GKA deel 2 college 2

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GKA deel 2 college 2

  1. 2. Beardsley: Vaccines Sci Am 272-1, Jan 1995, 68-75 <ul><li>Advantages vaccines </li></ul><ul><ul><li>Costs </li></ul></ul><ul><ul><li>Safety </li></ul></ul><ul><li>Disadvantages </li></ul><ul><ul><li>Cost before disease </li></ul></ul><ul><ul><li>Safety! </li></ul></ul><ul><ul><li>Transport </li></ul></ul><ul><ul><li>Multiple injections </li></ul></ul><ul><li>Infectious diseases: cause of death nr 1 (worldwide) </li></ul><ul><li>All vaccines from now to all people: </li></ul><ul><ul><li>Prevents millions of death </li></ul></ul>HIV 2009 the Scientist, febr 2007, photo H.C. Robinson
  2. 3. Prevalence of DKT-vaccination <ul><li>Difterie, kinkhoest, tetanus-vaccin </li></ul>HIV 2009
  3. 4. Some vaccines in development HIV 2009 Credit: © 2008 Massachusetts Medical Society. All rights reserved <ul><li>Vaccinations in Netherlands: </li></ul><ul><li>DKTP </li></ul><ul><li>BMR </li></ul><ul><li>Influenza </li></ul><ul><li>Meningococ </li></ul>
  4. 5. Soorten vaccins <ul><li>Gedode organismen </li></ul><ul><ul><li>Kinkhoest, griep, polio (Salk-vaccin), hepatitis A </li></ul></ul><ul><li>Verzwakte toxines </li></ul><ul><ul><li>Difterie, tetanus </li></ul></ul><ul><li>Subunit vaccin </li></ul><ul><ul><li>Hepatitis B, meningitis, HIV (gp120) </li></ul></ul><ul><li>Verzwakte vorm (‘attenuated’) </li></ul><ul><ul><li>Pokken, polio, bof, mazelen, rode hond. </li></ul></ul><ul><li>Conjugaat: glycoprotein-aan een drager eiwit </li></ul><ul><ul><li>Meningococ, griep </li></ul></ul><ul><li>Adjuvantia: verhogen de immuunrespons a-specifiek </li></ul><ul><ul><li>Alum (aluminiumoxide, ISCOMS, liposomen, BCG) </li></ul></ul><ul><ul><ul><li>Bacillus Calmette-Guerin </li></ul></ul></ul><ul><li>Kaal DNA (subunit-vaccin) </li></ul>HIV 2009
  5. 6. Formaldehyde inactivatie 100 10 1 0,1 0 virus infectiviteit in %
  6. 7. Formaldehyde inactivatie 100 10 1 0,1 0 virus infectiviteit in % Logaritmische schaal!!
  7. 8. Formaldehyde inactivatie 100 10 1 0,1 0 virus infectiviteit in % Logaritmische schaal!! tijd in min
  8. 9. Formaldehyde inactivatie 100 10 1 0,1 0 tijd in min virus infectiviteit in % Logaritmische schaal!!
  9. 10. Formaldehyde inactivatie 100 10 1 0,1 0 tijd in min virus infectiviteit in % Logaritmische schaal!! Geïnactiveerd virus = gedood vaccin
  10. 11. Formaldehyde inactivatie 100 10 1 0,1 0 0 15 30 45 60 tijd in min virus infectiviteit in % Logaritmische schaal!! Geïnactiveerd virus = gedood vaccin
  11. 12. Safety! Monkey virus may be cleared of cancer link <ul><li>Polio vaccine in 1955 contaminated with SV40 </li></ul><ul><ul><li>Simian virus 40 </li></ul></ul><ul><ul><li>Induces tumors in hamsters </li></ul></ul>HIV 2009 Nature 431, 2004, 495
  12. 13. Rotavirus second chance <ul><li>Rotavirus verantwoordelijk voor ± miljoen slachtoffers/jaar </li></ul><ul><li>Eerste vaccin bijwerkingen </li></ul>HIV 2009 “ Then came a devastating setback. In summer 1999, the U.S. Centers for Disease Control and Prevention (CDC) reported a rare but alarming association between the vaccine and a potentially fatal bowel obstruction, called intussusception. Wyeth immediately pulled the vaccine, RotaShield, from the market, amid consensus that the risk, then pegged at 1 in 2500 children immunized, was far too great in the United States, where diarrheal deaths are exceedingly rare.” From: Science, 305, 2004, 1890-1893
  13. 14. Correlates of immune protection HIV 2009 Pantaleo and Koup, Nature Medicine 10, 2004, 806
  14. 15. Correlates of immune protection HIV 2009 Pantaleo and Koup, Nature Medicine 10, 2004, 806 Amazing LTLP
  15. 16. Problem: multiple vaccinations <ul><li>First vaccination </li></ul><ul><ul><li>Primo vaccination </li></ul></ul><ul><ul><li>Short and low response </li></ul></ul><ul><ul><ul><li>IgM vs IgG </li></ul></ul></ul><ul><li>Second and following vaccinations </li></ul><ul><ul><li>Booster </li></ul></ul><ul><ul><li>Better and longer-lasting response </li></ul></ul><ul><li>Multiple injections required </li></ul><ul><ul><li>Pox: 1-2; polio 3-8 </li></ul></ul><ul><ul><li>Life-long immunity </li></ul></ul>HIV 2009 1 st exposure 2 nd exposure weeks 1° response 2° response Ab titer
  16. 17. Problem for vaccine makers: The poliovaccine drama in 1955 Science 310, 2005, 975. <ul><li>The Cutter Incident </li></ul><ul><li>How America’s First Polio Vaccine Led to the Growing </li></ul><ul><li>Vaccine Crisis, </li></ul><ul><li>Paul A.Offit, Yale University Press, New Haven, CT, 2005, 250 pp. $27.50. ISBN 0300-10864-8. </li></ul>HIV 2009 <ul><li>http://americanhistory.si.edu/polio/virusvaccine/clinical.htm </li></ul>
  17. 18. Problem for vaccine makers: The poliovaccine drama in 1955 Science 310, 2005, 975. <ul><li>The Cutter Incident </li></ul><ul><li>How America’s First Polio Vaccine Led to the Growing </li></ul><ul><li>Vaccine Crisis, </li></ul><ul><li>Paul A.Offit, Yale University Press, New Haven, CT, 2005, 250 pp. $27.50. ISBN 0300-10864-8. </li></ul>HIV 2009 <ul><li>http://americanhistory.si.edu/polio/virusvaccine/clinical.htm </li></ul>
  18. 19. Major WHO victories <ul><li>Smallpox </li></ul><ul><ul><li>Eradicated in 1977 </li></ul></ul><ul><ul><li>Cheap, stable vaccin </li></ul></ul><ul><li>Polio </li></ul><ul><ul><li>Nearly!..... </li></ul></ul><ul><ul><ul><li>Science 2004, 303: p.1960 </li></ul></ul></ul><ul><ul><li>Herd immunity </li></ul></ul><ul><ul><ul><li>Staphorst </li></ul></ul></ul><ul><li>Worldwide vaccination of </li></ul><ul><ul><li>DTP+measles+tetanus+pertussis (‘kinkhoest’) </li></ul></ul><ul><ul><li>Saves 3x10 6 lives </li></ul></ul>HIV 2009                                                                                  
  19. 20. Polio uitbraak Nigeria Nature medicine, 12 december 2007 <ul><li>News: </li></ul><ul><li>Nature Medicine 13, 1394 (2007) Polio eradication campaign copes with unusual outbreak, Cassandra Willyard </li></ul>HIV 2009 ===================

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