3. What is immunisation?
Immunisation is the process by which an
individual becomes immune or resistant
against immunogen.
Can be achieved in active or passive
manner.
Vaccination is an active form of
immunisation.
4. History
Father of vaccination
Dr Edward jenner
> He created world’s first
Successful vaccine against
Small pox.
> Small pox eradicated from
India in 1977.
5. Vaccine impacts
Direct and indirect effect
Control, elimination, eradication of vaccine
preventable diseases
Outbreak control
6. Direct effect
>
Protects individual against infection and
thereby prevent symptomatic illness
>
Blunts severity of clinical illness e.g.
rotavirus vaccine and severe
gastroenteritis
>
Reduce complications e.g. zoster
vaccine and postherpetic neuralgia
7. Indirect effect
Herd immunity : some immunisations reduce
transmission of infectious disease agents from
immunised person to other thereby reducing
impact of spread of infection
The level of immunisation in population
required to achieve herd immunity varies
substantially with specific vaccine and disease
8.
9. Control
control of vaccine preventable disease helps
to:
Decrease poor illness outcomes
Reduces disruptive impacts associated with
outbreaks in community
Redcues absence from work for ill person
and those who are caring for the ill person.
Limits health care utilisation associated with
treatment visit
10. Elimination ,eradication & outbreak control
Elimination
> means reduction of cases to zero in a
defined geographical area.
Eradication
> It is achieved when the elimination of disease is
sustained without the need to continue interventions e.g.
> small pox is globally eradicated .
> wild polio virus type 2,3 eradicated globally.
Outbreak control
> vaccinations helps to control disease outbreaks
12. Types of vaccines
Live attenuated
vaccines e.g
1. MMR
2. Varicella zoster
Inactivated (killed)
whole cell vaccines
e.g.
1. Hepatitis A
2. Influenza
Component vaccines e.g.
1.Td (adsorbed toxoid)
2. Human papilloma virus
3. Meningococcal
4. Pneumococcal
5. Hepatitis B
13. Live attenuated vaccines:
>prepared from live organisms
>these organisms have been passed repeatedly in tissue
culture or chick embryos & have
>lost capacity to cause full blown disease but retain
immunogenicity
Inactivated/killed vaccines : >produced by growing
virus or bacteria in culture media and inactivated them in
chemicals(formalin)
Subunit vaccines: >made of single or multiple
antigenic components of microorganisms
14. Routes of administration
Administer by IM route only Administer by IM or
Subcutaneous (Subcut) route
• Diphtheria-tetanus-pertussis (DTaP,
Tdap)
• Diphtheria-tetanus (DT, Td)
• Haemophilus influenzae type b (Hib)
• Hepatitis A (HepA)
• Hepatitis B (HepB)
• Human papillomavirus (HPV)
• Inactivated influenza vaccine (IIV)
• Meningococcal serogroups A,C,W, Y
(MenACWY)
• Meningococcal serogroup B (MenB)
• Pneumococcal conjugate (PCV)
• Zoster (RZV)
• Measles, mumps, and rubella (MMR II
[Merck] only)
• Pneumococcal polysaccharide
(PPSV23)
• Varicella (VAR)
15.
16. Adult vaccines recommended in india
Tdap
Influenza
Hepatitis B
Hepatitis A
Varicella zoster
Meningococcal
MMR
Pneumococcal
Human papilloma virus (cervical cancer)
Zoster
17. Measles ,mumps and rubella
Vaccines
In india MMR live attenuated vaccine is manufactured using following
strains:
>> the measles and the rubella components – human diploid cells
>> mumps components – chick embryo.
Schedule
>>0.5 ml by subcutaneous route
>> two doses at interval of 4 weeks.
Recommendations :
>> adolescent and adults
>> non pregnant women Rubella rash
18. Diptheria, pertussis, tetanus (Tdap/Td)
Vaccine : Tdap :diptheria & tetanus toxoid and acelluar pertussis ag
Td : diptheria & tetanus toxoid (SII Td-Vac)
Recommendations -Routine vaccination :
>> Previously did not receive Tdap at or after age 11 years: 1
dose Tdap, then Td every 10 years
Special situations:
>> Previously did not receive primary vaccination series for
tetanus, diphtheria, or pertussis: 1 dose Tdap followed by 1 dose Td at
least 4 weeks later, and a third dose of Td 6–12 months later
(Tdap can be substituted for any Td dose, but preferred as first
dose)
>> Td every 10 years thereafter
19. Tdap/Td continued…
>> pregnancy: 1 dose immediately after detection of
pregnancy, 2 dose after 4 weeks and booster dose if
conceieve within 3 years
>> wound management
Schedule:
>> Dosage : 0.5 ml
>> Route : IM (deltoid muscle)
tetanus
20. Varicella (chicken pox)
Vaccines
>> two live attenuated vzv (oka strains) vaccines are available in india.
1. varilrix (gsk)
2. okavax
Schedule
>> two doses 0.5 ml each by subcutaneous route.
>> interval between 2 doses should be 4-8 weeks .
Recommendatios
>> all susceptible adults and adolescents should be vaccinated
>> also important for susceptible persons
-health care workers
- family contact of immunocompromised persons
- high risk exposure ( e.g.teachers, day care employees etc)
Chicken pox
21. Shingles (zoster)
Vaccines
>> Zostavax (live attenuated vaccine having oka
strain of varicella zoster)
Schedule
>> single 0.65 ml dose subcutaneously in the upper arm.
Recommendations
>> for persons > 60 years
>> high risk for developing recurrent herpes zoster such as
- patient with ckd
- diabetes mellitus
- rheumatoid arthritis
Shingles
