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Vaccines and Immunizations. Sidelsky 2007. Immunization . The induction of artifical immunity by giving preformed antibodies ( immunoglobulins) Administration of an antigen ( active Immunization). Immunity and immunoglobulins. Non Specific - collected from pooled serum of a high titer
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Vaccines and Immunizations Sidelsky 2007
Immunization • The induction of artifical immunity by giving preformed antibodies ( immunoglobulins) • Administration of an antigen ( active Immunization)
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
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
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
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
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
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
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
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
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
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, 2000;181:S110-S115; Hadfield, T. L. et al. Journal of Infectious Diseases, 2000;181:S116-S120.
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
Polio • Caused by an enterovirus • Enters the body through the oral route • Enters through the gastrointestinal route
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.
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
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
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
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
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
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
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
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.
Side Effects of Vaccine • Rash • Fever of 103oF • Measles vaccine is grown in eggs it represents a problem for people with egg allergies
Initial vaccination • First immunization given between 12-15 months • Second shot given at 4-6 years • Boosters may be given before entry to college
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
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
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
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.
Effects of Haemophilus influenza • High Fever • Swollen lymph nodes • Headache • Drowsiness • Irritability • Epigottitis • Osteomyelitis • Meningitis
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.
Vaccine type • Conjugate vaccine made by binding a polysaccharide to a protein
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
Transmission • Sexual contact • Breast milk • Serum ( used to be called serum Hepatitis
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