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Active and Passive Immunization.pptx
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- 2. The Nature ofDisease •Pathogenic Organisms • Genetic Disorders • Toxic Chemicals • Other Environmental Factors • Physical Damage to Organs • Nutritional Disorders
- 3. Types of PathogenicOrganisms •Viruses • Bacteria • Protozoan • Fungi • Animal • Parasites
- 4. Mechanisms of DiseasebyPathogens • Utilization of host nutritional resources • Physical damage to host tissues • Production of toxic substances • Chromosomal and gene damage • Body cells behave abnormally
- 5. Defense Mechanisms 1. ExternalDefense 2. Internal Defense 3. Immune Defense
- 6. • Skin actsas barrier to microbes and viruses - sweat has a low pH • Mucus traps foreign particles • Tears - Lysozyme has antimicrobial action • Gastric stomach acid 1st Line of Defense
- 7. Body Coverings: TheSkin sweat gland epidermis sebaceous glands
- 8. Body Coverings: MucousMembranes mucus cilia
- 9. • Phagocytic cells(WBCs) - Natural Killer (NK) Cells: attack virus infected cells • • Inflammatory Response Antimicrobial proteins - Lysozyme - Interferon - Antibodies 2nd Line of Defense
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- 12. Inflammatory Response Histamine & prostaglandins released Capillariesdilate Clotting begins Chemotactic factors attract phagocytic cells Phagocytes consume pathogens & cell debris
- 13. Lymphatic System 3rd Lineof Defense Human
- 14. Immunity: • The stateof being immune from or insusceptible to a particular disease. • The condition that permits either natural or acquired resistance to disease. • The ability of the cell to react immunologically in the presence of antigen.
- 15. How immunitydevelops • Duringthe body’s first encounter with a pathogen there will be few lymphocytes with specific receptors • It takes time to divide to form clones, B lymphocytes to secrete antibodies, T lymphocyteproduction • If the same pathogen invades again persisting memory cells can give a faster, more effective response
- 16. Characteristics ofImmunity • Recognitionof self versus non-self • Response is specific • Retains a “memory” allowing an accelerated second response • Can respond to many different materials • Involves lymphocytes and antibodies
- 17. Types of Immunity •Active Immunity - Naturally-Acquired Active Immunity - Artificially-Acquired Active Immunity • Passive Immunity - Naturally-Acquired Passive Immunity - Artificially-Acquired Passive Immunity
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- 19. • An infectionis an example of acquiring natural immunity. It is called ACTIVE as your body needs to work to produce the necessary antibodies • When a mother breast feeds her baby she passes antibodies to it. This is a way of acquiring PASSIVE immunity as it is a way of gaining antibodies without the immune system having to produce them. • The thick, yellowish milk (colostrum) that is produced for the first few days after birth is particularly rich in antibodies. Natural immunity: active andpassive
- 20. Artificial immunity: activeandpassive • An alternative to natural immunity developing is to give vaccinations (artificial immunity) • Antigen is injected into the body. • This may be in the form of an inactivated bacterial toxin or attenuated (not harmful) virus which would promote ACTIVE immunity; • or the injection of antibodies or antitoxins which would promote PASSIVE immunity (eg Clostridium tetani)
- 21. • The productionof antibodies against a specific disease by the immune system. • Naturally acquired through disease • Artificially acquired through vaccination • Vaccines include inactivated toxins, killed microbes, parts of microbes, and viable but weakened microbes. • Memory cells are only produced in active immunity. • Protection for active immunity is permanent whereas in passive immunity it is only temporary. • Antigens are only encountered in active immunity. • Active immunity takes several weeks to become active but passive is immediate ActiveImmunity
- 22. • A vaccinatedperson has a secondary response based on memory cells when encountering the specific pathogen. • Routine immunization against infectious diseases such as measles and whooping cough, and has led to the eradication of smallpox, a viral disease. • Unfortunately, not all infectious agents are easily managed by vaccination. • HIV vaccine in the works
- 23. PassiveImmunity • When antibodiesproduced in one body (human or animal) are transfer to another to induce protection against disease. • Body does not produce its own antibodies, depends upon ready-made antibodies. • Passive immunity may be induced by: - Administration of an antibody-containing preparation (immune globulin or antiserum) - Transfer of maternal antibodies across the placenta - Transfer of lymphocytes, to induce passive cellular immunity
- 24. • Passive Immunity-Protection against disease through antibodies produced by another human being or animal. • Ex. Maternal antibodies , Colostrum • Passive immunity doesn’t last as long as active immunity (only weeks or months): • No lymphocytes are stimulated to clone themselves • No memory cells have been made • Effective, but temporary as this type of immunity can only last as long as the antibodies/toxins last in the blood PassiveImmunity Cntd…
- 25. PassiveImmunity Cntd… • Passiveimmunity can be transferred artificially by injecting antibodies from an animal that is already immune to a disease into another animal. • Rabies treatment: injection with antibodies against rabies virus that are both passive immunizations (the immediate fight) and active immunizations (longer term defense).
- 26. PassiveImmunity Cntd… • Passiveimmunity differs from active immunity in the following respects: - Immunity is rapidly established - Immunity produced is only temporary (days to month) - No education of the reticuloendothelial system • Active immunity is superior to passive immunity because: - Duration of protection is long lasting - Severe reactions are rare - Protective efficacy is more - Active immunization is less expensive
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- 28. Vaccination • Vaccination isa 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”. One of the most effective «weapons» in medicine 1798 Edward Jenner immunizes first time against smallpox 1885 Louis Pasteur prepares the 1st vaccine against Rabbies 1927 BCG (bacillus Galmette-Guerin) 1955 Salk vaccine against poliomyelitis 1960 MMR (Measles, Mumps and Rubella)……..
- 29. Types ofvaccines • Livevaccines • Attenuated live vaccines • Inactivated (killed vaccines) • Toxoids • Polysaccharide and polypeptide (cellular fraction) vaccines • Surface antigen (recombinant) vaccines
- 30. Live vaccines • Livevaccines 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.
- 31. 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. • Attenuated– live microbe (usually virus) which has a vital function inactivated by heat, chemicals or genetic manipulation e.g. Rabies virus vaccine, MMR (Bacillus antibody (Measles, Mumps and Rubella), BCG Calmette Guerin vaccine for M. tuberculosis • Risk it could revert back to infectious agent • will stimulate both cell mediated and mediated immune response
- 32. Live attenuated (avirulent)vaccinescontd.. Live attenuated vaccines should not be administered to persons with suppressed immune response due to: • Leukemia and lymphoma • Other malignancies corticosteroids and anti-metabolic • Receiving agents • Radiation • pregnancy
- 33. Inactivated (killed)vaccines • Organismsare 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
- 34. Toxoids • They areprepared 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.
- 35. Polysaccharide and polypeptidevaccines •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.
- 36. 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.
- 37. TYPES OFVACCINES Live vaccines Live Attenuated vaccines Killed Inactivated vaccines Toxoids Cellular fraction vaccines Recombinan tvaccines •Small pox variola vaccine •BCG •Typhoid oral •Plague •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 •Oral polio •Yellow fever •Measles •Mumps •Rubella •Intranasal Influenza •Typhus
- 38. Routes ofadministration • Deepsubcutaneous or intramuscular route (most vaccines) • Oral route ( oral BCG vaccine) • Intradermal route (BCG vaccine) • Scarification (small pox vaccine) • Intranasal route (live attenuated influenza vaccine)
- 39. Scheme ofimmunization • Primaryvaccination • One dose vaccines (BCG, variola, measles, mumps, rubella, yellow fever) • Multiple dose vaccines (polio, DPT (diphtheria, pertussis, tetanus toxoids), hepatitis B) • Booster vaccination To maintain immunity level after it declines after some
- 40. Periods of maintainedimmunity by vaccines • Short period (months): • Two years: • Three to five years: • Five or more years: • Ten years: • Solid immunity: cholera vaccine TAB vaccine DPT vaccine BCG vaccine Yellow fever vaccine MMR (measles, mumps, and rubella vaccines)
- 41. Levels ofeffectiveness • Absolutelyprotective(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.
- 42. The ColdChain • 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.
- 43. The Cold ChainEquipment Coldchain 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
- 44. • (d) Coldboxes: Cold boxes peripheral centers. These are are supplied to all 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.
- 45. • Among thevaccines, Polio vaccine 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
- 46. VaccinationCoverage • Vaccination coverageis 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.
- 47. Herd immunity: Atleast 80-85% of the population need to be vaccinated to reduce the chance of somebody catching the disease – even some one who has not been vaccinated- to safe levels.
- 48. Ways of achievingsatisfactoryimmunization 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
- 49. Application of activeimmunization •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