison of cases of Measles
35
Side Effects of Vaccine
  • Rash
  • Fever of 103oF
  • Measles vaccine is grown in eggs it represents a
    problem for people with egg allergies

36
Initial vaccination
  • First immunization given between 12-15 months
  • Second shot given at 4-6 years
  • Boosters may be given before entry to college

37
Rubella German Measles
  • Rubella -commonly known as German measles or
    3-day measles
  • It is an infection that primarily affects the
    skin and lymph nodes. It is caused by the rubella
    virus

38
Teratogenic virus
  • 85 of women infected with Rubella in the first
    trimester of pregnancy have children with severe
    birth defects
  • Children are born with blindness, deafness, and
    severe heart defects

39
Rubella titer
  • Women of reproductive age if planning a pregnancy
    should have a blood test to determine their
    status
  • Rubella titers measure the antibody level in the
    blood

40
Rubella
41
Hib Vaccine for Haemophilus influenza
  • Haemophilius influenza type B
  • Licensed for use in children under the age of 5
    years old
  • Mild symptoms
  • Redness around the injection site
  • Low grade fever
  • For many years it was believed that bactericidal
    antibody directed against PRP capsule ofH.
    influenzae type b was entirely responsible for
    host resistance to infection.

42
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43
Effects of Haemophilus influenza
  • High Fever
  • Swollen lymph nodes
  • Headache
  • Drowsiness
  • Irritability
  • Epigottitis
  • Osteomyelitis
  • Meningitis

44
Pathogenicity
  • For many years it was believed that bactericidal
    antibody directed against PRP capsule of H.
    influenzae type b was entirely responsible for
    host resistance to infection.

45
Vaccine type
  • Conjugate vaccine made by binding a
    polysaccharide to a protein

46
Hib vaccine in the Americas
47
Comparison of vaccinated and non vaccinated
48
Hepatitis B
  • 300,000 people in the United States are infected
    with Hepatitis B
  • Affects the liver and can cause cirrhosis
  • Can also lead to liver cancer
  • Vaccine has had a significant impact
  • 10 million people have been vaccinated

49
Transmission
  • Sexual contact
  • Breast milk
  • Serum ( used to be called serum Hepatitis

50
Immune Response to Hepatitis B
  • Virions consist of an outer lipid envelope and an
    icosahedal core, the latter being composed of
    both protein and DNA.
  • The outer envelope contains embedded proteins
    which are involved in viral binding of, and
    release into, susceptible cells.
  • Virion shape is generally spherical with a
    diameter of 40 - 48 nanometers (nm) but
    pleomorphic forms exist, including filamentous
    and spherical bodies lacking a core. These
    "subviral" particles are not infectious

51
Hepatitis B Symptoms
52
Cycle
  • Upon entry into a host cell, the virus'
    double-stranded DNA genome is relocated to the
    cell's nucleus and converted to covalently closed
    circular DNA form, from which viral mRNAs are
    transcribed
  • These transcripts are exported to cytoplasm for
    translation of the envelope proteins (also known
    as hepatitis B surface antigen, or HBsAg),
    hepatitis B e antigen (HBeAg), and the X protein,
    whose function is still under debate
  • A fourth pre-genomic RNA is transcribed, which
    translates the polymerase and core proteins.
  • Polymerase and pre-genomic RNA are encapsidated
    in the assembling core particles, where reverse
    transcription of the pre-genomic RNA to genomic
    DNA occurs by the Reverse Transcriptase (RT)
    protein. The mature core particle then exits the
    cell via normal secretory pathway, acquiring an
    envelope along the way.

53
Antigens
54
Cirrhosis of the liver
55
World Wide Distribution of surface antigen
56
Hepatavax
  • Purified (!) HBsAg from the blood of chronic
    carriers has been used as a vaccine since 1981
    (Hepatavax-B) and continues to be used in some
    areas of the world. Recombinant HBsAg vaccines
    produced in yeast have been available since 1986
    and are now most widely used (e.g. Engerix-B,
    Recombivax-HB), e.g. part of the W.H.O. expanded
    program on immunization. A combined hepatitis A
    and B vaccine (Twinrix - GlaxoSmithKline
    Biologicals) is now licenced for use in persons
    aged 18 years. This consists of the antigenic
    components used in Havrix (HAV) and Engerix-B
    (HBV) vaccines. These are vaccines are safe and
    effective - one of the few recombinant vaccines
    to date. Effective vaccination campaigns could

57
New Research
  • Lamivudine (3TC - 2'deoxy, 3'thiacytidine - a
    reverse transcriptase inhibitor) is currently
    being investigated for therapy of chronic HBV
    infection. Early results suggest this drug may be
    effective in patients who have previously failed
    to clear the virus with a-IFN.A number of other
    nucleoside and nucleotide analogues are now known
    to inhibit HBV replication in vitro and in vivo,
    including penciclovir, lobucavir and adefovir

58
Rotavirus Infant Diarrhea inThird World
Countries
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