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Immunity

Immunity. Dr. Pracheth R , MBBS , MD, DNB, PGDPHSM. Assistant Professor, Department of Community Medicine, Yenepoya Medical College. What is it ?. Specific protective antibodies Previous infection Immunization. Active immunity. Infection-clinical or subclinical or immunization

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Immunity

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  1. Immunity Dr. Pracheth R, MBBS, MD, DNB, PGDPHSM. Assistant Professor, Department of Community Medicine, Yenepoya Medical College.

  2. What is it ? • Specific protective antibodies • Previous infection • Immunization

  3. Active immunity • Infection-clinical or subclinical or immunization • Specific for disease • Individual immune to further disease from same organism

  4. Primary response • Antigen introduced: first time • Latent period: 3- 10 days- antibodies • First elicited: IgM type • Rises: 2-3 days- peak:declines

  5. Secondary (booster) response • Shorter latent period • Antibody produced more rapid • Abundant • Higher levels • Both IgM and Ig G

  6. Humoral immunity • From B cells: proliferate, manufacture antibodies • Specific: react with same antigen which provoked production • So no protection against more than one antigen

  7. Cellular immunity • Some organisms escape action of humoral immunity • Mediated by T cells • Example : TB

  8. Passive immunity • Antibodies produced –one body: transferred to another • Body doesn’t produce own antibodies: ready made antibodies • Immunoglobulin/antiserum • Maternal: child- Ig A

  9. Difference from active immunity • Immunity rapidly established • Temporary • Useful: difficult –produce antibodies

  10. Herd immunity • Level of resistance-community/group • Beyond immunization • Immunological barrier: spread of disease

  11. Continued…. • Depends on: • Infection • Immunization of herd • Herd structure • Example: polio

  12. Vaccines • Immuno-biological substance-protection: disease • Stimulates production of antibody

  13. Live vaccine • Organisms passed repeatedly: laboratory/tissue culture • Lost potential: full-blown diseases • BCG, Measles, Chicken Pox, Oral Polio

  14. Inactivated/killed vaccines • Killed: heat/chemicals • Safe, less efficacious • Rabies, Hepatitis B, Typhoid, cholera

  15. Toxoids • Exotoxins: diphtheria, tetanus • Detoxicated, used to prepare vaccines • Immunoglobulin: G, M, A , D, E • Antisera

  16. National Immunization Schedule • Birth: BCG, Hep B, OPV 0 • 6 weeks: OPV 1,Pentavalent, IPV, Rotavirus • 10 weeks: OPV 2, Pentavalent, Rotavirus • 14 weeks: OPV 3, Pentavalaent, IPV, Rotavirus • 9 months: Measles, Vitamin A • 16-24 months: DPT, OPV booster, Measles (2nd disease), JE, Vitamin A • 5-6 years: DPT booster • 10, 16 years: TT

  17. BCG Vaccine

  18. Pentavalent vaccine

  19. Cold chain • System- storage and transport vaccines • From manufacture to vaccination site • Freezer: Polio, measles • Cold part, not freeze: typhoid, tetanus, DPT, DT, BCG

  20. Walk-in cold rooms (WIC)

  21. Deep freezers

  22. Ice-lined refrigerators (ILR)

  23. Dial thermometer

  24. Vaccine carriers

  25. Ice packs

  26. The Vaccine Vial Monitor (VVM)

  27. Adverse Events Following Immunization (AEFI) • Medical incident: after immunization- caused by immunization • Can be true adverse events/ coincidental events

  28. Classification • Vaccine reaction: • Vaccine given correctly • Caused by properties of vaccine • Common minor reactions • Hypersensitivity- anaphylactic shock, serum sickness

  29. Continued…. • Reactions due to programme error: • Faulty techniques • Incorrect dose, diluent • Vaccine stored incorrectly • Improperly sterilized syringes/needles

  30. Continued…. • Coincidental events: • Unconnected with vaccine • Injection reaction: • Anxiety: fainting, headache

  31. Precautions • Test for sensitivity: • Instill drop : conjunctival sac • Intradermal injection-antiserum: wheal, flare • Adrenaline for anaphylaxis • Proper sterilization of syringes • Proper selection product • Training • Cold chain

  32. Investigation of AEFI • Confirm information • Investigate and collect data about: • Patient • Event • Vaccine • Other people

  33. Continued…. • Assess service by asking about: • Vaccine storage • Sterilization • Training • Observe the service in action: • What else is stored in refrigerator • Immunization procedure

  34. Continued….. • Formulate working hypothesis • Test working hypothesis • Conclude investigation: take action

  35. Summary

  36. Thank You

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