vacinnation

1. Immunization and UNEPI
Dr. Franceska Akello
Lecturer
Department of Pediatrics and Child Health
27, February, 2019

2. Outline of presentation
• Definitions
• Immune system
• Vaccination schedule in Uganda
• Vaccine side effects

3. Introduction
• A vaccine- a preparation of the causative agent of a
disease, specially treated for use in vaccination, in order to induce or
increase immunity.
• Immunity: Protection from disease
• Immune system is designed to produce a coordinated response following
the entry of an antigen into the body
• Classified into Innate and adaptive immunity
• Innate immunity.
• The first line of defense against pathogen
• Includes
1. external/ anatomical barriers such as skin and mucous memebranes

4. Innate immune response…
2. Physiologic –Temp, PH, chemicals such as enzymes, complements
3. Phagocytic-Monocytes, neutrophils, macrophages
4. Inflammatory cells
• Innate immune responses are present intrinsically

5. Adaptive(acquired) immunity
• Requires preparation
• Response is by T and B lymphocytes
• Immune recognition is highly specific for particular pathogens
• Response changes after successful encounter with a pathogen
• Subsequent encounter with the same pathogen produces faster and
greater magnitude due to memory cell

6. Characteristics of innate immune response
• Are present intrinsically with or without previous exposure
• Have limited specificity
• Not enhanced by re-exposure.
• Once the barrier of the innate immune response has been breached,
the adaptive immune response is activated in an antigen specific
fashion to provide for the elimination of the antigen and lasting
protection from future re-exposure.

7. Components of adaptive immune response
• Lymphocytes-T and B cells
• Characteristics of the adaptive immune response
• Specific for a particular antigen
• Enhanced in repeat exposure
• Diverse
• Capable of self/non self recognition.

8. Immunization
• Definition: The process of inducing immunity against a specific disease
• Immunity can be induced passively through administration of Preformed
antibodies to an individual to induce transient protection against an
infectious agent
• It can also be achieved through physiological transfer of maternal
antibodies to a baby
• Immunity can also be induced actively by administering a vaccine or a
toxoid to stimulate either humoral or cell mediated immune response or
both

9. Immunization…
• It is among the most successful and cost effective public health interventions in
preventing a childhood mortality.
• Immunization prevents illness, disability and death from wide range of
communicable diseases.
• Globally Immunization currently averts an estimated 2 to 3 million deaths every
year.
Uganda
• Overall immunization coverage was at 50% for children 12 -23 months( 2006
UDHS).

10. Vaccines
• Vaccines are whole or parts of microorganisms administered to prevent an infectious disease.
• They can consist of whole inactivated microorganisms (e.g., polio and HepA),
• Parts of the organism (e.g., acellular pertussis, HPV, and HepB)
• Polysaccharide capsules (e.g., pneumococcal and meningococcal polysaccharide vaccines).
• Polysaccharide capsules conjugated to protein carriers (e.g., Hib, pneumococcal, and
meningococcal conjugate vaccines)
• Live-attenuated microorganisms (measles, mumps, rubella, varicella, rotavirus, and live-
attenuated influenza vaccines), and toxoids (tetanus and diphtheria

11. Vaccine…
• Preservatives, stabilizers, and antimicrobial agents are used to inhibit bacterial growth and to
prevent degradation of the antigen
• Adjuvants are used in some vaccines to enhance the immune response.
• Vaccines can induce immunity by stimulating antibody formation, cellular immunity, or both.
• Protection induced by most vaccines is thought to be mediated primarily by B lymphocytes,
which produce antibody.
• Such antibodies can inactivate toxins, neutralize viruses, and prevent their attachment to cellular
receptors, facilitate phagocytosis and killing of bacteria, interact with complement to lyse
bacteria, and prevent adhesion to mucosal surfaces by interacting with the bacterial cell surface.

12. Vaccine…
• To ensure potency, vaccines should be stored at recommended
temperatures before and after reconstitution ( Cold chain)

13. Initiation of a vaccine response
Following injection
• The pathogen-associated patterns contained in vaccine antigens attract
dendritic cells, monocytes and neutrophils that patrol throughout the body
• Activated monocytes and dendritic cells change their surface receptors
migrate along lymphatic vessels to the draining lymph nodes
• Activation of T and B lymphocytes takes place.

14. Generation of T cell effector responses
.
• Antigens are phagocytosed by DCs , processed into small peptides and
displayed at the cell surface in the groove of MHC class I and/or class II
molecules (2).
• CD4+ T cells activated and differentiate in effector cells that produce
preferentially Th1 or Th2 cytokines.
• Th1 CD4+ T cells produce INF-gamma and TNF-alpha that promote
CD8+ T cell function
• Th2 produce IL-4 that suppresses CD8+ T cell function.

15. Uganda National Expanded Programme on
Immunization ( UNEPI).
• It is a national program that mainly targets infant and women of childbearing age.
• Vision-To ensure that the Ugandan population is free of vaccine preventable
diseases.
• Offers the following services:
• Routine immunization services through static and outreach activities
• Supplement immunization activities (SIAs)-Organized periodically to interrupt transmission
and disease spread.
• Accelerated Routine immunization
• Surveillance and outbreak response.

16. Recommended Immunizable diseases under
UNEPI
1. Poliomyelitis-OPV/IPV
2. Whooping cough-Pertusis (DPT-HepB-Hib)
3.Diptheria
4. Tetanus
5. Measles-Measles vaccine
6. Neonatal tetanus-TTV for WCBA
7. Hepatitis B infection
8. H. influenza
9. Cancer of Cervix-HPV
10. Pneumococcal infection-Pneumococcal Conjugate vaccine
11. Tuberculosis-BCG
12.Rota virus

17. Immunization schedule-Print

18. Common vaccine side effects
• OPV-vaccine associated poliomyelitis
• Pertussis-Convulsions
• Fever
• Pain at the site of injection.
• Rash
• Enchepalitis

19. ANY QUESTIONS?