Your SlideShare is downloading. ×
Immunization Dr.T.V.Rao
Upcoming SlideShare
Loading in...5
×

Thanks for flagging this SlideShare!

Oops! An error has occurred.

×

Introducing the official SlideShare app

Stunning, full-screen experience for iPhone and Android

Text the download link to your phone

Standard text messaging rates apply

Immunization Dr.T.V.Rao

10,838
views

Published on

Published in: Health & Medicine, Business

3 Comments
9 Likes
Statistics
Notes
No Downloads
Views
Total Views
10,838
On Slideshare
0
From Embeds
0
Number of Embeds
7
Actions
Shares
0
Downloads
921
Comments
3
Likes
9
Embeds 0
No embeds

Report content
Flagged as inappropriate Flag as inappropriate
Flag as inappropriate

Select your reason for flagging this presentation as inappropriate.

Cancel
No notes for slide

Transcript

  • 1. Immunization. Current Trends 2007 Dr.T.V.Rao MD
  • 2. Immunization = Vaccination
    • What is a Vaccine
    • A vaccine is a substance that is introduced into the body to prevent Infection or a certain Pathogen
    • Can be used in bacterial, Viral, Parasitic Infections.
  • 3. History Guides the Future
  • 4. Edward Jenner Vaccinating
  • 5. Beginning of Vaccination .
    • Vaccination ( Latin ; Vacca- Cow )
    • Edward Jenner used the term Vaccination
    • Cow pox virus provided immunity in prevention of Small pox
  • 6. Scientific Era of Vaccination .
    • Louis Pasteur adopts the principles of Vaccination
    • For his scientific work.
    • Vaccination for prevention of Rabies creates awareness on Immunization with scientific fundamentals
  • 7. Major Principles and Methods of Vaccination Biological events guide the Vaccination
  • 8. Major content of Vaccines
    • Toxoids
    • Inactivated vaccines.
    • Attenuated vaccines
    • Subunit vaccines
    • Hyper immune globulins.
  • 9. What we have achieved with Vaccination
    • Cost effective method in controlling the infectious diseases.
    • Small pox - Eradicated.
    • Immunization prevents many diseases
    • We have created Herd immunity in commonly prevalent diseases.
  • 10. Eradication of Small Pox
    • WHO efforts with various Governmental and Social Organizations have changed History of Medicine
  • 11. Principles of Immunization Development of Immunology has foundations on Vaccines
  • 12. Different protocols to Immunization
    • Passive Immunization
    • Active Immunization .
  • 13. Passive Immunization
    • Passive immunization
    • Artificially created by passive method
    • Can be created at short notice,
    • Effective for limited periods,
    • Antibodies are created in various sources from animals to humans
    • Can be Antiviral ,Antibacterial,
    • Source can be Animals, or Humans
    • Human source will be effective for 3-6 months.
    • Animals ( Heterologus ) effective for few weeks,
  • 14. Passive Immunization
    • Diphtheria antitoxin - Horse- Equine Diptheriae antitoxin.
    • Botulism - Antitoxin
    • Tetanus – Antitoxin. – Equine
    • Human Tetanus Immunoglobulin,
    • Pooled Immunoglobulins
    • Human Normal Immunoglobulin
    • Used for short term prophylaxis,
    • Eg Hepatitis A Immunoglobulin,
  • 15. Passive Immunization Highly Successful Saves in Acute Infections
    • Diphtheria Antitoxin
    • Tetanus Antitoxin
    • Rabies Hyper immune Globulins( HRIG )
    • Varicella Zoster Hyper Immune Globulins (HZIG)
  • 16. Active Immunization . Most Ideal, Cost effective, method to prevent communicable Diseases.
  • 17. Active Immunization with Toxoids
    • Types 1
    • Toxoids - Single Toxin Modified
    • Preserves Antigenicity,
    • Loses its Toxicity.
    • Eg 1 Tetanus Toxoid
    • 2 Diphtheria Toxoid
  • 18. Active Immunization
    • Inactivated / Killed Vaccines ,
    • Microbes are killed
    • Eg 1 Pertusis , (Whooping cough )
    • 2 Influenza ( Flu)
    • 3 Salk - Killed vaccine for
    • (Poliomyelitis) ,
  • 19. Active Immunization
    • Attenuated Live vaccine
    • Inactivation destroys pathogen city,
    • Protective immunity is retained
    • Contains living organisms with reduced virulance,
    • 1 Live polio vaccines –Sabins,
    • 2 Yellow fever vaccine 17D strain.
  • 20. Different schedules of Vaccination May vary from Nation to Nation Depends on Geographic, Economic and prevalence of Specific Diseases
  • 21.  
  • 22. Herd Immunity
    • Definition – When most of the People in a community are immune to particular infection-Natural transmission is inhibited.
    • Herd Immunity works in infections transmitted from person to person only.
    • The Mass oral polio vaccine creates a Herd Immunity and protects the Society .
  • 23. Immunization Schedules
    • Depend on
    • Need,
    • Efficacy,
    • Safety,
    • Ease of administration,
  • 24. Vaccines which Changed the History of Medicine Vaccination for Polio, Tetanus Diphtheria, Pertusis. Rabies Universally accepted
  • 25. Vaccination for Diphtheria, Tetanus and Pertusis
    • Triple Antigen ( DTP )
    • Contains Toxoids of Diphtheria and Tetanus
    • Pertusis component Contains whole Cell preparation from Bordetella pertusis.
    • Three Doses given at the interval of 4-6 weeks
    • Boosters at Later date
  • 26. Vaccination for Poliomyelitis A great break through in Vaccine Research Millions saved from disabling Polio
  • 27. Pioneers in Prevention of Poliomyelitis
  • 28. Vaccination in Poliomyelitis
    • Vaccination for Poliomyelitis, can be oral or inject able.
    • Sabins – Mixture of 3 types poliovirus1,2,3
    • Live attenuated vaccine, A oral vaccine colonizes the gut produces the local immunity and antibody mediated immunity protects , Rarely hazardous,
    • Salk – vaccine a killed vaccine not used in routine immunization schedules. India
    • Sabin’s live polio vaccine is economical for mass vaccination in populous countries
    • Component of Mass Pulse Polio Immunization programme
  • 29. Commonly used vaccines,
    • MMR Vaccine
    • Used for the prevention of
    • Measles, Mumps, and Rubella.
    • Contains live attenuated strains,
    • Given at the age between 12-15 months,
    • But Measles vaccination is done early in India at 9 months.
    • Rubella
    • Rubella Vaccine is given separately to young women
    • Given to all sero negative women of child bearing age
  • 30. Vaccination for Tuberculosis
    • BCG – Attenuated strains of Bovine Tubercle Bacilli, ( Bacilli –Chalmette-Guerin)
    • Efficacy ? But useful in the prevention of Tuberculosis meningitis, and Leprosy
    • Given on lateral aspect of arm, at the deltoid insertion
    • To be given intradermally,
  • 31. Emerging Vaccines Recently several persons benefited.
  • 32. Haemophilus influenza
    • Type b serotype is capsulated and highly pathogenic,
    • Produces Meningitis,Bacteremias, Epiglottis's.
    • Encapsulated strain b is selected for vaccination.
    • Vaccine contains capsular polysaccharide linked to a protein and protects against against type B strains.
    • In U K given along with DPT vaccine
    • When not given earlier A single dose for 1 – 4 years children.
    • Elder children and Adults do not need unless immunosupressed.
  • 33. Meningococcal Vaccine Men C Vaccine
    • The component of the vaccine is Meningococcal C antigen,
    • The polysaccharide component is linked to protein carrier,
    • In developed countries given at 2, 3, 4 months duration.
    • Produces prolonged immune response.
  • 34. Vaccination in Hepatitis A Virus Infection
    • A formaldehyde inactivated vaccine prepared from HAV grown in Diploid cells
    • A vaccination is effective for 10 years
    • Advised mainly in persons entering endemic areas with HAV Infection.
  • 35. Bio-Engineering creates Vaccine Hepatitis B Vaccine
  • 36. Molecular Biology and Genetic Engineering contributed for HBV Vaccine .
  • 37. Vaccination for Hepatitis B Infection .
    • Hepatitis B Vaccine
    • Bio Engineered vaccine,
    • 0 - 1 - 6 months ( Dosage )
    • Deltoid region
    • 90% successful
    • Universal Immunization – an ideal goal in prevention of Hepatitis B infections .
  • 38. Combined Vaccination for Hepatitis A and B Infections.
    • Now a combined vaccine is available for prevention of Hepatitis A and B
    • Available as
    • TWINRIX ( GSK )
  • 39. Vaccination for Typhoid
    • Oral – Live ( Typhoral )
    • Stable mutant of S.typhi
    • Strain Ty2 ( Lacking enzyme UDP –Galactose 4 Epimerase).
    • Injectable vaccine ( Ty vi ) contains
    • Purified Vi polysaccharide Antigen
    • Efficacy lasts for 3 years
    • Needed for people traveling to Endemic areas
  • 40. Other Vaccines
    • Pneumococcal vaccine
    • A polyvalent polysaccharide containing capsular antigen with 23 Sero types
    • Gives 80 -90 % protection
    • Used in
    • Dysfunctional spleen
    • Sickle cell diseases,
    • Chronic diseases of Liver, lungs, heart,
    • Renal failure.
    • HIV infection
    • Effective in > 2 years old children,
  • 41. Vaccine for Varicella zoster
    • OKA strain, A live attenuated strain,
    • Single dose for children ( 1-12 years children)
    • Not to be given in Immune suppressed / HIV patients.
  • 42. Vaccine for Influenza(virus )
    • Always use new vaccines with prevailing strains,
    • Now recombinant vaccines are available.
    • Made in embroyonated eggs.
  • 43. New Vaccines Developed or on Trails
  • 44. Vaccines for Rota Virus
    • Rota Rix ( GSK )
    • Introduced in Brazil, Elsalvador, Mexico, Panama and Venezuela
    • Under Phase III trails in Africa, and Malawi
    • Rota Teq ( MEREK)
    • Introduced in Nicaragua
  • 45. Newer Pneumococcal Vaccine
    • A Seven Valent conjugate vaccine (Prevenar )
    • Effective against 7 strains prevalent in certain geographic locations
    • Effective in 83 % HIV uninfected.
    • Effective in 65 % of HIV infected.
  • 46. Human Papilloma Virus Vaccine
    • Gardasil ( HPV vaccine ) developed by Merck.
    • Effective against 4 common serotypes
    • ( includes prominent serotypes 16 and 18 causing Cancer cervix ).
    • Adolescents and preadolescents considered for vaccination.
  • 47. Newer Meningococcal Meningitis A Vaccine ( Men A )
    • Effective in Meningococcal Diseases
    • Phase I trails in India
    • Phase II trails , Mali, and Gambia
    • Phase III trails in Ethiopia /Senegal
  • 48. Influenza Current Vaccine
    • In view of changing strains the antigens configuration for Influenza need a new model vaccine every year / frequently
    • Currently CSL Biotherapies vaccine is licensed on 28 th Sept 2007 for current use.
  • 49. Need for Vaccines in HIV/AIDS
  • 50. Why Vaccines are Difficult to Development in AIDS
    • H I V infection is produced by most complex virus ever identified and it is extremely good at evading any Immune Mediated strategy detected against.
    • H I V is Genetically diverse.
    • New forms ( clades ) are emerging all through infection,
  • 51. Vaccine Options
    • 1 Live attenuated or whole killed HIV virus Failed due to safety fears, Trails stopped .
    • 2 Sub Unit vaccines ( gp 20 model )
    • Failed in Major trails .
    • 3 DNA vaccines
    • Isolated HIV genes used to stimulate
    • cell mediated Immunity .
  • 52. Vaccine Options ( Contd )
    • 4 Recombinant Vaccine - Isolated genes delivered through another viral vector,
    • Most trials use this method
  • 53. Vaccine Options
    • 5 Combination Vaccines.
    • Multiples trails are in progress with combination of Designs, strategies,
    • And
    • Immunogens which can produce a broader more powerful, and more durable immune response.
  • 54. The Quest for the AIDS vaccine continues Various National and International Organization are committed for development of a effective Vaccine
  • 55. Present HIV Vaccination Trails
  • 56. Vaccination for People at special risk
    • Anthrax
    • Cholera
    • Hepatitis A
    • Hepatitis B
    • Influenza
    • Japanese B encephalitis
    • Meningococcal Infection
    • Plague
    • Pneumococcal infection
    • Q fever,
    • Rabies
    • Tick borne encephalitis.
    • Typhoid
    • Typhus
    • Varicella Zoster
    • Yellow fever.
  • 57. Contraindication to Vaccination In spite of great success with many vaccines, yet a caution and wisdom are essential I
  • 58. Contra -indications to Vaccination
    • Do not give vaccines to acutely ill patients.
    • Avoid giving live vaccines to pregnant women
    • Avoid all types of vaccines in the first Trimester of pregnancy,
    • Do not give live vaccines to immunosupressed patients and patients suffering with RES malignancies,
  • 59. Contraindication ( Cont )
    • In spite of Immune suppression in HIV infected, we can still give MMR and Oral polio drops ( But Salk killed vaccine is safe).
    • In HIV patients do not give BCG vaccine
  • 60. What is an ideal vaccine.
    • Promotes effective immunity.
    • Controls lifelong protection.
    • Safe, do not carry side effects.
    • Stable, cheap,
    • Acceptance by public.
    • Yet there is No Ideal Vaccine .
  • 61. Care in Vaccination
    • Some subjects may develop acute anaphylaxis with vaccination,
    • Be prepared to resuscitate the individuals,
  • 62. Unresolved problems
    • Nothing is perfect
    • No Vaccine is totally Protective
    • Influenza – Needs very frequent updating
    • Cholera vaccine –Little effective in reality
  • 63. WHO Initiatives On Vaccine Strategies and Development
  • 64. WHO
    • Supports the Research of various Biological
    • Organizations which produce the Newer
    • Vaccines
    • Helps the Implementation various programmers related to Vaccines
  • 65. Vaccine Research
    • Now major research is focused on finding the safe and Socially acceptable vaccines
    • Refer for current knowledge on Vaccines.
    • VACCINE - is a International peer-reviewed journal of Vaccination Research
    • Indexed in Medline pISSN: 0264-410X
  • 66. Science Hopes a Vaccine for every Disease
  • 67. Vaccination created HOPE in Humanity
  • 68. Created for awareness among Medical and Health care workers in Developing world. Dr.T.V.Rao MD [email_address]