Dr. ihsan edan abdulkareem alsaimary PROFESSOR IN MEDICAL MICROBIOLOGY AND MOLECULAR IMMUNOLOGY ihsanalsaimary@gmail.com mobile : 009647801410838 university of basrah - college of medicine - basrah -IRAQ

1. Vaccines,
vaccination
and Immunization
Prepared by
Prof.dr. ihsan edan alsaimary
Department of microbiology – college
of medicine – university of basrah

2. Immunity
Specific defenses
Immunity
Passive immunity
Active immunity
Following clinical infection
Following subclinical infection
Following vaccination Following administration of
Immunoglobulin or antiserum
Transfer of maternal
Antibodies Through milk
Transfer of maternal
Antibodies Through placenta
natural
acquired

3. Active immunity
• Resistance developed in response to
stimulus by an antigen (infecting agent or
vaccine) and is characterized by the
production of antibodies by the host.

4. Passive immunity
• Immunity conferred by an antibody
produced in another host. It may be
acquired naturally or artificially (through
an antibody-containing preparation).

5. Immunizing agents
Immunizing agents
antisera
immunuglobulins
vaccines

6. Immunoglobulins
• There are 5 major classes: IgM, IgA, IgG,
IgE, IgD.
• Two types of immunoglobulin preparations
are available for passive immunization:
– Normal human immunoglobulin
– Specific (hyper-immune) human
immunoglobulin

7. Antisera or antitoxins
• These are materials prepared in animals or
non human sources such as horses.

8. Immunoglobulin and antiserum
Human normal
immunoglobulin
Human specific
immunoglobulin
Non human ig
(antisera)
Hepatitis A
Measles
Rabies
Tetanus
Mumps
Hepatitis B
Varicella
Diphtheria
Diphtheria
Tetanus
Gas gangrene
Botulism
Rabies

9. Vaccination
• Vaccination is a method of giving antigen to
stimulate the immune response through
active immunization.
• A vaccine is an immuno-biological substance
designed to produce specific protection
against a given disease.
• A vaccine is “antigenic” but not “pathogenic”.

10. Types of vaccines
• Live vaccines
• Attenuated live vaccines
• Inactivated (killed vaccines)
• Toxoids
• Polysaccharide and polypeptide (cellular
fraction) vaccines
• Surface antigen (recombinant) vaccines.

11. Live vaccines
• Live vaccines are made from live infectious
agents without any amendment.
• The only live vaccine is “Variola” small pox
vaccine, made of live vaccinia cow-pox
virus (not variola virus) which is not
pathogenic but antigenic, giving cross
immunity for variola.

12. Live attenuated (avirulent) vaccines
• Virulent pathogenic organisms are treated to
become attenuated and avirulent but antigenic.
They have lost their capacity to induce full-
blown disease but retain their immunogenicity.
• Live attenuated vaccines should not be
administered to persons with suppressed
immune response due to:
– Leukemia and lymphoma
– Other malignancies
– Receiving corticosteroids and anti-metabolic agents
– Radiation
– pregnancy

13. Inactivated (killed) vaccines
• Organisms are killed or inactivated by heat
or chemicals but remain antigenic. They
are usually safe but less effective than live
attenuated vaccines. The only absolute
contraindication to their administration is a
severe local or general reaction to a
previous dose.

14. Toxoids
• They are prepared by detoxifying the exotoxins
of some bacteria rendering them antigenic but
not pathogenic. Adjuvant (e.g. alum
precipitation) is used to increase the potency of
vaccine.
• The antibodies produces in the body as a
consequence of toxoid administration neutralize
the toxic moiety produced during infection
rather than act upon the organism itself. In
general toxoids are highly efficacious and safe
immunizing agents.

15. Polysaccharide and polypeptide
(cellular fraction) vaccines
• They are prepared from extracted cellular
fractions e.g. meningococcal vaccine from the
polysaccharide antigen of the cell wall, the
pneumococcal vaccine from the polysaccharide
contained in the capsule of the organism, and
hepatitis B polypeptide vaccine.
• Their efficacy and safety appear to be high.

16. Surface antigen (recombinant)
vaccines.
• It is prepared by cloning HBsAg gene in
yeast cells where it is expressed. HBsAg
produced is then used for vaccine
preparations.
• Their efficacy and safety also appear to be
high.

17. Types of vaccines
Live
vaccines
Live
Attenuated
vaccines
Killed
Inactivated
vaccines
Toxoids Cellular fraction
vaccines
Recombinant
vaccines
•Small pox
variola
vaccine
•BCG
•Typhoid
oral
•Plague
•Oral polio
•Yellow
fever
•Measles
•Mumps
•Rubella
•Intranasal
Influenza
•Typhus
•Typhoid
•Cholera
•Pertussis
•Plague
•Rabies
•Salk polio
•Intra-
muscular
influenza
•Japanise
encephalitis
•Diphtheria
•Tetanus
•Meningococcal
polysaccharide
vaccine
•Pneumococcal
polysaccharide
vaccine
•Hepatitis B
polypeptide
vaccine
•Hepatitis B
vaccine

18. Routes of administration
• Deep subcutaneous or intramuscular route
(most vaccines)
• Oral route (sabine vaccine, oral BCG
vaccine)
• Intradermal route (BCG vaccine)
• Scarification (small pox vaccine)
• Intranasal route (live attenuated influenza
vaccine)

19. Scheme of immunization
• Primary vaccination
– One dose vaccines (BCG, variola, measles,
mumps, rubella, yellow fever)
– Multiple dose vaccines (polio, DPT, hepatitis B)
• Booster vaccination
To maintain immunity level after it declines after
some time has elapsed (DT, MMR).

20. Periods of maintained immunity
due to vaccines
• Short period (months): cholera vaccine
• Two years: TAB(typhoid and paratyphoid
A& B) vaccine
• Three to five years: DPT vaccine
• Five or more years: BCG vaccine
• Ten years: yellow fever vaccine
• Solid immunity: measles, mumps, and
rubella vaccines.

21. Levels of effectiveness
• Absolutely protective(100%): yellow fever
vaccine
• Almost absolutely protective (99%): Variola,
measles, mumps, rubella vaccines, and
diphtheria and tetanus toxoids.
• Highly protective (80-95%): polio, BCG,
Hepatitis B, and pertussis vaccines.
• Moderately protective (40-60%) TAB, cholera
vaccine, and influenza killed vaccine.

22. The Cold Chain
• The "cold chain" is a system of storage
and transport of vaccines at low
temperature from the manufacturer to the
actual vaccination site.
• The cold chain system is necessary
because vaccine failure may occur due to
failure to store and transport under strict
temperature controls.

23. The Cold Chain Equipment
Cold chain equipment consists of the following:
(a) Walk in cold rooms: They are located at
regional level, meant to store vaccines up to 3
months and serve districts.
(b) Deep freezers (300 ltr) and Ice lined
Refrigerators: supplied to all districts and the
WIC locations to store vaccines. Deep freezers
are used for making ice packs and to store OPV
and measles vaccines.
(c) Small deep freezers and ILR (140 ltr) : One
set is provided to PHCs, and Family Planning
Centers

24. • (d) Cold boxes: Cold boxes are supplied to all
peripheral centers. These are used mainly for
transportation of the vaccines.
• (e) Vaccine carriers: Vaccine carriers are used to
carry small quantities of vaccines (16-20 vials)
for the out of reach sessions. 4 fully frozen ice
packs are used for lining the sides, and vials of
DPT, DT, TT and diluents should not be placed
in direct contact with frozen ice packs. The
carriers should be closed tightly.
• (f) Ice packs: The ice packs contain water and
no salt should be added to it.

25. • Among the vaccines, polio is the most
sensitive to heat, requiring storage at
minus 20 degree C.
• Vaccines which must be stored in the
freezer compartment are : polio and
measles.
• Vaccines which must be stored in the
COLD PART but never allowed to freeze
are : typhoid, DPT, tetanus toxoid, DT,
BCG and diluents

26. HAZARDS OF
IMMUNIZATION
• No immune response is entirely free from the
risk of adverse reactions or remote squeal. The
adverse reactions that may occur may be
grouped under the following heads:
1. Reactions inherent to inoculation
2. Reactions due to faulty techniques
3. Reactions due to hypersensitivity
4. Neurological involvement
5. Provocative reactions
6. Others

27. • 1. Reactions inherent to inoculation:
These may be local general reactions. The local
reactions may be pain, swelling, redness,
tenderness and development of a small nodule
or sterile abscess at the site of injection.
• The general reactions may be fever, malaise,
headache and other constitutional symptoms.
Most killed bacterial vaccines (e.g., typhoid)
cause some local and general reactions.
Diphtheria and tetanus toxoids and live polio
vaccine cause little reaction.

28. • 2. Reactions due to faulty techniques:
Faulty techniques may relate to
• faulty production of vaccine (e.g. inadequate inactivation of the
microbe, inadequate detoxication),
• too much vaccine given in one dose,
• improper immunization site or route,
• vaccine reconstituted with incorrect diluents,
• wrong amount of diluent used,
• drug substituted for vaccine or diluent,
• vaccine prepared incorrectly for use (e.g., an adsorbed vaccine not
shaken properly before use),
• vaccine or dliluent contaminated,
• vaccine stored incorrectly,
• contraindications ignored (e.g. a child who experienced a severe
reaction after a previous dose of DPT vaccine is immunized with he
same vaccine),
• reconstituted vaccine of one session of immunization used again at
the subsequent session.

29. • Use of improperly sterilized syringes and
needles carry the hazard of hepatitis B
virus, and staphylo - and streptococcal
infection

30. • 3. Reactions due to hypersensitivity:
• Administration of antisera (e.g., ATS) may occasionally
give rise to anaphylactic shock and serum sickness.
Many viral vaccines contain traces of various antibiotics
used in their preparation and some individuals may be
sensitive to the antibiotic which it contains. Anaphylactic
shock is a rare but dangerous complication of injection
of antiserum. There is bronchospasm, dyspnoea, pallor,
hypotension and collapse.
• The symptoms may appear within a few minutes of
injection or may be delayed up to 2 hours. Some viral
vaccines prepared from embryonated eggs (e.g.,
influenza) may bring about generalized anaphylactic
reactions. Serum sickness is characterized by symptoms
such as fever, rash, oedema and joint pains occurring 7 -
12 days of injection of antiserum.

31. • 4. Neurological involvement:
• Neuritic manifestations may be seen after the
administration of serum or vaccine. The well-
known examples are the postvaccinial
encephalitis and encephalopathy following
administration of anti -rabies and smallpox
vaccines.
• GuillainBarre syndrome in association with the
swine influenza vaccine is another example.

32. • 5. Provocative reactions:
• Occasionally following immunization there may
occur a disease totally unconnected with the
immunizing agent (e.g., provocative polio after
DPT or DT administration against diphtheria).
• The mechanism seems to be that the individual
is harboring the infectious agent and the
administration of the vaccine shortens the
incubation period and produces the disease or
what may have been otherwise only a latent
infection is converted into a clinical attack.

33. • 6. Others:
• These may comprise damage to the fetus
(e.g., with rubella vaccination);
displacement in the age-distribution of a
disease (e.g., a potential problem in mass
vaccination against measles, rubella and
mumps).

34. PRECAUTIONS TO BE TAKEN
• Before administration of the antiserum or
antitoxin, it is necessary to test for sensitivity
reaction. This can be done in 2 ways:
(a) instilling a drop of the preparation into the
conjunctival sac. A sensitized person will develop
pricking of the conjunctiva.
(b) a more reliable way of testing is by intradermal
injection of 0.2 ml of antiserum diluted 1 : 10
with saline. A sensitized patient will develop a
wheal and flare within 10 minutes at the site of
injection. It should be borne in mind that these
tests are not infallible.

35. • Adrenaline (1: 1000 solution) should be kept ready when
giving foreign serum. In the event of anaphylaxis, for an
adult, 0.5 ml of adrenaline solution should be injected
intramuscularly immediately, followed by 0.5 ml every 20
minutes if the systolic blood pressure is below 100 mm
of mercury.
• An injection of antihistaminic drug should also be given,
e.g., 10-20 mg of chlorpheniramine maleate by the
intramuscular route, to minimise the after-effects such
as urticaria or oedema. The patient should be observed
for 30 minutes after any serum injection.

36. • The risk of adverse reactions can be reduced by proper
sterilization of syringes and needles, by proper selection
of the subject and the product, and if due care is
exercised in carrying out the procedure. Measles and
BCG vaccines should be reconstituted only with the
diluent supplied by the manufacturer.
• Reconstituted vaccine should be discarded at the end of
each immunization session and NEVER retained for use
in subsequent sessions. In the refrigerator of the
immunization centre, no other drug and substances
should be stored beside vaccines.
• Training of immunization worker and their close
supervision to ensure that proper procedures are being
followed are essential to prevent complications and
deaths following immunization.

37. Vaccination Coverage
• Vaccination coverage is the percent of at
risk or susceptible individuals, or
population who have been fully immunized
against particular diseases by vaccines or
toxoids. To be significantly effective in
prevention of disease on mass or
community level at least a satisfactory
proportion (75% or more) of the at risk
population must be immunized.

38. Ways of achieving satisfactory
immunization coverage
• Efficient immunization service; urban and rural
• Health awareness and cooperation of the public
• Periodic mass immunization campaigns, to cover
those who missed regular immunizations
• Outreach programs in rural and nomad areas, and
home visits

39. Application of active immunization
• Infants and children expanded immunization
program (schedule)
• Active immunization for adult females
• Vaccination for special occupations
• Vaccination for special life styles
• Vaccination for special environmental situations
• Vaccinations for special health status persons
• Vaccinations in travel
• Vaccines against bioterrorism

40. Compulsory (obligatory) vaccination for
infants, and booster vaccination for
children (Expanded immunization
program)
• See local schedule of vaccination
• Note (children failing to complete
childhood vaccination schedule)

41. Active immunization for adult
females
• MMR( measle , mumps and rubella) vaccine is given in
adolescence before or after marriage, but not during
pregnancy and has to be before 3 months of conception
• Tetanus toxoid in pregnancy to prevent tetanus
neonatorum in the newborn. In the first pregnancy on
the third month and after 1 month. The third dose in the
second pregnancy, and the fourth on the third
pregnancy with a maximum of 5 doses. If 10 years
elapse, and then pregnancy occurs, the doses are given
from the start.
• Live attenuated vaccines should not be given during
pregnancy.

42. Vaccination for special occupations
• Health care workers: hepatitis B, influenza, MMR, polio
• Public safety personnel (police, fire fighters) and staff of
institutions for the developmentally disabled: hepatitis B,
influenza
• Vets and animal handlers: rabies, plague and anthrax
• Sewage workers: DT, hepatitis A, polio, TAB
• Food handlers: TAB
• Military troops and camp dwellers: pneumococcal,
meningococcal, influenza, BCG (for non reactors), tetanus

43. Vaccination for special life styles and
special environmental situations
• Homosexually active males, Heterosexual
with promiscus sexual partner specially who
has STDs, and Injecting drug users
• Inmates of long term correctional institutes,
residents of institutions for the
developmentally disabled, and household
contacts of HBV carriers or patients
All should receive hepatitis B vaccine

44. Vaccinations for special health
status persons
• Immuno-compromised persons ( Leukemia,
lymphoma, HIV, malignancy…)
• Hemodialysis and transplantation
Should receive the following vaccines
according to their situation:
HBV, Influenza, Pneuomococcal vaccines

45. Vaccinations in travel
• Varies according to the country of arrival and
departure.
– Primary vaccine series
– Continuation of booster doses
– Specific vaccine according to the country traveled to:
• TAB, YF, cholera, meningiococcal, pneuomococcal, HIB,
influenza, rabies, plague, Japanese encephalitis.
• Haj for instance necessates meningococcal vaccination from
all over, and YF from places like south Africa, and cholera
from places like India.

46. Vaccines against bioterrorism
• Anthrax
• Small pox
• plague

47. New approaches
• Schistosomiasis
• Cancer
• HIV/AIDS
• Malaria

48. Vaccine surveillance and testing
“monitoring vaccine effectiveness”
Through:
• Randomized field trials
• Retrospective cohort studies
• Case-control studies
• Incidence density measures

49. Randomized field trials
– The standard way to measure the
effectiveness of a new vaccine introduced.
– In this type of trial, susceptible persons are
randomized into two groups and are then
given the vaccine or the placebo
– The vaccinated and the unvaccinated are
followed through the high risk season of the
year

50. Randomized field trials (cont.)
• The attack rate (AR) is then determined in each
group:
• AR =
Number of persons ill
Number of persons exposed to the disease
• next the vaccine effectiveness (VE) is calculat
VE =
AR (unvaccinated) - AR (vaccinated)
AR (unvaccinated)
X 100

51. Retrospective cohort studies
• The antigenic variability of influenza virus
necessitates frequent (often yearly)
changes in the constituents of the vaccine
to keep them up date with the new strains.
Retrospective cohort studies are thus done
to evaluate the protective efficacy of the
vaccines.

52. Case-control studies
• Done because randomized control trials
are very costly.
• VE = 1-
AR (vaccinated)
AR (unvaccinated)
= (1- RR) or (1- OR)

53. Incidence density measures
• They are used to determine the the
optimal timing for administration of a new
vaccine and the duration of the immunity
produced. It has the following formula:
• ID =
Number of new cases of a disease
Person-time of exposure (days, weeks, month

54. Computer Aided Vaccine Design

55. Concept of Drug and Vaccine
• Concept of Drug
– Kill invaders of foreign pathogens
– Inhibit the growth of pathogens
• Concept of Vaccine
– Generate memory cells
– Trained immune system to face various
existing disease agents

56. VACCINES
A. SUCCESS STORY:
• COMPLETE ERADICATION OF SMALLPOX
• WHO PREDICTION : ERADICATION OF PARALYTIC
POLIO THROUGHOUT THE WORLD BY YEAR 2003
• SIGNIFICANT REDUCTION OF INCIDENCE OF DISEASES:
DIPTHERIA, MEASLES, MUMPS, PERTUSSIS, RUBELLA,
POLIOMYELITIS, TETANUS
B.NEED OF AN HOUR
1) SEARCH FOR NONAVAILABILE EFFECTIVE VACCINES FOR
DISEASES LIKE:
MALARIA, TUBERCULOSIS AND AIDS
2) IMPROVEMENT IN SAFETY AND EFFICACY OF PRESENT
VACCINES
3) LOW COST
4) EFFICIENT DELIVERY TO NEEDY
5) REDUCTION OF ADVERSE SIDE EFFECTS

57. DEVELOPMENT OF NEW VACCINES: REQUIREMENT
A.
1. BASIC RESEARCH: Sound Knowledge of
Fundamentals
2. Combination of computer and Immunology
B.
1.Prediction of T and B cell epitopes
2. Prediction of Promiscuous MHC binders

58. Foreign Invaders or Disease Agents

59. Protection Mechanism

60. Exogenous Antigen processing

61. Animated Endogenous antigen processing

62. Major steps of endogenous antigen processing

63. Why computational tools are required for prediction.
200 aa proteins
Chopped to overlapping
peptides of 9 amino
acids
192 peptides
invitro or invivo experiments for
detecting which snippets of protein will
spark an immune response.
10-20 predicted peptides
Bioinformatics Tools

64. Computer Aided Vaccine Design
• Whole Organism of Pathogen
– Consists more than 4000 genes and proteins
– Genomes have millions base pair
• Target antigen to recognise pathogen
– Search vaccine target (essential and non-self)
– Consists of amino acid sequence (e.g. A-V-L-
G-Y-R-G-C-T ……)
• Search antigenic region (peptide of length
9 amino acids)

65. Computer Aided Vaccine Design
• Problem of Pattern Recognition
– ATGGTRDAR Epitope
– LMRGTCAAY Non-epitope
– RTTGTRAWR Epitope
– EMGGTCAAY Non-epitope
– ATGGTRKAR Epitope
– GTCVGYATT Epitope
• Commonly used techniques
– Statistical (Motif and Matrix)
– AI Techniques

66. Prediction Methods for MHC-I binding
peptides
• Motifs based methods
• Quantitative matrices based methods
• Machine learning techniques based methods
- ANN
- SVM
• Structural based methods

67. • Composed of two anti-
parallel alpha helices
arranged on beta sheets
• Peptide binds in between
the two alpha helices
• Difficulties associated
with developing prediction
methods
• Available methods
Introduction of MHC molecules

68. 1: Motif based Methods :
The occurrence of certain residues at specific positions in the peptide
sequence is used to predict the MHC ligands. These residues are known as
anchor residues and their positions as anchor positions.
? L ? ? ? ? ? V ?
Prediction accuracy - 60–65%

69. Limitations
• ALL binders don't have exact motifs.
• Ignorance to secondary anchor residues.
• Ignorance to residues having adverse effect on binding.
These limitations are overcome by the use of
quantitative matrices. These are essentially refined motifs,
covering the all amino acid of the peptide.

70. 2 : Quantitative matrices:
In QM, the contribution of each amino acid at specific position
within binding peptide is quantified.The QM are generated from
experimental binding data of large ensemble of sequence variants.

71. Available quantitative matrices for MHC class I :-
• Sette et al ., 1989
• Ruppert et al., 1993
• Parker et al., 1994
• Gulukota et al., 1997
• Bhasin and Raghava 2003 (submitted).
The score of the peptide is calculated by summing up the
scores of each amino acid of the peptide at specific position.

72. Score of peptide ILKE PVHGV will be calculated as follows:
Peptide score=I+L+K+E+P+V+G+V
Peptide score < threshold score = predicted
binder
Peptide score > threshold score = predicted
non-binder
In few cases the peptide score is calculated
by multiplying the score of each amino acid
of peptide.
The matrices based methods can predict peptides having
canonical motifs with fair accuracy.

73. Online methods based on quantitative matrices
Program URL Service available
ProPred http://www.imtech.res.in/raghava/propred1 47 MHC alleles
nHLAPred http://www.imtech.res.in/raghava/nhlapred 67 MHC alleles
SYFPEITHI http://www.syfpeithi.de > 200 MHC alleles
LpPEP http://reiner.bu.edu/zhiping/lppep.html 1 MHC allele
RANKPEP http://mif.dfci.harvard.edu/Tools/rankpep.html >40 MHC alleles
BIMAS http://bimas.dcrt.nih.gov/molbio/hla_bind/ >46 MHC alleles
MAPPP http://reiner.bu.edu/zhiping/lppep.html >50 MHC alleles
Limitations: These methods are not able to handle the non-
linearity in data of MHC binders and non-binders.

74. ARTIFICAL NEURAL NETWORKS :In order to handle the non-
linearity of data artificial neural network based approach has been
applied to classify the data of MHC binders and non-binders.
Dataset of MHC binders and non-binders
Training set Test set
Training of Neural network
Trained network
Results
The performance of the method is estimated
by measuring standard parameters like
Sensitivity, Specificity, Accuracy, PPV,
MCC
The performance of
methods evaluated
by using various cross-validation
tests Like 5 cross
validation , LOOCV
3: Machine learning Approach

75. Advantages:
Large set of experimentally proven peptides for each MHC allele is not
required.
Limitations:
• Very less amount data about 3D structure of MHC and Peptide.
• Computation is very slow
• Large number of false positive results because each pocket of MHC allele
can bind with side chain of many amino acids.
4: Structure Based MHC binders prediction
Based on the known structure of MHC molecules and peptide,
these methods evaluates the compatibility of different peptides to
fit into the binding groove of distinct MHC molecule. The MHC
ligands are chosen by threading the peptide in the binding groove
of MHC and getting an estimate of energy. The peptide with
lowest binding energy is considered as best binder.

76. Immunization: A Healthy Choice
for You & Your Baby

77.  Why immunization during and after pregnancy is important
 Why immunization is as important choice for your baby
 BC’s routine schedule and when to start
 Answers to your questions
 Where to get your baby’s shots
 Where to find more information
Today’s presentation

78. Section1:
Immunization & Pregnancy

79. Immunization is part of a healthy pregnancy
Immunizations help protect you and your baby from certain diseases
that can cause serious harm.

80. Get a flu shot!
It's recommended that you get a flu shot if you are pregnant during flu
season. Pregnant women are at higher risk of serious illness and
hospitalization from the flu.
The flu shot protects you and your baby during pregnancy and even
after birth.

81. Ask about other immunizations
Other immunizations are sometimes recommended for pregnant
women depending on their immunization history, lifestyle, health status,
risk of disease and travel plans.
Talk to your health care provider about which immunizations are
recommended for you.

82. Is it safe to get vaccines during
pregnancy?
It’s safe to get some vaccines during pregnancy. The flu vaccine is a
great example of a vaccine that is safe for pregnant women.
Some vaccines should not be given during pregnancy due to a lack of
safety data.

83. Catch up after your baby is born!
Catch up on any missing immunizations after your baby is born. This
helps protect you in future pregnancies and also helps protect your
baby from serious diseases during the time they are too young to get
immunized.

84. Section 2:
Immunization & Your Baby

85. Section 2.1:
The importance of getting immunized

86. Immunizations save lives
Immunizations (vaccinations, shots) have saved the lives of more
babies and children than any other medical intervention in the last 50
years.
When you immunize your baby you’re protecting them against illness
and serious harms such as meningitis, pneumonia, paralysis, deafness,
seizures, brain damage or even death.

87. BC’s childhood immunization program is
one of the best in the world.
Free vaccines are provided to protect your baby against these 14
diseases:
 Diphther
ia
 Pertussi
s
 Tetanus
 Polio
 Influenz
 Rotavirus
 Hepatitis B
 Measles
 Mumps
 Rubella
 Haemophilus influenzae
type B
 Meningococcal disease
 Pneumococcal disease
 Varicella

88. Section 2.2:
Understanding BC’s childhood
immunization schedule

89. What age do I start immunizing
my baby?
Routine immunizations start at 2 months of age. Most
vaccines need to be given more than once to build your
baby's immunity. That’s why it’s key to follow the schedule.
 1st vaccines, 2 months
 2nd vaccines, 4 months
 3rd vaccines, 6 months
 4th vaccines, 12 months
 5th vaccines, 18 months

90. Why do immunizations start at 2 months
of age?
To protect your baby as soon as possible, routine immunizations start at 2
months of age. Babies and young children are most at risk for vaccine-
preventable diseases during their first 2 years of life. This means that if
your baby is not immunized and catches a disease they could get very
sick or even die.

91. BC’s childhood immunization schedule:

92. Follow the routine immunization schedule:
For best protection, it’s recommended that you follow the routine
schedule and get all shots on time. Schedules that delay, withhold or
space out vaccines are not recommended and can be risky.

93. Six reasons why it’s best to follow the
routine immunization schedule:
1. The routine schedule is based on the best science of
today
2. The routine is safe and works very well
3. You will ensure your baby is protected as soon as
they can be
4. You will reduce your baby’s risk of developing
anxiety and needle fear
5. The risk for side effects is the same whether
vaccines are given together or separately

94. Your baby’s immune system is able to
respond to more than one vaccine at a time.
Your baby’s immune system is stronger than you may think. Vaccines
do not overwhelm or weaken your baby’s immune system. Instead, they
make it strong and ready to fight vaccine-preventable diseases.
Scientists estimate that babies could respond to about10,000 vaccines
at one time!

95. A better immunization experience!

96. Section 2.3:
Answers to your questions

97. Vaccines are very safe
Vaccines must pass many safety tests before they are ever given to
people. After a vaccine is approved for use, its safety is always
monitored. It’s much safer to get the vaccine than to get the disease.
Serious side effects from vaccines are very rare.
Did you know? Vaccines are one of the most monitor and studied
things in medicine because they are given to healthy babies and
children.

98. The ingredients in vaccines are safe
Vaccines need certain ingredients ensure they work to protect against
disease and to keep them safe. These ingredients are carefully tested
and are safe in the small amounts used in vaccines.

99. It’s much safer to get the vaccine than to
get the disease
The diseases vaccines protect against can cause serious illness, long-
term disability and even death. The risks from disease are much
greater than the risks of a serious side effect from a vaccine.

100. Vaccines do not cause autism
Vaccines do not cause autism. The study that suggested a possible link
between vaccines and autism was proven false. Many other studies have
since been completed and have found absolutely no link between
vaccines and autism.

101. Vaccines are still necessary
It’s true that many of the diseases vaccines prevent are not as common
in Canada as they once were but this is because most children are
immunized. If we stop immunizing these diseases will become more
common again.

102. Breastfeeding will not fully protect
your baby
Breastfeeding is important but it will not protect your baby against the
specific diseases that vaccines prevent.
For some diseases that mothers have been exposed to or immunized
against, protective antibodies may be passed to the baby in the breast
milk. However, this protection is insufficient and is only temporary.

103. Remedies or therapies promoted as alternatives to vaccines do not
protect against the germs (viruses and bacteria) that cause vaccine-
preventable diseases. A child who has received these products is
considered unimmunized and unprotected against diseases.
There are no effective alternatives to
vaccines

104. Section 2.4:
Where can I get my baby immunized?

105. Where can I get my baby immunized?
You can take your baby to your local public health unit to get
immunized. Some doctors and nurse practitioners also give vaccines to
babies. To avoid waitlists, call to book your child’s 2 month visit soon
after they are born. For other visits call well in advance.

106. Keep your baby’s record in safe place
Without a record of immunization, or proof of having had a disease,
your baby is considered unimmunized and unprotected. Take your
baby’s Child Health Passport or immunization record with you to each
visit so that your health care provider can fill it out. This is important
because health care providers in BC can’t easily share records at this
time.

107. Section 2.5:
Where can I get more information?

108. Who can answer my questions about
immunization?
Your doctor, public health nurse or primary health care provider is your
best source for questions about immunization.

109. A word about online information
When you look online for information about vaccines, it’s important to
be aware that not all sources are accurate. For the same reason we get
legal advice from lawyers and take our cars to mechanics, it’s important
to get your immunization information from reliable sources. If you are
concerned about what you read, speak to your health care provider.

110. What are some reliable websites?
Here is a list of reliable websites:
.
 ImmunizeBC.ca: www.immunizebc.ca
 Canadian Pediatric Society:
http://www.caringforkids.cps.ca/
 Immunize Canada: www.immunize.cpha.ca
 Public Health Agency of Canada: http://www.phac-
aspc.gc.ca/im/

111. Summary
o Consider immunizations before, during and after pregnancy
o You can give your baby the best protection by following the
routine immunization schedule
o Vaccines are safe, with huge benefits to your baby’s health
o Your primary heath care provider is your best source for
questions about immunization
o Visit ImmunizeBC.ca for more information

112. Thankyou