INTRODUCTION OF VACCINE & VACCINATION. HISTORY. TYPRE OF VACCINE CONTRAINDICATION. CLASSIFICATION ACCORDING TO PATHOGEN. PRECAUTION BEFORE TO VACCINE. DRUGS ADMINISTRATION -: ROUTES & DOSE SUMMARY. REFERENCES. ASSESSMENT QUESTIONS

1. PRESENTATOR
 Ms. SAKUN RASAILY
PAEDIATRIC WARD
BPKIHS

2. PRESENTATION OUTLINES
 INTRODUCTION OF VACCINE & VACCINATION.
 HISTORY.
 TYPRE OF VACCINE
 CONTRAINDICATION.
 CLASSIFICATION ACCORDING TO PATHOGEN.
 PRECAUTION BEFORE TO VACCINE.
 DRUGS ADMINISTRATION -: ROUTES & DOSE
 SUMMARY.
 REFERENCES.
 ASSESSMENT QUESTIONS.

3. VACCINE
Vaccine is an immuno-biological substances designed to
produce specific protection against a given disease.
It stimulates the production of protective antibody &
other immuno mechanisms,
Vaccines may be prepared from live modified organisms,
inactivated or killed organisms,extracted cellular
fractions, toxoids or combination of these.
VACCINATION
Vaccination is the administration of a vaccine to
help the immune system develop protection from
a disease. Vaccines contain a microorganism or
virus in a weakened, live or killed state, or
proteins or toxins from the organism.

7. TYPES OF VACCINE
1. LIVEATTENUATED VACCINE
Live vaccines { eg: BCG,measles,oral polio } are prepared from live or wild
{generally attenuated }organisms.
These organisms have been passed repeatedly in the laboratory in tissue
culture or check embrios and have a lost their capacity to include full
blown disease but retain their immunogenecity.
In general,,,,,
Live vaccines are more potent immunizing agents than killed vaccine
because of -:
 Live organisms multiply in the host & the resulting antigenic dose in
large than what is injected.
 Live vaccines have all the major & minor antigenic components.
 Live organisms engages certain tissues of the body,
example intestinal mucosa after administration of oral polio
vaccine.
 Immune response similar to natural infection.
 If weakned germs are given to a person she/he will contract only a very
mild illness but will also develop antibodies & they will protect
him/her against the severe form of that disease in the future.

8. VIRAL LIVE VACCINE
Measels, Mumps, Rubella, Small pox, Chicken pox, Yello fever, Oral
polio ,
Rota virus & Japanese encephalitis.
BACTERIAL LIVE VACCINE
BCG , Oral Typhoid ,HIB

9. CONTRAINDICATION
 Pregnant women.
 Immune compromised person.
Leukemia,lypoma,malignancy,SLE.
 Radiotherapy.
 Cortocosteroid therapy.

10. 2 INACTIVATED / KILLED VACCINE
Inactivated vaccine are produced by growing virus or bacteria in
culture media & then inactivating them with heat or chemicals {
usually formalin }, when injected into the body they stimulate
immunity.
They are usuallu safe but generally less efficacious than live vaccines.
eg : cholera vaccine offers only 50 % protection.The efficacy of 3 dose of
pertussis vaccine is about 80 % in the first 3 years, & almost “ NILL
“12 years after immunization.
In killed vaccine booster dose is required.The duration of immunity
following the use of inactivated vaccines varies from months to many
years.
Examples of inactivated vaccines include:
inactivated poliovirus (IPV) vaccine, whole cell pertussis (whooping
cough) vaccine, rabies vaccine and the hepatitis A virus vaccine.

11. 1 Anaphylaxis, a severe allergy to a vaccine component,
2 Is a contraindication to any vaccine containing that
component,
3 And a severe allergy following a dose of vaccine is
a contraindication to subsequent doses of that vaccine.
4 Previous dose of vaccines.
CONTRAINDICATION

12. 3 COMBINATION VACCINE
If more than one kind of immunizing agent is included in the vaccine, it is
called a mixed or combined vaccine.
The aim of combined vaccine is to simplyfy administration , reduce cost ,
minimise the number of contacts of the patient with the health system,
reducing the storage cost, improving timelines of vaccination & facilitating the
addition of new vaccine into immunization programme.
No evidence exits that the administration of seversl antigen in combined
vaccines increase the burden on the immune system which is capable of
responding to millions of antigens at a time.
The following are some of the well – known combined vaccines are : -
 DIPHTHERIA – PERTUSSIS – TETANUS.
 DIPHTHERIS – TETANUS.
 DIPHTHERIA – PERTUSSIS.
 MEASLES , MUMPS & RUBELLA.
 HEPA – A & B
 TYPHOID

13.  Allergy to any vaccine components.
 Pregnancy. { for toratogenecity }
 Lactation.
 Hostory of fever.Sepsis.
CONTRAINDICATION

14. 4 SUB – UNIT VACCINES
A vaccine can be made of single or multiple antigenic components of a
micro-organism that are capable of stimulating a specific Immune response
sufficient to protect from the relevant pathogen infection or from the clinical
menifestation of the disease.
Different types of sub-unit vaccine can be defined….
 TOXOID VACCINE
 PROTEIN VACCINE
 RECOMBINANT PROTEIN VACCINE
 POLYSACCHARIDE – BASED VACCINE
 CONJUGATED VACCINE

15. CONTRAINDICATION
History of serious allergic reaction (i.e.,
anaphylaxis) to vaccine components or
encephalopathy (e.g., coma or prolonged seizures)..

16. {A} TOXOIDS VACCINE
Certain organisms produce exotoxins, eg -:
diphtheria & tetanus bacilli. The toxins produced by
these organisms are detoxicated & used in the
preparation of vaccines.The antibodies produced
neutralized the toxic moiety produced during
infection , rather than act upon the organisms. In
general , toxoid preparations are highly efficacious
& safe immunizing agents.
Examples are -:
diphtheria and tetanus vaccines.

17. { B } PROTEIN VACCINE
Immunization with a single protein or a
combination of proteins from a pathogen is sufficient
to stimulate a protective immune response against
that particular micro – organisms ,
One of the most widely used sub unit protein vaccine
is the INFLEUNZA vaccine composed of
haemagglutinin & neuraminidase purified from the
inactivated infleunza virus

18. { C } RECOMBINANT PROTEIN VACCINE
Development of the recombinant deoxyribonucleic acid
{ DNA } technology has made possible the expression
of protective protein antigen in Heterologius expression
system such as E . Coli , Yeast or Baculovirus .
Eg-: the hepatitis B vaccine is made by inserting a
segment of the hepatitis B virus gene into a yeast cell.
The modified yeast cell produces large amounts of
hepatitis B surface antigen , which is purified &
harvested & used to produce the vaccine.

19. { D } POLYSACCHARIDE – BASED VACCINE
The extensive ploysaccharide coat entirely shields the bacteria
outer membrane , preventing other surface bacterial components
from becoming a target of the host immune response.
Neverthless , antibodies to bacterial surface polysaccharides can
clear the bacteria from the host by different mechanisms ,
such as complement – mediated killing and Opsonophagocytosis.
Eg - : of polysaccharide vaccines are HIB , SALMONELLA

20. { E } CONJUGATED VACCINE
Children under two years of age donot respond well to
antigen .
such as Polysaccharides , which produce antibodies via a T
– cell independent mechanism.
If these polysaccharide antigen are chemically conjugated to
a protein that T – cell recognize.
Then these conjugate vaccines can elicit strong immune
response & immune memory in young children.
Eg - : pneumococcal & meningo-coccal vaccines.

23. PRECAUTION PRIOR TO INJECTION
 Review of the patients hostory with respect to possible sensitivity & any previous
Adverse reaction to the vaccine or similar vaccine / previous immunization
history.
 Current knowledge of the literature concerning the use of the vaccine under
consideration.
 Special care should be taken to ensure that the injection dosenot enter a blood
vessels.
 WHO doesnot recommend mixing different vaccines in one syringe before
injection

24. ADMINISTRATION OF VACCINE { ROUTES & DOSES }

26. REFERENCES
1 A Text Book Of Community Health Nursing Part –I
MS Binda Ghimire.
2 A Text Book Of Preventive & Social Medicine.
K. PARK , page no 111
3 https://www.who.int/news-room/q-a-
detail/vaccines-and-immunization-
what-is-vaccination.
4 https://www.fraserhealth.ca/health-topics-a-to-
z/immunizations/
immunization-basics/what-is-
immunization#.YMuljWgzY2w.
5 National Immunization Programme.

27.  Assessment Questions
1 One step in producing a live vaccine is to make the pathogen _________.
 stronger
 weaker
 larger
 bacterial
2 _______________ are made from inactivated bacterial toxins.
 All vaccines
 Subunit vaccines
 Toxoids
 Recombinant vaccines
3 True or false? Killed or inactivated vaccines usually provide shorter length of
protection than live vaccines.
 True
 False